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全身振动单次或多次治疗对中风的影响:是否有证据支持其在康复中的临床应用?

Effects of Single or Multiple Sessions of Whole Body Vibration in Stroke: Is There Any Evidence to Support the Clinical Use in Rehabilitation?

作者信息

Costantino Cosimo, Petraglia Federica, Sabetta Laura Luigia, Giumelli Riccardo

机构信息

Department of Medicine and Surgery, University of Parma, Italy.

Physical Medicine and Rehabilitation Residency Program, University of Parma, Italy.

出版信息

Rehabil Res Pract. 2018 Jul 30;2018:8491859. doi: 10.1155/2018/8491859. eCollection 2018.

Abstract

BACKGROUND AND PURPOSE

Recently new technologies and new techniques, such as Whole Body Vibration (WBV), have been introduced by the health and fitness industry to pursue therapeutic or physical performance goals. The aim of this systematic review is to investigate the effectiveness of single or multiple WBV sessions alone or in association with traditional rehabilitation, compared to traditional rehabilitation therapy or with sham therapy in poststroke patients.

METHODS

Randomized Control Trials and controlled clinical trials written in English between January 1st, 2003, and December 31st, 2017, were selected from PubMed, Cochrane-Central-Register-of-Controlled-Trials, and Physiotherapy-Evidence-Database (PEDro). The single WBV session and multiple sessions' effects were assessed. Study characteristics, study population, intervention protocols, effects of WBV sessions, and adverse events were investigated with a descriptive analysis.

RESULTS

The search reported 365 articles and after screening and removal of duplicates, 11 manuscripts with PEDro score≥6/10 were selected (391 poststroke patients). Study characteristics, study population, intervention protocols (frequencies, amplitude of vibration, and peak acceleration), effects of a single or multiple WBV sessions, and adverse events were analyzed. They have been investigated with particular attention to bone turnover, structure and muscle functions, spasticity, postural control and risk of falls, functional mobility, somatosensory threshold, and activity and participation. Comparing WBV group with control group no significant benefits emerged.

DISCUSSION

This systematic review included studies involving participants with non homogeneous characteristics, just considering the incorporation of studies on individuals with chronic and postacute stroke. Despite these limits, WBV treatment has no significant risks for patients and shows interesting effects of WBV treatment in Structure and muscle functions, Spasticity and Postural control.

CONCLUSIONS

Even though treatment with WBV appears safe and feasible, there is insufficient evidence to support its clinical use in poststroke rehabilitation at this point. More studies assessing other functional tests and with more specific treatment protocols are needed.

摘要

背景与目的

近来,诸如全身振动(WBV)等新技术和新技巧已被健康与健身行业引入,以实现治疗或身体机能提升目标。本系统评价的目的是研究在中风后患者中,单次或多次WBV治疗单独使用或与传统康复相结合,相较于传统康复治疗或假治疗的有效性。

方法

从PubMed、Cochrane对照试验中心注册库和物理治疗证据数据库(PEDro)中选取2003年1月1日至2017年12月31日期间以英文撰写的随机对照试验和对照临床试验。评估单次WBV治疗和多次治疗的效果。通过描述性分析研究特征、研究人群、干预方案、WBV治疗效果及不良事件。

结果

检索报告了365篇文章,经筛选和去除重复项后,选取了11篇PEDro评分≥6/10的手稿(391例中风后患者)。分析了研究特征、研究人群、干预方案(频率、振动幅度和峰值加速度)、单次或多次WBV治疗的效果及不良事件。特别关注了骨转换、结构和肌肉功能、痉挛、姿势控制和跌倒风险、功能活动能力、体感阈值以及活动和参与情况。将WBV组与对照组进行比较,未发现显著益处。

讨论

本系统评价纳入的研究涉及特征不均一的参与者,仅纳入了关于慢性和急性后期中风患者的研究。尽管存在这些局限性,WBV治疗对患者无显著风险,且在结构和肌肉功能、痉挛和姿势控制方面显示出有趣的效果。

结论

尽管WBV治疗似乎安全可行,但目前尚无足够证据支持其在中风后康复中的临床应用。需要更多评估其他功能测试并采用更具体治疗方案的研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7284/6091286/2fc3acb756ac/RERP2018-8491859.001.jpg

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