University of Manitoba, Winnipeg, MB, Canada -
George & Fay Yee Center for Healthcare Innovation, University of Manitoba, Winnipeg, MB, Canada.
Eur J Phys Rehabil Med. 2019 Oct;55(5):558-569. doi: 10.23736/S1973-9087.19.05605-3. Epub 2019 Mar 11.
Results of several recent studies suggest that tendon/muscle vibration treatment may improve motor performance and reduce spasticity in individuals with stroke. We performed a systematic review and meta-analysis to assess the efficacy of tendon/muscle vibration treatment for upper limb functional movements in persons with subacute and chronic stroke.
We searched MEDLINE (Ovid), EMBASE (Ovid), and the Cochrane Central Register of Controlled Trials (Wiley) from inception to September 2017. We included randomized controlled trials comparing upper limb tendon/muscle vibration to sham treatment/rest or conventional interventions in persons with subacute and chronic stroke. Our primary outcome was upper limb functional movement at the end of the treatment period.
We included eight trials, enrolling a total of 211 participants. We found insufficient evidence to support a benefit for upper limb functional movement (standard mean difference -0.32, 95% confidence interval (CI) -0.74 to 0.10, I2 25%, 6 trials, 135 participants). Movement time for reaching tasks significantly decreased after using tendon/muscle vibration (standard mean difference -1.20, 95% CI -2.05 to -0.35, I2 65%, 2 trials, 74 participants). We also found that tendon/muscle vibration was not associated with a significant reduction in spasticity (4 trials).
Besides shorter movement time for reaching tasks, we did not identify evidence to support clinical improvement in upper limb functional movements after tendon/muscle vibration treatment in persons with subacute and chronic stroke. A small number of trials were identified; therefore, there is a need for larger, higher quality studies and to consider the clinical relevance of performance-based outcome measures that focus on time to complete a functional movement such as a reach.
最近的几项研究结果表明，肌腱/肌肉振动治疗可能改善运动表现并降低脑卒中患者的痉挛程度。我们进行了系统评价和荟萃分析，以评估肌腱/肌肉振动治疗对亚急性和慢性脑卒中患者上肢功能运动的疗效。
我们检索了 MEDLINE（Ovid）、EMBASE（Ovid）和 Cochrane 对照试验中心注册库（Wiley），从建库到 2017 年 9 月。我们纳入了比较上肢肌腱/肌肉振动与假治疗/休息或常规干预治疗亚急性和慢性脑卒中患者的随机对照试验。我们的主要结局是治疗结束时上肢功能运动。
我们纳入了 8 项试验，共纳入 211 名参与者。我们发现没有足够的证据支持上肢功能运动有获益（标准均数差-0.32，95%置信区间（CI）-0.74 至 0.10，I² 25%，6 项试验，135 名参与者）。使用肌腱/肌肉振动后，到达任务的运动时间显著缩短（标准均数差-1.20，95%CI-2.05 至-0.35，I² 65%，2 项试验，74 名参与者）。我们还发现肌腱/肌肉振动与痉挛程度的显著降低无关（4 项试验）。
除了到达任务的运动时间缩短外，我们没有发现证据支持亚急性和慢性脑卒中患者使用肌腱/肌肉振动治疗后上肢功能运动有临床改善。我们只确定了少数试验，因此需要更大、更高质量的研究，并考虑以完成功能性运动（如到达）所需时间为重点的基于表现的结局测量的临床相关性。
