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全身振动对中风患者偏瘫侧腿部痉挛状态下主动踝关节运动时皮质激活的急性影响:一项功能近红外光谱研究

Acute changes in cortical activation during active ankle movement after whole-body vibration for spasticity in hemiplegic legs of stroke patients: a functional near-infrared spectroscopy study.

作者信息

Miyara Kodai, Kawamura Kentaro, Matsumoto Shuji, Ohwatashi Akihiko, Itashiki Yuki, Uema Tomohiro, Noma Tomokazu, Ikeda Keiko, Shimodozono Megumi

机构信息

Department of Rehabilitation, Kagoshima University Hospital, Kagoshima, Japan.

Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

出版信息

Top Stroke Rehabil. 2020 Jan;27(1):67-74. doi: 10.1080/10749357.2019.1659639. Epub 2019 Sep 4.

DOI:10.1080/10749357.2019.1659639
PMID:31483746
Abstract

: A recent study revealed that whole-body vibration (WBV) tends to decrease spasticity in stroke-related hemiplegic legs. However, acute changes in cortical activation after WBV are unclear.: To examine whether WBV induces acute changes in sensorimotor cortical activation in patients with stroke-related hemiplegic legs.: Eleven stroke patients (mean age 52.6 [SD 15.4] years; median time after stroke 3 [25 and 75 percentiles; 3 and 10.5, respectively] months) participated in a comparative before-and-after intervention trial. Six healthy adults were also studied. WBV at 30 Hz was applied for 5 min to the hamstrings, gastrocnemius, and soleus muscles. Spasticity was assessed according to the modified Ashworth scale (MAS). Active and passive range of motion (A-ROM and -ROM, respectively) were also measured. Change in Oxy-Hb concentration in bilateral sensorimotor cortex associated with voluntary ankle dorsiflexion of the affected limb was assessed via functional near-infrared spectroscopy (fNIRS) before and immediately after WBV.: MAS score, A-ROM, and -ROM improved immediately after WBV. In the patients, while there was no significant interaction between effects of region (ipsilesional and contralesional sensorimotor cortex) and the WBV intervention (before and immediately after WBV) ( = 0.702, = .422), there was a significant main effect of the WBV intervention ( = 6.971, = .025). In the healthy participants, there was no association with the WBV intervention or region.: In patients with stroke-related spastic-hemiplegic legs, WBV might result not only in clinical improvement but also in acute increase in sensorimotor cortical activation.

摘要

最近的一项研究表明,全身振动(WBV)往往会减轻与中风相关的偏瘫腿部的痉挛。然而,WBV后皮质激活的急性变化尚不清楚。

目的

研究WBV是否会引起中风相关偏瘫腿部患者感觉运动皮质激活的急性变化。

11名中风患者(平均年龄52.6[标准差15.4]岁;中风后中位时间3[第25和75百分位数;分别为3和10.5]个月)参与了一项干预前后的对比试验。还对6名健康成年人进行了研究。对腘绳肌、腓肠肌和比目鱼肌施加30Hz的WBV,持续5分钟。根据改良Ashworth量表(MAS)评估痉挛程度。还测量了主动和被动活动范围(分别为A-ROM和P-ROM)。在WBV之前和之后立即通过功能近红外光谱(fNIRS)评估与患侧肢体自愿踝背屈相关的双侧感觉运动皮质中氧合血红蛋白(Oxy-Hb)浓度的变化。

WBV后MAS评分、A-ROM和P-ROM立即改善。在患者中,虽然区域(患侧和健侧感觉运动皮质)和WBV干预(WBV之前和之后立即)的效应之间没有显著交互作用(F = 0.702,P = 0.422),但WBV干预有显著的主效应(F = 6.971,P = 0.025)。在健康参与者中,与WBV干预或区域没有关联。

对于与中风相关的痉挛性偏瘫腿部患者,WBV不仅可能导致临床改善,还可能导致感觉运动皮质激活的急性增加。

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