Department of Physical Therapy, Federal University of Pernambuco, Recife, Brazil.
Department of Physical Therapy, Federal University of Pernambuco, Recife, Brazil.
J Bodyw Mov Ther. 2020 Apr;24(2):37-42. doi: 10.1016/j.jbmt.2019.05.018. Epub 2019 May 23.
This study aimed to evaluate the acute effects (up to 30 min) of whole-body vibration (WBV) on spinal excitability level and ankle plantar flexion spasticity in chronic stroke subjects.
Twenty-one subjects (age 30-70 years old) with chronic stroke and ankle plantar flexion spasticity were randomly assigned to the vibration group (VG, n = 11) or the control group (CG, n = 10). Subjects in the VG underwent 10 minutes of WBV with a frequency of 35 Hz and amplitude of 2 mm. Subjects in the CG remained on the platform for 10 min without receiving vibratory stimulus. The spinal excitability level was estimated by the Hmax/Mmax ratio extracted from the H-reflex with simple stimulus examination. The value of the second/first wave ratio (H2/H1 ratio) at the peak of the first facilitation was also considered through the recovery curve with double stimulation. Spasticity was estimated by the Modified Ashworth Scale (MAS) and global perception of change. All outcomes were assessed before and at 10, 20, and 30 min after the WBV, except for MAS, which was evaluated only 10 min after WBV.
No between-group differences were found in either the spinal excitability level or plantar flexor spasticity at the three evaluated moments after WBV.
These results suggest that WBV does not reduce spinal excitability level or spasticity of the plantar flexor muscles in chronic stroke patients in the first 30 min after vibratory stimulus.
本研究旨在评估全身振动（WBV）对慢性脑卒中患者脊髓兴奋性水平和踝关节跖屈痉挛的急性影响（最长 30 分钟）。
21 名年龄在 30-70 岁之间的慢性脑卒中合并踝关节跖屈痉挛患者被随机分配到振动组（VG，n=11）或对照组（CG，n=10）。VG 组接受 10 分钟频率为 35Hz、振幅为 2mm 的全身振动。CG 组在平台上停留 10 分钟，不接受振动刺激。通过 H 反射的简单刺激检查，从 H 反射中提取 Hmax/Mmax 比值来评估脊髓兴奋性水平。通过双刺激恢复曲线还考虑了第一个易化峰值时的第二/第一波比值（H2/H1 比值）。痉挛通过改良 Ashworth 量表（MAS）和整体变化感知来评估。所有结果均在 WBV 前以及 WBV 后 10、20 和 30 分钟进行评估，除 MAS 仅在 WBV 后 10 分钟评估外。
在 WBV 后三个评估时刻，两组间的脊髓兴奋性水平或跖屈肌痉挛均无差异。
这些结果表明，在振动刺激后 30 分钟内，WBV 不会降低慢性脑卒中患者的脊髓兴奋性水平或跖屈肌的痉挛程度。
