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局部肌肉振动治疗脑卒中后运动障碍和痉挛:系统评价。

Localized muscle vibration in the treatment of motor impairment and spasticity in post-stroke patients: a systematic review.

机构信息

Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy.

Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy.

出版信息

Eur J Phys Rehabil Med. 2021 Feb;57(1):44-60. doi: 10.23736/S1973-9087.20.06390-X. Epub 2020 Oct 28.

Abstract

INTRODUCTION

During the last decades, many studies have been carried out to understand the possible positive effects of vibration therapy in post-stroke rehabilitation. In particular, the use of localized muscle vibration (LMV) seems to have promising results. The aim of this systematic review was to describe the use of LMV in post-stroke patients to improve motor recovery, reducing spasticity and disability in both upper and lower limb.

EVIDENCE ACQUISITION

A search was conducted on PubMed, Scopus, Pedro and REHABDATA electronic database. Only randomized controlled trials have been included, excluding no-localized vibratory treatments and other pathological conditions. Fourteen studies met the inclusion criteria and were included in this review.

EVIDENCE SYNTHESIS

Collectively, the studies involved 425 stroke patients. Most studies included chronic stroke patients (ten) and treated only the upper limb (eleven). There is evidence that LMV therapy is effective in reducing spasticity and improving motor recovery, especially when associated with conventional physical therapy.

CONCLUSIONS

LMV may be a feasible and safe tool to be integrated into traditional and conventional neurorehabilitation programs for post-stroke patients to reduce spasticity. Analysis of the available clinical trials do not allow us to indicate vibration therapy as effective in functional motor recovery, despite some studies showed encouraging results. Further studies, with larger size of homogeneous patients and with a shared methodology are needed to produce more reliable data, especially on the lower limb.

摘要

简介

在过去的几十年中,许多研究旨在探究振动疗法在脑卒中康复中的可能积极影响。具体而言,局部肌肉振动(LMV)的应用似乎具有广阔的前景。本系统综述旨在描述 LMV 在脑卒中患者中的应用,以改善运动功能恢复,降低上肢和下肢的痉挛和残疾程度。

证据获取

在 PubMed、Scopus、Pedro 和 REHABDATA 电子数据库中进行了检索。仅纳入了随机对照试验,排除了非局部振动治疗和其他病理状况的研究。共有 14 项研究符合纳入标准,并纳入了本综述。

证据综合

这些研究共纳入了 425 名脑卒中患者。大多数研究纳入了慢性脑卒中患者(10 项研究),且仅治疗上肢(11 项研究)。有证据表明,LMV 治疗可有效降低痉挛程度并改善运动功能恢复,尤其是与传统物理治疗联合应用时。

结论

LMV 可能是一种可行且安全的工具,可以整合到传统的脑卒中康复方案中,以降低痉挛程度。对现有临床试验的分析表明,振动疗法在运动功能恢复方面的效果并不显著,尽管一些研究结果显示出令人鼓舞的效果。需要进一步开展研究,纳入更多具有同质性的患者并采用一致的方法,以获得更可靠的数据,特别是针对下肢。

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