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低频与高频局部振动对轻-中度肌肉痉挛的影响:多发性硬化症患者的超声和功能评估。

Effects of low vs. high frequency local vibration on mild-moderate muscle spasticity: Ultrasonographical and functional evaluation in patients with multiple sclerosis.

机构信息

Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı/Altındag, Ankara, Turkey.

Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.

出版信息

Mult Scler Relat Disord. 2021 Jun;51:102930. doi: 10.1016/j.msard.2021.102930. Epub 2021 Mar 31.

Abstract

BACKGROUND

Local vibration (LV) is a physiotherapy application that aims to reduce spasticity. The study aimed to compare the effects of 50 Hz vs. 100 Hz LV on mild-moderate spasticity, functional performance and muscle architecture.

METHODS

Thirty-three patients were randomly divided into three groups: 50 Hz LV group, 100 Hz LV group and the control group. Physical therapy was applied for one hour a day, three days a week, for a total of eight weeks. LV was applied to the right and left medial gastrocnemius muscles for five minutes. Clinical (spasticity, ankle joint position sense, balance, gait) and ultrasonographic (gastrocnemius fascicle length and pennation angle) measurements were performed before and after treatment.

RESULTS

The study was completed with 27 patients. The decrease in spasticity and the increase in fascicle length were found to be statistically significant in the 50 Hz group (both p<0.05). Ankle joint position sense, single-leg stance time, limits of stability/postural sway range in the medio-lateral direction significantly improved in the vibration treatment groups (all p<0.05). The antero-posterior limits of stability and postural sway showed significant improvement in all groups (all p<0.05). While the 50 Hz group showed significant improvement for all walking parameters; velocity, step length and base of support values improved in the 100 Hz group (all p<0.05). The exercise group showed significant improvement only for single support and stance phase percentages of the gait cycle (both p<0.05). According to between group comparisons, significant difference was found only in medio-lateral limits of stabillity (p<0.05). Medio-lateral limits of stabillity scores were better for the 50 Hz group than the 100 Hz and exercise group.

CONCLUSION

Our findings show that LV does not have any substantial effect except for medio-lateral limits of stability.

CLINICAL TRIAL NUMBER

NCT04192786.

摘要

背景

局部振动(LV)是一种物理治疗应用,旨在降低痉挛程度。本研究旨在比较 50 Hz 与 100 Hz LV 对轻度至中度痉挛、功能表现和肌肉结构的影响。

方法

33 名患者被随机分为三组:50 Hz LV 组、100 Hz LV 组和对照组。每天进行一次物理治疗,每周三次,共八周。LV 应用于右侧和左侧内侧比目鱼肌 5 分钟。治疗前后进行临床(痉挛、踝关节位置感、平衡、步态)和超声(比目鱼肌束长度和羽状角)测量。

结果

27 名患者完成了研究。发现 50 Hz 组的痉挛程度降低和束长度增加具有统计学意义(均 p<0.05)。振动治疗组的踝关节位置感、单腿站立时间、中-侧向稳定性/姿势摆动范围显著改善(均 p<0.05)。所有组的前-后向稳定性和姿势摆动均有显著改善(均 p<0.05)。虽然 50 Hz 组的所有步行参数均有显著改善;但 100 Hz 组的速度、步长和支撑基础值均有改善(均 p<0.05)。运动组仅对步态周期的单支撑和站立阶段百分比有显著改善(均 p<0.05)。根据组间比较,仅在中-侧向稳定性方面发现有显著差异(p<0.05)。50 Hz 组的中-侧向稳定性评分优于 100 Hz 组和运动组。

结论

除了中-侧向稳定性之外,我们的发现表明 LV 没有任何实质性影响。

临床试验编号

NCT04192786。

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