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全身振动训练对中风患者的平衡和步行功能有积极影响吗?一项荟萃分析。

Does whole-body vibration training have a positive effect on balance and walking function in patients with stroke? A meta-analysis.

作者信息

Yin Yikun, Wang Jialin, Yu Zhengze, Zhou Lina, Liu Xiaoman, Cai Hejia, Sun Junzhi

机构信息

College of Physical and Health Education, Guangxi Normal University, Guilin, China.

Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China.

出版信息

Front Hum Neurosci. 2023 Jan 4;16:1076665. doi: 10.3389/fnhum.2022.1076665. eCollection 2022.

Abstract

OBJECTIVE

After a stroke, patients usually suffer from dysfunction, such as decreased balance ability, and abnormal walking function. Whole-body vibration training can promote muscle contraction, stimulate the proprioceptive system, enhance the muscle strength of low limbs and improve motor control ability. The study aims to evaluate the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke.

METHODS

PubMed, CNKI, VIP, CBM, EBSCO, Embase and Web of Science were searched. According to the inclusion and exclusion criteria, randomized controlled trials on the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke were collected. The search time ranged from the date of database construction to November 2022. The included trials were evaluated by the Cochrane risk-of-bias tool. The meta-analysis was performed using two software packages, consisting of RevMan 5.4 and Stata 12.2. If the results included in the literature were continuous variables, use the mean difference (MD) and 95% confidence interval (CI) for statistics.

RESULTS

(1) A total of 22 randomized controlled trials (RCTs) with a total of 1089 patients were included. (2) The results of meta-analysis showed that: compared with the controls, step length (MD = 6.12, 95%CI [5.63, 6.62], < 0.001), step speed (MD = 0.14, 95%CI [0.09, 0.20], < 0.001), cadence (MD = 9.03, 95%CI [2.23, 15.83], = 0.009), stride length (MD = 6.74, 95%CI [-3.47, 10.01], < 0.001), Berg Balance Scale (BBS) (MD = 4.08, 95%CI [2.39, 5.76], < 0.001), Timed Up-and-Go test (TUGT) (MD = -2.88, 95%CI [-4.94, 0.81], = 0.006), 10-meter Walk Test (10MWT) (MD = -2.69, 95%CI [-3.35, -2.03], < 0.001), functional ambulation category scale (FAC) (MD = 0.78, 95%CI [0.65, 0.91], < 0.001), Fugl-Meyer motor assessment of lower extremity (FMA-LE) (MD = 4.10, 95%CI [2.01, 6.20], = 0.0001). (3) The results of subgroup analysis showed that, compared with other vibration frequencies, at 20-30 Hz frequency, WBV training had an obvious improvement effect only in TUGT. (4) The safety analysis showed that WBV training may be safe.

CONCLUSION

Whole-body vibration training has a positive effect on the balance and walking function of patients with stroke. Thus, whole-body vibration training is a safe treatment method to improve the motor dysfunction of patients with stroke.

SYSTEMATIC REVIEW REGISTRATION

[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD4202348263].

摘要

目的

中风后患者通常会出现功能障碍,如平衡能力下降和行走功能异常。全身振动训练可促进肌肉收缩,刺激本体感觉系统,增强下肢肌肉力量并改善运动控制能力。本研究旨在评估全身振动训练对中风患者平衡和行走功能的有效性。

方法

检索了PubMed、CNKI、VIP、CBM、EBSCO、Embase和Web of Science。根据纳入和排除标准,收集关于全身振动训练对中风患者平衡和行走功能有效性的随机对照试验。检索时间从数据库建库日期至2022年11月。采用Cochrane偏倚风险工具对纳入的试验进行评估。使用RevMan 5.4和Stata 12.2两个软件包进行荟萃分析。如果文献中的结果为连续变量,则使用均数差(MD)和95%置信区间(CI)进行统计。

结果

(1)共纳入22项随机对照试验(RCT),共计1089例患者。(2)荟萃分析结果显示:与对照组相比,步长(MD = 6.12,95%CI [5.63, 6.62],P < 0.001)、步速(MD = 0.14,95%CI [0.09, 0.20],P < 0.001)、步频(MD = 9.03,95%CI [2.23, 15.83],P = 0.009)、步幅(MD = 6.74,95%CI [-3.47, 10.01],P < 0.001)、伯格平衡量表(BBS)(MD = 4.08,95%CI [2.39, 5.76],P < 0.001)、计时起立行走测试(TUGT)(MD = -2.88,95%CI [-4.94, 0.81],P = 0.006)、10米步行测试(10MWT)(MD = -2.69,95%CI [-3.35, -2.03],P < 0.001)、功能性步行分类量表(FAC)(MD = 0.78,95%CI [0.65, 0.91],P < 0.001)、下肢Fugl-Meyer运动评估(FMA-LE)(MD = 4.10,95%CI [2.01, 6.20],P = 0.0001)。(3)亚组分析结果显示,与其他振动频率相比,在20 - 30 Hz频率下,全身振动训练仅在TUGT方面有明显改善效果。(4)安全性分析表明全身振动训练可能是安全的。

结论

全身振动训练对中风患者的平衡和行走功能有积极作用。因此,全身振动训练是改善中风患者运动功能障碍的一种安全治疗方法。

系统评价注册

[http://www.crd.york.ac.uk/PROSPERO],标识符[CRD4202348263]。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00a3/9846107/ddaf93b0c49c/fnhum-16-1076665-g001.jpg

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