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靶向振动疗法治疗本体感觉功能障碍:慢性腰痛老年患者的临床试验。

Targeted vibratory therapy as a treatment for proprioceptive dysfunction: Clinical trial in older patients with chronic low back pain.

机构信息

Department of Orthopaedic Surgery, National Center for Geriatrics and Gerontology, Obu, Aichi Prefecture, Japan.

Department of Electrical and Mechanical Engineering, Graduate School of Engineering Nagoya Institute of Technology, Nagoya, Aichi Prefecture, Japan.

出版信息

PLoS One. 2024 Jul 19;19(7):e0306898. doi: 10.1371/journal.pone.0306898. eCollection 2024.

Abstract

INTRODUCTION

Proprioceptive function declines with age, leading to falls, pain, and difficulties in performing activities of daily living among older adults. Although individuals with low back pain (LBP) exhibit decreased lumbosacral proprioception in various postures, the mechanism by which reduced proprioceptive function causes LBP remains uncertain. Vibratory stimulation may enhance proprioceptive function; however, its efficacy in treating LBP has not been investigated. Thus, we investigated the feasibility of improving proprioceptive function and its effect on alleviating chronic LBP in older patients through targeted vibratory therapy (TVT) administration.

METHODS

This single arm designed trial included older patients aged >65 years with non-specific chronic LBP. TVT involved applying vibratory stimulation, matching the frequency of dysfunctional receptors, for 1 min daily over 14 days to activate proprioceptors; patients performed TVT three times daily at home. In cases of reduced proprioceptive function at multiple sites, TVT was aimed at the lowest frequency band value. LBP and proprioceptive function were evaluated at 2 weeks after TVT and at 2 weeks after the end of TVT in patients with declined proprioception in the trunk or lower extremities.

RESULTS

Overall, 56 patients with chronic LBP were enrolled; 32 patients were recruited for treatment based on a proprioceptive dysfunction diagnosis and 24 patients were recruited with a normal diagnosis with no significant differences observed between the two sets of patients in sarcopenia-related factors and clinical proprioception-related characteristics. No patient had any adverse events. Two weeks after TVT, the numerical pain rating scale score improved to <3 points in 78.1% of patients, with 73.1% of patients achieving a score of ≤ 3 points. Proprioceptive function improved in 81.3% of cases, and engagement in activities of daily living improved significantly.

CONCLUSIONS

TVT demonstrated efficacy in improving proprioception and alleviating LBP in older patients with impaired proprioceptive function without affecting non-targeted proprioceptors.

摘要

简介

本体感觉功能随年龄增长而下降,导致老年人跌倒、疼痛和日常生活活动困难。尽管患有下腰痛(LBP)的个体在各种姿势下表现出腰骶部本体感觉下降,但导致本体感觉功能下降的机制尚不清楚。振动刺激可能增强本体感觉功能;然而,其治疗 LBP 的效果尚未得到研究。因此,我们研究了通过靶向振动治疗(TVT)来改善本体感觉功能并缓解老年患者慢性 LBP 的可行性。

方法

这项单臂设计试验纳入了年龄>65 岁的患有非特异性慢性 LBP 的老年患者。TVT 涉及应用振动刺激,与功能障碍受体的频率相匹配,每天 1 分钟,持续 14 天,以激活本体感受器;患者在家中每天进行 3 次 TVT。在多个部位本体感觉功能下降的情况下,TVT 的目标是最低频率带值。在 TVT 后 2 周和本体感觉功能下降的躯干或下肢 TVT 结束后 2 周,评估 LBP 和本体感觉功能。

结果

总体而言,纳入了 56 名患有慢性 LBP 的患者;根据本体感觉功能障碍诊断,32 名患者接受了治疗,24 名患者因正常诊断而接受了治疗,两组患者在与肌肉减少症相关的因素和临床本体感觉相关特征方面无显著差异。没有患者出现任何不良事件。TVT 后 2 周,78.1%的患者数字疼痛评分量表评分降至<3 分,73.1%的患者评分≤3 分。81.3%的病例本体感觉功能得到改善,日常生活活动能力显著改善。

结论

TVT 可有效改善本体感觉功能,缓解老年患者本体感觉功能障碍引起的 LBP,且不影响非靶向本体感受器。

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