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通过沃伊塔外周体感刺激在健康成年人中诱发自动步态:一项双盲随机对照试验。

Automatic gait evoking in healthy adults through Vojta's peripheric somatosensory stimulation: a double-blind randomized controlled trial.

作者信息

Perales-López Luis, Sanz-Esteban Ismael, Jiménez-Antona Camen, Serrano J Ignacio, San-Martín-Gómez Ana, Vives-Gelabert Xisca, Cano-de-la-Cuerda Roberto

机构信息

Department of Neurorehabilitation. Numen Foundation, Madrid, Spain.

Department of Physiotherapy. Physical Therapy and Health Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain.

出版信息

J Neuroeng Rehabil. 2024 Oct 1;21(1):174. doi: 10.1186/s12984-024-01470-2.

Abstract

BACKGROUND

To study the effects of different interventions on automatic gait processing in contrast with voluntary gait processing in healthy subjects.

METHODS

A double-blind randomised controlled trial was designed (120 able-body persons between 18 and 65 years old entered and completed the study), with pre-intervention and post-intervention assessments using the 6-Minute Walk Test (6MWT). The participants were randomly distributed into four groups. Prior to intervention, all participants performed voluntary gait on the ground (VoG) in a calibrated circuit following the 6MWT. The presence of automatic gait (AG) was explored post-intervention without a voluntary demand in the same circuit following the 6MWT. Each group received a different intervention for 30 min: Vojta stimulation, MOTOMED at no less than 60 revolutions/minute, treadmill walking at 3 km/h, and resting in a chair (control). The main assessment, conducted by a blinded rater, was the difference in distance covered (in meters) during the 6MWT between pre- and post-intervention. Surface electromyography (sEMG) average root mean square (RMS) signals in the right tibialis anterior, right soleus, right rectus femoris, and right biceps femoris were also considered outcome measures.

RESULTS

The Vojta group was the only one that initiated AG after the intervention (476.4 m ± 57.1 in VoG versus 9.0 m ± 8.9 in AG, p < 0.001) with comparable kinematics and EMG parameters during voluntary gait, except for ankle dorsal flexion. Within the Vojta group, high variability in kinematics, sEMG activity, and distance covered was observed.

CONCLUSIONS

AG isolation is approachable through Vojta at only one session measurable with the 6MWT without any voluntary gait demand. No automatic gait effects were observed post-intervention in the other groups.

TRIAL REGISTRATION

NCT04689841 (ClinicalTrials.gov).

摘要

背景

研究不同干预措施对健康受试者自动步态处理的影响,并与自主步态处理进行对比。

方法

设计了一项双盲随机对照试验(120名年龄在18至65岁之间的身体健全者进入并完成了研究),使用6分钟步行试验(6MWT)进行干预前和干预后评估。参与者被随机分为四组。干预前,所有参与者在6MWT后的校准线路上进行地面自主步态(VoG)。干预后,在6MWT后的同一线路上,在没有自主需求的情况下探索自动步态(AG)的存在。每组接受30分钟的不同干预:Vojta刺激、MOTOMED以不少于60转/分钟的速度运行、以3公里/小时的速度在跑步机上行走以及坐在椅子上休息(对照组)。由一名盲法评估者进行的主要评估是干预前后6MWT期间行走距离(以米为单位)的差异。右胫骨前肌、右比目鱼肌、右股直肌和右股二头肌的表面肌电图(sEMG)平均均方根(RMS)信号也被视为结果指标。

结果

Vojta组是唯一在干预后启动AG的组(VoG中为476.4米±57.1,AG中为9.0米±8.9,p<0.001),除了踝关节背屈外,自主步态期间的运动学和肌电图参数具有可比性。在Vojta组内,观察到运动学、sEMG活动和行走距离存在高度变异性。

结论

通过Vojta仅在一个疗程内即可实现AG隔离,可通过6MWT测量,且无需任何自主步态需求。其他组在干预后未观察到自动步态效应。

试验注册

NCT04689841(ClinicalTrials.gov)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a62/11443748/f4006f01d4bf/12984_2024_1470_Figa_HTML.jpg

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