不同下肢体位振动对脑卒中患者下肢肌力及运动功能的影响

A study on different lower limb position vibrations on lower limb muscle strength and motor function in patients with stroke

目的:探讨不同下肢体位振动治疗对脑卒中患者下肢功能和肌力的影响。方法:选择2018年7月至2019年8月于西南医科大学附属医院康复科收治的72例脑卒中患者,随机分为对照组、迈步振动组、后伸振动组、屈膝运动振动组,每组18例。三种振动治疗组在对照组基础上增加不同体位下的振动治疗,20min/次,1次/天,5天/周,持续6周。在基线、振动训练6周、随访12周时评估Fugl-Meyer量表下肢部分、起立-行走计时试验(TUG)、膝屈伸肌等速肌力峰力矩。结果:共66例患者完成该研究。各组6周及12周时Fugl-Meyer、TUG、双侧伸膝及屈膝肌峰力矩均较治疗前有显著性差异(P<0.05)。三种振动治疗组6周及12周时Fugl-Meyer、TUG、患侧伸膝肌峰力矩较对照组有显著性差异(P<0.05)。屈膝运动振动组6周时患侧伸膝肌峰力矩显著高于迈步组及后伸组(P<0.05)。四组健侧伸膝肌、双侧屈膝肌峰力矩在6周与12周差异不具备显著性意义(P>0.05)。结论:全身振动疗法能提高脑卒中患者患侧膝关节伸肌肌力与下肢整体运动功能,且屈膝运动振动治疗在提高患侧伸肌力量方面更具优势。

Objective:To investigate the effect of different vibration therapy on lower limb function and muscle strength in stroke patients.Method:A total of 72 stroke patients were randomly divided into four groups(18 in each):control group,upright vibration group,knee stretch motion and vibration group,and knee flexion motion and vibration group.Except the control group,the three vibration treatment groups took the vibration treatment under different body positions.The vibration stimulation program was 20 minutes/time,one time/day,five days/week,six weeks in total.At baseline,the end of six weeks vibration training,and 12 weeks follow-up,the Fugl-Meyer scale of the lower extremity,Time up and go(TUG),peak torque of isokinetic force of the flexor and extensor muscles of the knee were evaluated.Result:A total of 66 patients completed the study.The Fugl-Meyer,TUG,peak torque of knee extensor and flexor at six and 12 weeks were significantly improved in four groups(P<0.05),but the improvements were significant more in vibration groups than control group(P<0.05).The peak torque of the knee extensor and flexor on the affected side of the knee flexion vibration group was significantly higher than that of the upright vibration group and the extensor vibration group(P<0.05).The four parameters of four groups in week 6 had no statistically significant difference with those in week 12(P>0.05).Conclusion:Whole-body vibration therapy can improve the extension muscle strength of the hemiplegia side knee and the overall motor function of lower limbs in stroke patients.The knee flexion vibration therapy is more advantageous in improving the extension and flexion muscle strength of the affected side.