低频共振训练对脑卒中后偏瘫患者平衡及步行功能的影响

Low-frequency whole-body resonance stimulation can improve the balance and walking of hemiplegic stroke survivors

目的观察低频共振训练对脑卒中偏瘫患者平衡及步行能力的影响。方法按随机数字表法将符合纳入标准的66例脑卒中后偏瘫患者分为低频共振训练组、高频振动训练组和对照组,每组22例。研究全程共有4例病例脱落,最终62例纳入统计分析,即低频共振训练组22例、高频振动训练组20例、对照组20例。所有患者均接受常规运动训练,训练强度遵循个性化原则;采用德国SVG公司的Wellengang振动治疗仪(型号Excellence)进行全身振动训练。低频共振训练组、高频振动训练组和对照组(常规运动训练组)治疗频率分别为7、15和1 Hz,每次训练1 min,坐位休息1 min,5个循环,每日2次,每周治疗5 d,共治疗40次。分别于训练前(治疗前)和训练40次后(治疗后),采用Berg平衡量表(BBS)、起立-行走测试(TUGT)、10 m步行测试(10MWT)、步长、步频、步速等参数指标对患者平衡及步行能力进行评估和分析。结果训练前,3组患者BBS、TUGT、10MWT、步长、步频、步速组间比较,差异均无统计学意义(P>0.05)。不同频率训练后,上述参数均不同程度改善,组内差异均有统计学意义(P<0.05);组间比较,低频共振训练组各参数指标改善均优于其余二组(P<0.05),高频振动训练组亦明显优于对照组(P<0.05)。结论7 Hz低频共振训练能更有效地改善脑卒中偏瘫患者平衡及步行能力。

Objective To observe any effect of low-frequency whole body resonant stimulation on the balance and walking ability of hemiplegic stroke survivors.Methods Sixty-six stroke survivors with hemiplegia were randomly divided into a low-frequency resonance training group,a high-frequency vibration training group and a control group,each of 22.All received routine exercise training at individualized intensities.All three groups underwent five 1-minute cycles of 7Hz,15Hz or 1Hz stimulation twice a day,five days a week for eight weeks.Before and after the intervention,balance and walking ability were evaluated using the Berg Balance Scale,the timed up and go test and a 10m walking test.Step length,step frequency and step speed were also measured.Results There were no significant differences among the three groups before the training.Afterward,significant improvement was observed in all of the groups in terms of all of the measurements.The average results of the low-frequency resonance training group were at that point significantly better than the other two groups'averages,while the high-frequency vibration training group's results were superior to those of the control group.Conclusion Resonance training at 7Hz is the most effective in improving the balance and walking ability of stroke survivors with hemiplegia.