Acute changes in cortical activation during active ankle movement after whole-body vibration for spasticity in hemiplegic legs of stroke patients: a functional near-infrared spectroscopy study
Acute changes in cortical activation during active ankle movement after whole-body vibration for spasticity in hemiplegic legs of stroke patients: a functional near-infrared spectroscopy study
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DOI：
10.1080/10749357.2019.1659639
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发表时间：
2019-09-04
影响因子：
2.2
通讯作者：
Shimodozono, Megumi
中科院分区：
文献类型：
--
作者：
Miyara, Kodai;Kawamura, Kentaro;Shimodozono, Megumi
背景：最近的一项研究表明，全身振动（WBV）倾向于减少中风相关偏瘫腿的痉挛。然而，WBV后皮质激活的急性变化尚不清楚。目的：研究WBV是否引起脑卒中偏瘫患者感觉运动皮层激活的急性变化。研究方法：11例卒中患者（平均年龄52.6 [SD 15.4]岁;卒中后中位时间3 [第25次和第75次随访;分别为3个月和10.5个月]）参加了干预前后的比较试验。还研究了6名健康成年人。将30 Hz的WBV施加于腘绳肌、腓肠肌和比目鱼肌5 min。根据改良Ashworth量表（MAS）评估痉挛。还测量了主动和被动活动度（分别为A-ROM和P-ROM）。通过功能性近红外光谱（fNIRS）评估WBV前和WBV后即刻双侧感觉运动皮层中与患肢踝关节自主背屈相关的Oxy-Hb浓度变化。结果：MAS评分、A-ROM和P-ROM在WBV后立即改善。在患者中，虽然区域（同病灶和对病灶感觉运动皮层）和WBV干预（WBV前和WBV后立即）之间没有显著的相互作用（F-1，F-10 = 0.702，p = 0.422），但WBV干预有显著的主效应（F-1，F-10 = 6.971，p = 0.025）。在健康参与者中，与WBV干预或地区无关。结论：在中风相关的痉挛偏瘫患者中，WBV不仅可能导致临床改善，而且可能导致感觉运动皮层激活的急性增加。
Background: A recent study revealed that whole-body vibration (WBV) tends to decrease spasticity in stroke-related hemiplegic legs. However, acute changes in cortical activation after WBV are unclear. Objective: To examine whether WBV induces acute changes in sensorimotor cortical activation in patients with stroke-related hemiplegic legs. Methods: Eleven stroke patients (mean age 52.6 [SD 15.4] years; median time after stroke 3 [25(th) and 75(th) percentiles; 3 and 10.5, respectively] months) participated in a comparative before-and-after intervention trial. Six healthy adults were also studied. WBV at 30 Hz was applied for 5 min to the hamstrings, gastrocnemius, and soleus muscles. Spasticity was assessed according to the modified Ashworth scale (MAS). Active and passive range of motion (A-ROM and P-ROM, respectively) were also measured. Change in Oxy-Hb concentration in bilateral sensorimotor cortex associated with voluntary ankle dorsiflexion of the affected limb was assessed via functional near-infrared spectroscopy (fNIRS) before and immediately after WBV. Results: MAS score, A-ROM, and P-ROM improved immediately after WBV. In the patients, while there was no significant interaction between effects of region (ipsilesional and contralesional sensorimotor cortex) and the WBV intervention (before and immediately after WBV) (F-1,F-10 = 0.702, p = .422), there was a significant main effect of the WBV intervention (F-1,F-10 = 6.971, p = .025). In the healthy participants, there was no association with the WBV intervention or region. Conclusions: In patients with stroke-related spastic-hemiplegic legs, WBV might result not only in clinical improvement but also in acute increase in sensorimotor cortical activation.