Immediate Effects of Functional Vibratory Stimulation on the Gait of Stroke Hemiplegia Patients
Immediate Effects of Functional Vibratory Stimulation on the Gait of Stroke Hemiplegia Patients
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DOI：
10.1166/jnsne.2017.1105
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
Y. Sueyoshi;M. Shimodozono;K. Kawahira;Maki Yamashita
中科院分区：
文献类型：
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作者：
Y. Sueyoshi;M. Shimodozono;K. Kawahira;Maki Yamashita
很大一部分中风幸存者有步态障碍。步态恢复是脑卒中后康复治疗的重要目标。本研究的目的是评估对偏瘫下肢进行较强的功能性振动刺激对脑卒中偏瘫患者下肢步态速度和摆动速度的即时影响。12名中风患者参加了这项研究。所有人都能在有或没有助行器的情况下行走。功能振动刺激系统由一个封闭在塑料盒中的直流电机组成。将两个振动器固定在偏瘫侧胫骨前肌和臀中肌上的皮肤上，并在步态测量期间连续施加。受试者的步态速度，站立和摆动的持续时间，以及最大的角速度在大腿，小腿和膝盖的麻痹和非麻痹侧被用作结果的措施。在偏瘫患者中加入功能性振动刺激后，步态运动的变化如下。麻痹侧的站立相持续时间从0.94±0.04 s降至0.87±0.04 s（p 0.01），非麻痹侧从1.08±0.05 s降至1.03±0.05 s（p 0.01）。摆动相持续时间在轻瘫侧从0.67±0.02 s减少到0.64±0.02 s，在非轻瘫侧从0.52±0.02 s减少到0.50±0.02 s（无显著差异）。步态速度从25.3±1.3 m/min显著增加至28.2±1.5 m/min（p 0.01）。麻痹侧的峰值腿部角速度从169.3±9.5度/秒增加到182.3±10.0度/秒（p 0.01），非麻痹侧的峰值腿部角速度也从246.0±7.9度/秒增加到261.1±7.5度/秒（p 0.01）。麻痹侧的峰值大腿角速度从85.3±3.5度/秒降至84.3±3.7度/秒（无显著差异），但非麻痹侧的峰值大腿角速度从100.3±3.8度/秒增至105.0±3.2度/秒（p 0.05）。在行走过程中对目标偏瘫下肢进行增强的功能性振动刺激显著改善了步态速度、站立相持续时间和摆动相下肢的峰值角速度。我们的研究结果表明，功能性振动刺激是有用的治疗偏瘫肢体治疗步态训练过程中。
A large proportion of stroke survivors have gait disorders. Restoration of gait is an important goal of poststroke rehabilitation. The purpose of this study was to evaluate the immediate effect of stronger functional vibratory stimulation to the hemiplegic lower limb on gait speed and swing speed of the lower limbs of stroke patients with hemiplegia. Twelve stroke patients participated in this study. All were able to walk with or without walking aids. The functional vibratory stimulation system consists of a direct current motor enclosed in a plastic box. Two vibrators were fixed on the skin overlying the tibialis anterior and the gluteus medius muscles of the hemiplegic side and were applied continuously during measurement of gait. Subject's gait speed, stance and swing duration, and maximal angular velocity at the thigh, leg, and knee of both the paretic and nonparetic sides were used as outcome measures. Changes in gait movement in the hemiplegic patients by adding functional vibratory stimulation were as follows. The stance phase duration decreased from 0.94±0.04 s to 0.87±0.04 s on the paretic side (p 0.01) and decreased from 1.08±0.05 s to 1.03±0.05 s on the nonparetic side (p 0.01). The swing phase duration decreased from 0.67±0.02 s to 0.64±0.02 s on the paretic side and decreased from 0.52±0.02 s to 0.50±0.02 s on the non-paretic side (no significant differences). The gait speed significantly increased from 25.3±1.3 m/min to 28.2±1.5 m/min (p 0.01). Peak leg angular velocity increased from 169.3±9.5 deg/s to 182.3±10.0 deg/s on the paretic side (p 0.01) and also increased from 246.0±7.9 deg/s to 261.1±7.5 deg/s on the non-paretic side (p 0.01). Peak thigh angular velocity decreased from 85.3±3.5 deg/s to 84.3±3.7 deg/s on the paretic side (no significant difference), but increased from 100.3±3.8 deg/s to 105.0±3.2 deg/s on the non-paretic side (p 0.05). Enhanced functional vibratory stimulation to the targeted hemiplegic lower limb during walking significantly improved gait speed, stance phase duration and peak angular velocity at the lower extremities during the swing phase. Our results demonstrated that functional vibratory stimulation is useful as a treatment during therapeutic gait training for hemiplegic extremities.