不同频率下全身振动疗法对不随意运动型脑瘫患儿下肢粗大运动及步行功能的影响  

Effects on different frequencies of whole body vibration on gross motor function and walking function in children with dyskinetic cerebral palsy

作　　者：张秋 虞记华 李卫平 凌运其 王剑雄 胥方元 ZHANG Qiu;YU Jihua;LI Weiping;LING Yunqi;WANG Jianxiong;XU Fangyuan(Department of Rehabilitation,the Affiliated Hospital of Southwest Medical University,Departmentof Rehabilition Medicine,Southwest Medical University,Rehabilition Medicine and Engineering Key Laboratoryof Luzhou,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院康复医学科,西南医科大学康复医学系,康复医学与工程泸州市重点实验室,四川泸州646000

出　　处：《实用医学杂志》2024年第3期353-359,共7页The Journal of Practical Medicine

基　　金：四川省科学技术厅社会发展项目(编号:23ZDYF2793)。

摘　　要：目的基于不同频率下全身振动疗法(whole body vibration,WBV)对不随意运动型脑瘫粗大运动及步行功能的影响,为后续WBV临床推广提供参考意义。方法选取2021年10月至2022年11月在西南医科大学附属医院康复医学科门诊和/或入院6~12岁不随意运动型脑瘫60例,按随机数字表法分为对照组(n=20)、(25±5)Hz组(n=20)及(35±5)Hz组(n=20)。3组均进行常规康复训练,(25±5)Hz组额外接受振动频率为(25±5)Hz的WBV,(35±5)Hz组接受(35±5)Hz的WBV,3组均治疗8周。在治疗前后对3组患儿使用Berg平衡量表(Berg Balance Scale,BBS)、起立-行走计时测试(Time to Up and Go Test,TUGT)、粗大运动功能测试量表(Gross Motor Function Measure-88,GMFM-88)及足印分析法评定疗效。结果治疗后3组患儿各项评分指标均优于治疗前(P<0.001);其中(35±5)Hz组BBS评分(F=12.502)、TUGT(F=8.211)、GMFM-88的D区、E区评分(F=12.802、8.505)、跨步长(F=12.279)、步宽(F=13.582)及1 min步行距离(F=12.619)均优于(25±5)Hz组及对照组(P<0.05或P<0.01);(25±5)Hz组疗效优于对照组(P<0.05或P<0.01)。结论WBV可提高不随意运动型脑瘫儿童躯干控制、改善其下肢粗大运动及步行功能,且(35±5)Hz的WBV疗效优于(25±5)Hz的WBV。Objective To provide reference for the subsequent clinical application of WBV,based on the impacts of whole body vibration(WBV)with different frequencies on gross motor function and walking function in children with dyskinetic cerebral palsy.Methods 60 children aged 6~12 with dyskinetic cerebral palsy,who had been treated at the department of rehabilitation medicine in the Affiliated Southwest Medical University from October 2021 to November 2022,were selected.They were randomly divided into a control group(n=20),(25±5)Hz group(n=20),and(35±5)Hz group(n=20).All the three groups received conventional rehabilitation,while the(25±5)Hz group received additional WBV with(25±5)Hz and the(35±5)Hz group received WBV with(35±5)Hz.They were treated for eight weeks.The scores on D and E domains of GMFM-88,TUGT,the score on Berg Balance Scale,and footprint analysis were used for assessment of the efficacy after treatment.Results As compared with the baselines,the scores were improved in the three groups after treatment(P<0.001).BBS(F=12.502),TUGT(F=8.211),scores on D and E domains of GMFM-88(F=12.802 and 8.505),stride length(F=12.279),1MWT distance(F=12.619),and step width(F=13.582)were better in the(35±5)Hz group than in the(25±5)Hz group and the control group(P<0.05 and P<0.01);and the efficacy was better in the(25±5)Hz group than in the control group,the difference was statistically significant(P<0.05 and P<0.01).Conclusion WBV can improve trunk control,lower limb gross motor function,and walking function in children with involuntary motor type cerebral palsy.(35±5)Hz is better than(25±5)Hz for the efficacy of WBV.

关 键 词：不同频率 全身振动疗法 不随意运动型脑瘫 粗大运动 步行功能 

分 类 号：R493[医药卫生—康复医学]