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

doi:10.3969/j.issn.1006-5725.2024.03.013

Abstract

Abstract:

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.

Key words: different frequency, whole body vibration, dyskinetic cerebral palsy, gross motor function, gait function

CLC Number:

R493

Qiu ZHANG,Jihua YU,Weiping LI,Yunqi LING,Jianxiong WANG,Fangyuan XU. Effects on different frequencies of whole body vibration on gross motor function and walking function in children with dyskinetic cerebral palsy[J]. The Journal of Practical Medicine, 2024, 40(3): 353-359.

Figures/Tables 4

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References 32

1	中国康复医学会儿童康复专业委员会，中国残疾人康复协会小儿脑性瘫痪康复专业委员会，中国医师协会康复医师分会儿童康复专业委员会，等. 中国脑性瘫痪康复指南（2022）第一章：概论［J］. 中华实用儿科临床杂志， 2022，37（12）：887-892. doi:10.3760/cma.j.cn101070-20220505-00500 doi: 10.3760/cma.j.cn101070-20220505-00500
2	VITRIKAS K， DALTON H， BREISH D. Cerebral Palsy： An Overview［J］. Am Fam Physician， 2020，101（4）： 213-220. doi:10.1016/j.cpha.2020.06.004 doi: 10.1016/j.cpha.2020.06.004
3	MONBALIU E， HIMMELMANN K， LIN J P， et al. Clinical presentation and management of dyskinetic cerebral palsy［J］. Lancet Neurol， 2017，6（9）：741-749. doi:10.1016/s1474-4422(17)30252-1 doi: 10.1016/s1474-4422(17)30252-1
4	DAMIANO D L， LONGO E. Early intervention evidence for infants with or at risk for cerebral palsy： an overview of systematic reviews［J］. Dev Med Child Neurol， 2021， 63（7）：771-784. doi:10.1111/dmcn.14855 doi: 10.1111/dmcn.14855
5	TEKIN F， KAVLAK E. Short and long-term effects of whole-body vibration on spasticity and motor performance in children with hemiparetic cerebral palsy［J］. Percept Mot Skills， 2021，128（3）：1107-1129. doi:10.1177/0031512521991095 doi: 10.1177/0031512521991095
6	HEGAZY R G， ABDEL-AZIEM A A. Effect of whole-body vibration exercise on hamstrings-to-quadriceps ratio， walking performance， and postural control in children with hemiparetic cerebral palsy： a randomized controlled trial［J］. J Manipulative Physiol Ther， 2022，45（9）：660-670. doi:10.1016/j.jmpt.2023.04.011 doi: 10.1016/j.jmpt.2023.04.011
7	唐久来，秦炯，邹丽萍，等. 中国脑性瘫痪康复指南（2015）：第一部分［J］. 中国康复医学杂志， 2015，30（7）：747-754.
8	PISCITELLI D， FERRARELLO F， UGOLINI A， et al. Measurement properties of the gross motor function classification system， gross motor function classification system-expanded & revised， manual ability classification system， and communication function classification system in cerebral palsy： a systematic review with meta-analysis［J］. Dev Med Child Neurol， 2021，63（11）：1251-1261. doi:10.1111/dmcn.14910 doi: 10.1111/dmcn.14910
9	MESEGUER-HENAREJOS A B， RUBIO-APARICIO M， LOPEZ-PINA J A， et al. Characteristics that affect score reliability in the Berg Balance Scale： a meta-analytic reliability generalization study［J］. Eur J Phys Rehabil Med， 2019，55（5）：570-584. doi:10.23736/s1973-9087.19.05363-2 doi: 10.23736/s1973-9087.19.05363-2
10	SMITH J， DIVITO M， FERGUS A. Reliability and discriminant validity of the quantitative timed up and go in typically developing children and children with cerebral palsy GMFCS levels I-II［J］. J Pediatr Rehabil Med，2023，16（1）：25-35. doi:10.3233/prm-210034 doi: 10.3233/prm-210034
11	杨亚丽，徐玲，马海霞，等. 正常儿童及脑性瘫痪患儿步行足印参数值研究［J］. 中华物理医学与康复杂志， 2004， 26（11）：37-39. doi:10.3760/j:issn:0254-1424.2004.11.010 doi: 10.3760/j:issn:0254-1424.2004.11.010
12	KITAI Y， HIRAI S， OKUYAMA N， et al. Functional outcomes of children with dyskinetic cerebral palsy depend on etiology and gestational age［J］. Eur J Paediatr Neurol， 2021， 30（1）：108-112. doi:10.1016/j.ejpn.2020.11.002 doi: 10.1016/j.ejpn.2020.11.002
13	李俊，周满相，杨孝霞. 本体感觉训练在不随意运动型脑瘫中的疗效分析［J］. 世界最新医学信息文摘， 2019， 19（85）：95+99.
14	MUNSHI P， KHAN M H， ARORA N K， et al. Effects of plyometric and whole-body vibration on physical performance in collegiate basketball players： a crossover randomized trial［J］. Sci Rep， 2022， 12（1）：5043-5052. doi:10.1038/s41598-022-09142-8 doi: 10.1038/s41598-022-09142-8
15	SHADLOO N， KAMALI F， SALEHI-DEHNO N. A comparison between whole-body vibration and conventional training on pain and performance in athletes with patellofemoral pain［J］. J Bodyw Mov Ther， 2021，27（1）：661-666. doi:10.1016/j.jbmt.2021.03.003 doi: 10.1016/j.jbmt.2021.03.003
16	RUHDE L， HULLA R. An overview of the effects of whole-body vibration on individuals with cerebral palsy［J］. J Pediatr Rehabil Med， 2022，15（1）：193-210. doi:10.3233/prm-201508 doi: 10.3233/prm-201508
17	严善钟，金娟，陈世动，等. 全身振动训练对痉挛型脑瘫患儿20例步行速度及粗大运动功能影响研究［J］. 中国实用儿科杂志， 2021， 36（1）：33-37.
18	ELSHAFEY M A， ABDRABO M S， ELNAGGAR R K. Effects of a core stability exercise program on balance and coordination in children with cerebellar ataxic cerebral palsy［J］. J Musculoskelet Neuronal Interact， 2022， 22（2）：172-178.
19	CHEN B， DONG Y， GUO J， et al. effects of whole-body vibration on lumbar-abdominal muscles activation in healthy young adults： a pilot study［J］. Med Sci Monit， 2019， 25（01）：1945-1951. doi:10.12659/msm.912720 doi: 10.12659/msm.912720
20	KANG S R， KIM G W， KO M H， et al. The effect of exercise load deviations in whole body vibration on improving muscle strength imbalance in the lower limb［J］. Technol Health Care， 2020， 28（S1）：103-114. doi:10.3233/thc-209011 doi: 10.3233/thc-209011
21	CELIK E， FINDIKOGLU G， OZDEMIR- KART S， et al. The adaptations in muscle architecture following whole body vibration training［J］. J Musculoskelet Neuronal Interact， 2022， 22（2）：193-202.
22	BONANNI R， CARIATI I， ROMAGNOLI C，et al. whole body vibration： a valid alternative strategy to exercise？［J］. J Funct Morphol Kinesiol， 2022， 7（4）：99-118. doi:10.3390/jfmk7040099 doi: 10.3390/jfmk7040099
23	COLSON S S， GIODA J， DA-SIVA F. Whole body vibration training improves maximal strength of the knee extensors， time-to-exhaustion and attenuates neuromuscular fatigue［J］. Sports （Basel）， 2023，11（5）：94-107. doi:10.3390/sports11050094 doi: 10.3390/sports11050094
24	RITTWEGER J， MUTSCHELKNAUSS M， FELSENBERGe D. Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise［J］. Clin Physiol Funct Imaging， 2003， 23（2）：81-86. doi:10.1046/j.1475-097x.2003.00473.x doi: 10.1046/j.1475-097x.2003.00473.x
25	蒋子豪，王广兰，陈鹏，等. 离心训练结合不同频率全身振动训练治疗髌腱末端病［J］. 中国组织工程研究， 2024，28（4）：493-498. doi:10.12307/2024.211 doi: 10.12307/2024.211
26	YOON J Y， KANG S R， KIM H S， et al. Effects of low-frequency whole-body vibration on muscle activation， fatigue， and oxygen consumption in healthy young adults： a single-group repeated-measures controlled trial［J］. J Sport Rehabil， 2022，31（8）：984-992. doi:10.1123/jsr.2021-0170 doi: 10.1123/jsr.2021-0170
27	PEUNGSUWAN P， CHATCHAWAN U， DONPUNHA W， et al. Different protocols for low whole-body vibration frequency for spasticity and physical performance in children with spastic cerebral palsy［J］. Children （Basel）， 2023，10（3）：458-470. doi:10.3390/children10030458 doi: 10.3390/children10030458
28	任满迎. 同振幅下不同频率振动刺激对肌肉力量训练效果的对比研究［D］. 河北师范大学， 2007.
29	陈红，黄雨滟，黄强. 不同频率的全身振动训练对脑卒中患者平衡功能及步行功能的影响［J］. 实用医学杂志， 2021，37（16）：2160-2163. doi:10.3969/j.issn.1006-5725.2021.16.026 doi: 10.3969/j.issn.1006-5725.2021.16.026
30	WEI N， CAI M. Optimal frequency of whole body vibration training for improving balance and physical performance in the older people with chronic stroke： A randomized controlled trial［J］. Clin Rehabil，2022，36（3）：342-349. doi:10.1177/02692155211050564 doi: 10.1177/02692155211050564
31	刘韬，蒙利娇，黄敏，等. 局部振动疗法抑制脑卒中后患者痉挛的研究进展［J］. 中华物理医学与康复杂志， 2021，43（5）：465-467. doi:10.3760/cma.j.issn.0254-1424.2021.05.020 doi: 10.3760/cma.j.issn.0254-1424.2021.05.020
32	WUESTEFELD A， FUERMAIER ABM， BERNARDO-FILHO M， et al. Towards reporting guidelines of research using whole-body vibration as training or treatment regimen in human subjects-A Delphi consensus study［J］. PLoS One， 2020， 15（7）：e0235905-e0235935. doi:10.1371/journal.pone.0235905 doi: 10.1371/journal.pone.0235905

组别	例数	性别（例）		GMFCS分级（例）		年龄（岁，x ± s）	体质量（kg）	身高（cm）
组别	例数	男	女	Ⅰ	Ⅱ	年龄（岁，x ± s）	体质量（kg）	身高（cm）
对照组	20	12	8	9	11	9.00 ± 1.37	26.89 ± 4.11	121.25 ± 6.02
（25 ± 5）Hz组	20	11	9	10	10	8.86 ± 1.83	24.69 ± 2.83	119.55 ± 9.13
（35 ± 5）Hz组	20	9	11	7	13	8.53 ± 1.61	25.14 ± 3.29	118.20 ± 8.65
F/χ ² 值		0.938		0.950		0.444	1.701	0.721
P值		0.626		0.622		0.644	0.192	0.491

组别	例数	Berg评分（分）		t值	P值	TUGT（s）		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	20	13.75 ± 4.04	17.25 ± 4.79	-6.007	< 0.001	26.75 ± 6.43	24.25 ± 5.98	4.802	< 0.001
（25 ± 5）Hz组	20	15.10 ± 4.49	21.25 ± 5.10^a	-7.289	< 0.001	27.30 ± 4.76	21.20 ± 3.62^a	7.321	< 0.001
（35 ± 5）Hz组	20	13.05 ± 4.25	25.35 ± 5.15^bc	-14.641	< 0.001	25.20 ± 4.83	18.15 ± 4.37^bc	13.047	< 0.001
F值		1.390	13.040			0.815	8.211
P值		0.257	< 0.001			0.449	< 0.001

组别	例数	GMFM-88 D区		t	P值	GMFM-88 E区		t值	P值
组别	例数	治疗前	治疗后	t	P值	治疗前	治疗后	t值	P值
对照组	20	54.10 ± 10.58	59.87 ± 10.76	-9.405	< 0.001	37.57 ± 5.42	42.64 ± 7.32	-5.801	< 0.001
（25 ± 5）Hz组	20	61.92 ± 14.17	70.38 ± 13.83^a	-4.084	< 0.001	38.82 ± 7.23	51.81 ± 11.45^a	-11.118	< 0.001
（35 ± 5）Hz组	20	60.26+10.17	77.69 ± 7.90^bc	-19.304	< 0.001	37.01 ± 5.52	58.33 ± 10.38^bc	-14.490	< 0.001
F值		2.444	13.032			0.458	12.744
P值		0.196	< 0.001			0.635	< 0.001

组别	例数	跨步长（cm）		t值	P值	步宽（cm）		t值	P值	1 min步行距离（m）		t值	P值
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
对照组	20	40.15 ± 6.56	43.75 ± 6.41	-17.121	< 0.001	26.20 ± 3.64	23.95 ± 3.73	12.795	< 0.001	40.26 ± 3.71	43.14 ± 3.60	-14.547	< 0.001
（25 ± 5）Hz组	20	42.80 ± 4.37	47.70 ± 4.70^a	-11.959	< 0.001	25.60 ± 3.14	21.70 ± 3.10^a	13.482	< 0.001	42.20 ± 4.31	45.76 ± 4.25^a	-18.257	< 0.001
（35 ± 5）Hz组	20	41.65 ± 3.92	51.60 ± 4.96^bc	-20.566	< 0.001	24.55 ± 3.73	19.35 ± 3.51^bc	19.436	< 0.001	40.75 ± 2.89	48.46 ± 4.25^bc	-13.226	< 0.001
F值		1.367	10.537			1.131	8.848			1.496	8.636
P值		0.263	< 0.001			0.330	< 0.001			0.233	< 0.001

[1]	Liangwen SUN,Chunxia WEI,Miao LIU,Min LU,Shaojun GAO,Bo WANG,Qiang DUAN,Wei LI,Xiaoqun HUANG. Effects of whole body vibration training combined with blood flow restriction on motor function and community activity in elderly stroke patients with hemiplegia [J]. The Journal of Practical Medicine, 2024, 40(20): 2874-2879.
[2]	CHEN Hong, HUANG Yuyan, HUANG Houqiang.. Effect of whole body vibration training with different frequencies on balance and walking function of stroke patients [J]. The Journal of Practical Medicine, 2021, 37(16): 2160-2163.

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

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