振动疗法在康复中的应用及其影响因素
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摘要
振动疗法利用振动因素使人体局部组织或全身发生周期性或非周期性的变化,从而产生治疗效果,其作为一种物理疗法在康复领域中发挥着重要的作用。应用振动疗法时,最主要的影响因素是频率参数的选择,认为存在一种最佳振动频率(谐振)是提高疾病康复效果的最有效方法。应用最佳振动频率刺激作用于机体使之能够在短时间内对神经肌肉性能产生影响,并对其进行时-量-效标准化分析以进一步优化振动疗法,这具有进一步深入研究的意义。本文将从振动疗法的定义、起源、作用原理、在康复治疗中的应用、影响因素以及未来振动疗法的优化等方面进行综述,并提出关于谐振的初步探讨。
Vibration therapy which utilizes vibration factors to produce periodical or nonperiodic changes in the local tissue or the whole body of human for treatment plays an important role in the field of rehabilitation as a physical therapy. The most important influencing factor in vibration therapy is the choice of frequency parameters. It is considered that there is an optimal vibration frequency(resonance) which is the most effective method to improve the efficiency of rehabilitation treatment. Applying the best vibration frequency to stimulate the body can make it possible to affect the neuromuscular performance in a short time,and performing time-quantity-effect standardization analysis can further improve vibration therapy, which is worthy of further study. Herein the definition, origin and application of rehabilitation therapy are reviewed; influencing factors and the optimizations of vibration therapy in the future are summarized; and a preliminary discussion on resonance is presented.
Vibration therapy which utilizes vibration factors to produce periodical or nonperiodic changes in the local tissue or the whole body of human for treatment plays an important role in the field of rehabilitation as a physical therapy. The most important influencing factor in vibration therapy is the choice of frequency parameters. It is considered that there is an optimal vibration frequency(resonance) which is the most effective method to improve the efficiency of rehabilitation treatment. Applying the best vibration frequency to stimulate the body can make it possible to affect the neuromuscular performance in a short time,and performing time-quantity-effect standardization analysis can further improve vibration therapy, which is worthy of further study. Herein the definition, origin and application of rehabilitation therapy are reviewed; influencing factors and the optimizations of vibration therapy in the future are summarized; and a preliminary discussion on resonance is presented.
引文
[1]符之富.振动疗法结合超声波治疗膝关节侧副韧带损伤的临床观察[D].哈尔滨:黑龙江中医药大学,2017.FU Z F.Vibration therapy combined with ultrasound treatment clinical observation of the injury collateral ligament of the knee joint[D].Harbin:Heilongjiang University of Chinese Medicine,2017.
[2]PERCHTHALER D,HORSTMANN T,GRAU S.Variations in neuromuscular activity of thigh muscles during whole-body vibration in consideration of different biomechanical variables[J].J Sport Sci Med,2013,12(3):439-446.
[3]EKLUND G,HAGBARTY K E.Normal variability of tonic vibration reflexs in men[J].Exp Neurol,1966,16:80-92.
[4]JOHNSTON R M,BISHOP B,COFFEY G H.Mechanical vibration of skeletal muscles[J].Phys Ther,1970,50(4):499.
[5]张小满,石萍,喻洪流.振动疗法在康复中的研究及应用[J].北京生物医学工程,2016,35(5):538-543.ZHANG X M,SHI P,YU H L.Vibration therapy and its application in rehabilitation[J].Beijing Biomedical Engineering,2016,35(5):538-543.
[6]王兴泽.振动负荷训练研究进展[J].中国运动医学杂志,2012,31(7):648-653.WANG X Z.Research progress on vibration load training[J].Chinese Journal of Sports Medicine,2012,31(7):648-653.
[7]方成华,邹晓峰.不同频率振动训练对速滑运动员下肢爆发力的影晌[J].沈阳体育学院学报,2013,32(5):125-127.FANG C H,ZOU X F.Effects of lower limbs muscle strength with vibration training on different frequency[J].Journal of Shenyang Sport University,2013,32(5):125-127.
[8]张少伟,邹晓峰,张浩.全身振动训练对老年人下肤肌力影响的实验研究[J].沈阳体育学院学报,2013,32(4):79-81.ZHANG S W,ZOU X F,ZHANG H.Effects of whole-body vibration exercise on lower-extremity muscle strength and power of the elderly[J].Journal of Shenyang Sport University,2013,32(4):79-81.
[9]CARDINALE M,BOSCO C.The use of vibration as an exercise intervention[J].Exerc Sport Sci Rev,2003,31(1):3.
[10]RITTWEGER J,MUTSCHELKNAUSS M,FELSENBERG D.Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise[J].Clin Physiol Funct Imaging,2003,23:81-86.
[11]张丽,瓮长水.全身振动训练及其对脑卒中患者运动功能康复价值[J].中国实用内科杂志,2013,33(8):587-590.ZHANG L,WENG C S.Whole body vibration training and its value in rehabilitation of motor function in stroke patients[J].Chinese Journal of Practical Internal Medicine,2013,33(8):587-590.
[12]COCHRANE D,STANNARD S.Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players[J].Br J SportsMed,2005,39(11):860-865.
[13]CELLETTI C,FARA M A,FILIPPI G M,et al.Focal muscle vibration and physical exercise in postmastectomy recovery:an explorative study[J].Biomed Res Int,2017,2017(4):7302892.
[14]CALABRòR S,NARO A,RUSSO M,et al.Is two better than one?Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function:a pilot randomized controlled trial[J].PLoSOne,2017,12(10):e0185936.
[15]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906.ZHU C E,YU B,ZHANG W,et al.Observation on clinical efficacy of muscle vibration therapy combined with conventional rehabilitation treating shoulder-hand syndrome after stroke[J].Chinese Journal of Rehabilitation Medicine,2017,32(8):902-906.
[16]陈钊德,龙耀斌,梁天佳,等.局部振动对脑卒中后偏瘫患者上肢痉挛和功能障碍的影响[J].中华物理医学与康复杂志,2015,37(8):600-601.CHEN Z D,LONG Y B,LIANG T J,et al.Effects of local vibration on upper limb paralysis and dysfunction in patients with hemiplegia after stroke[J].Chinese Journal of Physical Medicine and Rehabilitation,2015,37(8):600-601.
[17]NOMA T,MATSUMOTO S,SHIMODOZONO M,et al.Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients:a proof-ofprinciple study[J].J Rehabil Med,2012,44(4):325-330.
[18]CHEN C M,TSAI C C,CHUNG C Y,et al.Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation[J].Health Qual Life Out,2015,13(1):1-10.
[19]GERHARDT F,DUMITRESCU D,G?RTNER C,et al.Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension:a randomised clinical study[J].Heart,2017,103(8):592-598.
[20]SA?UDO B,CéSAR-CASTILLO M,TEJERO S,et al.Cardiac autonomic response during recovery from a maximal exercise using whole body vibration[J].Complement Ther Med,2013,21(4):294-299.
[21]AAE S,YOUSSEF E F,MUAIDI Q I,et al.Whole body vibration versus magnetic therapy on bone mineral density in elderly osteoporotic individuals[J].J Back Musculoskelet,2017,30(4):1-10.
[22]EL-SHAMY S.Effect of whole body vibration training on quadriceps strength,bone mineral density,and functional capacity in children with hemophilia:a randomized clinical trial[J].J Musculoskel Neuron,2017,17(2):19-26.
[23]陆铁,仲维佳,周君琳,等.全身振动对预防老年女性骨质疏松性骨折的作用[J].中华临床医师杂志(电子版),2012,6(5):1113-1116.LU T,ZHONG W J,ZHOU J L,et al.Effect of whole body vibration on the postmenopausal osteoporotic fracture[J].Chinese Journal of Clinicians(Electronic Version),2012,6(5):1113-1116.
[24]方斌,易春智,陈雷雷,等.全身机械振动对老年男性骨质疏松症患者骨密度和生活质量的影响[J].广东医学,2014(16):2548-2551.FANG B,YI C Z,CHEN L L,et al.Effects of whole body mechanical vibration on bone mineral density and quality of life in elderly male osteoporosis patients[J].Guangdong Medical Journal,2014(16):2548-2551.
[25]SAGGINI R,ANCONA E,CARMIGNANO S M,et al.Effect of combined treatment with focused mechano-acoustic vibration and pharmacological therapy on bone mineral density and muscle strength in post-menopausal women[J].Clinical Cases in Mineral&Bone Metabolism,2017,14(3):305.
[26]黄鹏.不同频率振动刺激对废用性肌萎缩大鼠康复效果及机制研究[D].北京:北京体育大学,2012.HUANG P.Rehabilitation effect and mechanism of different frequency vibration stimulation on disuse atrophy in rats[D].Beijing:Beijing Sport University,2012.
[27]WAKELING J M,NIGG B M,ROZITIS A I.Muscle activity damps the soft tissue resonance that occurs in response to pulsed and continuous vibrations[J].J Appl Physiol,2002,93(3):1093-1103.
[28]RITZMANN R,GOLLHOFER A,KRAMER A.The influence of vibration type,frequency,body position and additional load on the neuromuscular activity during whole body vibration[J].Eur J Appl Physiol,2013,113(1):1-11.
[29]DOUCET B M,GRIFFIN L.High-versus low-frequency stimula-tion effects on fine motor control in chronic hemiplegia:a pilot study[J].Top Stroke Rehabil,2013,20(4):299-307.
[30]TAVERNESE E,PAOLONI M,MANGONE M,et al.Segmental muscle vibration improves reaching movement in patients with chronic stroke.A randomized controlled trial[J].Neurorehabilitation,2013,32(3):591-599.
[31]CONSTANTINO C,GALUPPO L,ROMITI D.Efficacy of mechanoacoustic vibration on strength,pain,and function in post-stroke rehabilitation:a pilot study[J].Top Stroke Rehabil,2014,21(5):391-399.
[32]DI GIMINIANI R,TIHANYI J,SAFAR S,et al.The effects of vibration on explosive and reactive strength when applying individualized vibration frequencies[J].J Sports Sci,2009,27:169-177.
[33]CARLUCCI F,ORLANDO G,HAXHI J,et al.Older age is associated with lower optimal vibration frequency in lower-limb muscles during whole-body vibration[J].Am J Phys Med Rehabil,2015,94:522-529.
[34]GIOMBINI A,MACALUSO A,LAUDANI L,et al.Acute effect of whole-body vibration at optimal frequency on muscle power output of the lower limbs in older women[J].Am J Phys Med Rehabil,2013,92:797-804.
[35]LABANCA L,LAUDANI L,MENOTTI F,et al.Asymmetrical lower extremity loading early after anterior cruciate ligament reconstruction is a significant predictor of asymmetrical loading at the time of return to sport[J].Am J Phys Med Rehabil,2016,95:248-255.
[36]MATTSSON E.Energy cost of level walking[J].Scand J Rehabil Med Suppl,1989,23:1-45.
[37]NOLLET F,BEELEN A,SARGEANT A J,et al.Submaximal exercise capacity and maximal power output in polio subjects[J].Arch Phys Med Rehabil,2001,82:1678-1685.
[38]古福明,蒋丽.振动训练对大鼠腓肠肌生物力学性能的影响[J].成都体育学院学报,2014,40(7):63-66.GU F M,JIANG L.Effect of vibration training on biomechanical properties of rat gastrocnemius[J].Journal of Chengdu Sport University,2014,40(7):63-66.
[39]张园园.人体肌肉生物谐振刺激的初步研究[D].南京:南京医科大学,2012.ZHANG Y Y.A preliminary study on the bioresonance stimulation of human muscle[D].Nanjing:Nanjing Medical University,2012.
[40]PISTONE E M,LAUDANI L,CAMILLIERI G,et al.Effects of early whole-body vibration treatment on knee neuromuscular function and postural control after anterior cruciate ligament reconstruction:a randomized controlled trial[J].J Rehabil Med,2016,48(48):880-886.
[41]GIOMBINI A,MENOTTI F,LAUDANI L,et al.Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males[J].Biol Sport,2015,32:243-247.
[42]张文通.生物谐振影响脊髓运动神经元兴奋性的电生理研究[D].南京:南京医科大学,2013.ZHANG W T.Electrophysiological study on the effect of biological resonance on the excitability of spinal motor neurons[D].Nanjing:Nanjing Medical University,2013.
[43]LIAO L R,LAM F M,PANG M Y,et al.Leg muscle activity during whole-body vibration in individuals with chronic stroke[J].Med Sci Sports Exerc,2014,46(3):537-545.
[44]TUDOR-LOCKE D C,ROWE D A.Using cadence to study free-living ambulatory behaviour[J].Sports Med,2012,42(5):381-398.
[45]AMOR S,PEFEROEN L A,VOGEL D Y,et al.Inflammation in neurodegenerative diseases-an update[J].Immunology,2014,129(2):154-169.
[2]PERCHTHALER D,HORSTMANN T,GRAU S.Variations in neuromuscular activity of thigh muscles during whole-body vibration in consideration of different biomechanical variables[J].J Sport Sci Med,2013,12(3):439-446.
[3]EKLUND G,HAGBARTY K E.Normal variability of tonic vibration reflexs in men[J].Exp Neurol,1966,16:80-92.
[4]JOHNSTON R M,BISHOP B,COFFEY G H.Mechanical vibration of skeletal muscles[J].Phys Ther,1970,50(4):499.
[5]张小满,石萍,喻洪流.振动疗法在康复中的研究及应用[J].北京生物医学工程,2016,35(5):538-543.ZHANG X M,SHI P,YU H L.Vibration therapy and its application in rehabilitation[J].Beijing Biomedical Engineering,2016,35(5):538-543.
[6]王兴泽.振动负荷训练研究进展[J].中国运动医学杂志,2012,31(7):648-653.WANG X Z.Research progress on vibration load training[J].Chinese Journal of Sports Medicine,2012,31(7):648-653.
[7]方成华,邹晓峰.不同频率振动训练对速滑运动员下肢爆发力的影晌[J].沈阳体育学院学报,2013,32(5):125-127.FANG C H,ZOU X F.Effects of lower limbs muscle strength with vibration training on different frequency[J].Journal of Shenyang Sport University,2013,32(5):125-127.
[8]张少伟,邹晓峰,张浩.全身振动训练对老年人下肤肌力影响的实验研究[J].沈阳体育学院学报,2013,32(4):79-81.ZHANG S W,ZOU X F,ZHANG H.Effects of whole-body vibration exercise on lower-extremity muscle strength and power of the elderly[J].Journal of Shenyang Sport University,2013,32(4):79-81.
[9]CARDINALE M,BOSCO C.The use of vibration as an exercise intervention[J].Exerc Sport Sci Rev,2003,31(1):3.
[10]RITTWEGER J,MUTSCHELKNAUSS M,FELSENBERG D.Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise[J].Clin Physiol Funct Imaging,2003,23:81-86.
[11]张丽,瓮长水.全身振动训练及其对脑卒中患者运动功能康复价值[J].中国实用内科杂志,2013,33(8):587-590.ZHANG L,WENG C S.Whole body vibration training and its value in rehabilitation of motor function in stroke patients[J].Chinese Journal of Practical Internal Medicine,2013,33(8):587-590.
[12]COCHRANE D,STANNARD S.Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players[J].Br J SportsMed,2005,39(11):860-865.
[13]CELLETTI C,FARA M A,FILIPPI G M,et al.Focal muscle vibration and physical exercise in postmastectomy recovery:an explorative study[J].Biomed Res Int,2017,2017(4):7302892.
[14]CALABRòR S,NARO A,RUSSO M,et al.Is two better than one?Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function:a pilot randomized controlled trial[J].PLoSOne,2017,12(10):e0185936.
[15]朱昌娥,余波,张雯,等.肌肉振动治疗配合常规康复对脑卒中后肩-手综合征的临床效果观察[J].中国康复医学杂志,2017,32(8):902-906.ZHU C E,YU B,ZHANG W,et al.Observation on clinical efficacy of muscle vibration therapy combined with conventional rehabilitation treating shoulder-hand syndrome after stroke[J].Chinese Journal of Rehabilitation Medicine,2017,32(8):902-906.
[16]陈钊德,龙耀斌,梁天佳,等.局部振动对脑卒中后偏瘫患者上肢痉挛和功能障碍的影响[J].中华物理医学与康复杂志,2015,37(8):600-601.CHEN Z D,LONG Y B,LIANG T J,et al.Effects of local vibration on upper limb paralysis and dysfunction in patients with hemiplegia after stroke[J].Chinese Journal of Physical Medicine and Rehabilitation,2015,37(8):600-601.
[17]NOMA T,MATSUMOTO S,SHIMODOZONO M,et al.Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients:a proof-ofprinciple study[J].J Rehabil Med,2012,44(4):325-330.
[18]CHEN C M,TSAI C C,CHUNG C Y,et al.Potential predictors for health-related quality of life in stroke patients undergoing inpatient rehabilitation[J].Health Qual Life Out,2015,13(1):1-10.
[19]GERHARDT F,DUMITRESCU D,G?RTNER C,et al.Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension:a randomised clinical study[J].Heart,2017,103(8):592-598.
[20]SA?UDO B,CéSAR-CASTILLO M,TEJERO S,et al.Cardiac autonomic response during recovery from a maximal exercise using whole body vibration[J].Complement Ther Med,2013,21(4):294-299.
[21]AAE S,YOUSSEF E F,MUAIDI Q I,et al.Whole body vibration versus magnetic therapy on bone mineral density in elderly osteoporotic individuals[J].J Back Musculoskelet,2017,30(4):1-10.
[22]EL-SHAMY S.Effect of whole body vibration training on quadriceps strength,bone mineral density,and functional capacity in children with hemophilia:a randomized clinical trial[J].J Musculoskel Neuron,2017,17(2):19-26.
[23]陆铁,仲维佳,周君琳,等.全身振动对预防老年女性骨质疏松性骨折的作用[J].中华临床医师杂志(电子版),2012,6(5):1113-1116.LU T,ZHONG W J,ZHOU J L,et al.Effect of whole body vibration on the postmenopausal osteoporotic fracture[J].Chinese Journal of Clinicians(Electronic Version),2012,6(5):1113-1116.
[24]方斌,易春智,陈雷雷,等.全身机械振动对老年男性骨质疏松症患者骨密度和生活质量的影响[J].广东医学,2014(16):2548-2551.FANG B,YI C Z,CHEN L L,et al.Effects of whole body mechanical vibration on bone mineral density and quality of life in elderly male osteoporosis patients[J].Guangdong Medical Journal,2014(16):2548-2551.
[25]SAGGINI R,ANCONA E,CARMIGNANO S M,et al.Effect of combined treatment with focused mechano-acoustic vibration and pharmacological therapy on bone mineral density and muscle strength in post-menopausal women[J].Clinical Cases in Mineral&Bone Metabolism,2017,14(3):305.
[26]黄鹏.不同频率振动刺激对废用性肌萎缩大鼠康复效果及机制研究[D].北京:北京体育大学,2012.HUANG P.Rehabilitation effect and mechanism of different frequency vibration stimulation on disuse atrophy in rats[D].Beijing:Beijing Sport University,2012.
[27]WAKELING J M,NIGG B M,ROZITIS A I.Muscle activity damps the soft tissue resonance that occurs in response to pulsed and continuous vibrations[J].J Appl Physiol,2002,93(3):1093-1103.
[28]RITZMANN R,GOLLHOFER A,KRAMER A.The influence of vibration type,frequency,body position and additional load on the neuromuscular activity during whole body vibration[J].Eur J Appl Physiol,2013,113(1):1-11.
[29]DOUCET B M,GRIFFIN L.High-versus low-frequency stimula-tion effects on fine motor control in chronic hemiplegia:a pilot study[J].Top Stroke Rehabil,2013,20(4):299-307.
[30]TAVERNESE E,PAOLONI M,MANGONE M,et al.Segmental muscle vibration improves reaching movement in patients with chronic stroke.A randomized controlled trial[J].Neurorehabilitation,2013,32(3):591-599.
[31]CONSTANTINO C,GALUPPO L,ROMITI D.Efficacy of mechanoacoustic vibration on strength,pain,and function in post-stroke rehabilitation:a pilot study[J].Top Stroke Rehabil,2014,21(5):391-399.
[32]DI GIMINIANI R,TIHANYI J,SAFAR S,et al.The effects of vibration on explosive and reactive strength when applying individualized vibration frequencies[J].J Sports Sci,2009,27:169-177.
[33]CARLUCCI F,ORLANDO G,HAXHI J,et al.Older age is associated with lower optimal vibration frequency in lower-limb muscles during whole-body vibration[J].Am J Phys Med Rehabil,2015,94:522-529.
[34]GIOMBINI A,MACALUSO A,LAUDANI L,et al.Acute effect of whole-body vibration at optimal frequency on muscle power output of the lower limbs in older women[J].Am J Phys Med Rehabil,2013,92:797-804.
[35]LABANCA L,LAUDANI L,MENOTTI F,et al.Asymmetrical lower extremity loading early after anterior cruciate ligament reconstruction is a significant predictor of asymmetrical loading at the time of return to sport[J].Am J Phys Med Rehabil,2016,95:248-255.
[36]MATTSSON E.Energy cost of level walking[J].Scand J Rehabil Med Suppl,1989,23:1-45.
[37]NOLLET F,BEELEN A,SARGEANT A J,et al.Submaximal exercise capacity and maximal power output in polio subjects[J].Arch Phys Med Rehabil,2001,82:1678-1685.
[38]古福明,蒋丽.振动训练对大鼠腓肠肌生物力学性能的影响[J].成都体育学院学报,2014,40(7):63-66.GU F M,JIANG L.Effect of vibration training on biomechanical properties of rat gastrocnemius[J].Journal of Chengdu Sport University,2014,40(7):63-66.
[39]张园园.人体肌肉生物谐振刺激的初步研究[D].南京:南京医科大学,2012.ZHANG Y Y.A preliminary study on the bioresonance stimulation of human muscle[D].Nanjing:Nanjing Medical University,2012.
[40]PISTONE E M,LAUDANI L,CAMILLIERI G,et al.Effects of early whole-body vibration treatment on knee neuromuscular function and postural control after anterior cruciate ligament reconstruction:a randomized controlled trial[J].J Rehabil Med,2016,48(48):880-886.
[41]GIOMBINI A,MENOTTI F,LAUDANI L,et al.Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males[J].Biol Sport,2015,32:243-247.
[42]张文通.生物谐振影响脊髓运动神经元兴奋性的电生理研究[D].南京:南京医科大学,2013.ZHANG W T.Electrophysiological study on the effect of biological resonance on the excitability of spinal motor neurons[D].Nanjing:Nanjing Medical University,2013.
[43]LIAO L R,LAM F M,PANG M Y,et al.Leg muscle activity during whole-body vibration in individuals with chronic stroke[J].Med Sci Sports Exerc,2014,46(3):537-545.
[44]TUDOR-LOCKE D C,ROWE D A.Using cadence to study free-living ambulatory behaviour[J].Sports Med,2012,42(5):381-398.
[45]AMOR S,PEFEROEN L A,VOGEL D Y,et al.Inflammation in neurodegenerative diseases-an update[J].Immunology,2014,129(2):154-169.