《Chinese Journal of Rehabilitation Theory and Practice》 ›› 2023, Vol. 29 ›› Issue (1): 55-63.doi: 10.3969/j.issn.1006-9771.2023.01.008
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WANG Yunting, SONG Beibei, ZHAO Di, BAI Kaixiang()
Received:
2022-12-29
Revised:
2022-12-30
Published:
2023-01-25
Online:
2023-02-17
Contact:
BAI Kaixiang, E-mail: 347973428@qq.com
Supported by:
CLC Number:
WANG Yunting, SONG Beibei, ZHAO Di, BAI Kaixiang. Health and functional outcome of whole body vibration for children and adolescents with cerebral palsy: a systematic review using WHO-FICs[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(1): 55-63.
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人群(Population) | 干预 (Intervention) | 比较 (Comparison) | 结局 (Outcome) | ||
---|---|---|---|---|---|
健康及健康相关状况 | ICD-11编码 | ICF编码 | |||
疾病类型 脑瘫 功能障碍 神经肌肉骨骼和运动有关功能 活动和参与功能 年龄3~12.3岁 | 08神经系统疾病 L1-8D2 脑瘫 8D20痉挛型脑瘫 8D20.1痉挛型双侧脑瘫 8D20.10痉挛型四肢瘫脑瘫 8D2Z未特指的脑瘫 | b 身体功能 b7 神经肌肉骨骼功能 s 身体结构 s7 与运动有关的结构 d 活动与参与 d4 活动 d5 自理 | 干预姿势 卧位 站位 蹲位 干预方式 振动频率 振幅 干预时间 干预场所 医疗机构 学校 家庭 干预属性 治疗性 恢复性 | 是否接受WBVT | 身体运动功能 b710 关节活动功能 b730 肌肉力量功能 b735 肌张力功能 b760 随意运动控制功能 s7 与运动有关的结构 活动和参与 d410 改变身体的基本姿势 d415 保持一种身体姿势 d420 移动自身 d450 步行 d455 到处移动 |
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研究 | 国家 | 样本特征 | 健康及功能状况 | 干预场所 | 干预属性 | 干预方案 | 比较 | 健康结局指标 |
---|---|---|---|---|---|---|---|---|
Ibrahim等[ (2014) | 埃及 | 痉挛型双侧脑瘫 年龄8~12岁,平均9.63岁 样本量30 | 能使用或不使用助行器行走,步态异常,能听懂或听从指令,MAS分级1~2级 | 医疗机构 | 治疗性康复 恢复性康复 | 患者穿鞋站在交替振动平台上,膝盖略微弯曲 频率12~18 Hz 振幅4~6 mm 每次9 min,每周3次,共3个月 | 接受WBVT改善膝关节伸肌力量和痉挛程度、步行能力、运动能力 | 身体运动功能 膝关节伸肌力量增加 膝关节伸肌痉挛程度降低 活动与参与 GMFM (E区)评分提高 步速加快 |
Ali 等[ (2021) | 埃及 | 痉挛型双侧脑瘫 年龄4~6岁 样本量30 | MAS分级1级和1+级 | 医疗机构 | 治疗性康复 恢复性康复 | 患者蹲在振动平台上,保持这种姿势 频率30 Hz 振幅2 mm 每次10 min,每周3次,共12周 | 接受WBVT改善腹肌厚度、坐立能力和粗大运动能力效果更好 | 身体运动功能 腹内斜肌厚度增加17.39%、腹外斜肌增加31.25%、腹横肌增加29.03%、腹直肌增加14.93% 坐立能力改善 活动与参与 GMFM-88总分提高29.41% |
EI-Shamy[ (2014) | 埃及 | 痉挛型双侧脑瘫 年龄8~12岁 样本量30 | 使用或不使用助行器的情况下能够行走,MAS分级1+~2级,能理解和遵循简单的语言指令 | 医疗机构 | 治疗性康复 恢复性康复 | 患者站在左右交替的垂直正弦振动平台,膝、髋关节屈曲10°~45° 频率12~18 Hz 振幅2~6 mm 每次9 min,每周5次,共3个月 | 接受WBVT改善肌力、姿势控制和平衡作用更好 | 身体运动功能 股四头肌肌力增强 总体稳定性指数、前后稳定性指数和内侧稳定性指数增加 活动与参与 保持身体姿势能力改善 |
Cheng等[ (2015) | 中国 | 痉挛型双侧脑瘫或痉挛型四肢瘫脑瘫 年龄9.2岁 样本量16 | 在佩戴或不佩戴助行器的情况下步行至少6 min,具有理解命令的能力 | 医疗机构 | 治疗性康复 恢复性康复 | 患者站在垂直振动平台上,膝盖从完全伸展到微屈曲约30°,必要时抓住栏杆 频率20 Hz 振幅2 mm 每次10 min,每周3次,共8周 | 接受WBVT可改善肌肉张力、关节活动范围和步行能力 | 身体运动功能 膝关节伸肌MAS评分下降 膝关节主动关节活动度增加 活动与参与 步行能力改善,步行速度提高 |
Lee等[ (2013) | 韩国 | 痉挛型双侧脑瘫或痉挛型四肢瘫脑瘫 年龄:试验组平均10岁,对照组平均9.6岁 样本量30 | 健康状况未详细说明 | 医疗机构 | 治疗性康复 恢复性康复 | 患者赤脚站在左右交替的垂直正弦振动平台,采取下蹲姿势 频率5~25 Hz 振幅1~9 mm 每周3次,共8周 | 接受WBVT改善步行能力、踝关节活动度、胫骨前肌和比目鱼肌厚度 | 身体运动功能 胫骨前肌和比目鱼肌厚度分别增加0.15 cm和0.18 cm 踝关节活动度增加6.28° 活动与参与 步速提高0.11 m/s,步长增加0.1 m,步行周期缩短0.27 s 活动能力改善 |
Ruck等[ (2010) | 加拿大 | 脑瘫(未特指) 年龄6.2~12.3岁 样本量20 | 粗大运动分级Ⅱ~Ⅳ级 | 学校 | 治疗性康复 | 患者置于倾斜台上,双脚穿鞋接触左右交替的垂直正弦振动板 频率12~18 Hz 振幅2~6 mm 每次9 min,每周3~5次,共6个月 | 接受WBVT改善步速 | 活动与参与 10米步行测试用时缩短 活动能力改善 |
Wren 等[ (2010) | 美国 | 脑瘫(未特指) 年龄6~12岁 样本量31 | 能在有或没有辅助(如助行器)的情况下站立10 min | 家庭 | 治疗性康复 恢复性康复 | 患者站在振动平台,可佩戴踝足矫形器 频率30 Hz 振幅未说明 每次10 min,共6个月 | 接受WBVT增加胫骨干皮质骨面积 | 身体运动功能 胫骨干皮质骨面积增加,结构特性改善 |
严善钟等[ (2021) | 中国 | 痉挛型脑瘫 年龄3~6岁 样本量40 | 粗大运动分级Ⅰ~Ⅳ级 | 医疗机构 | 治疗性康复 恢复性康复 | 患者赤足,双腿屈膝30°~40°,站在左右交替振动平台上,双脚分开与肩同宽并与平台中心等距 频率5~25 Hz 振幅0~5.2 mm 每次15 min,每周5次,共12周 | 接受WBVT改善运动能力、步行 | 身体运动功能 坐立位能力增强 活动与参与 GMFM-88 D区和E区评分增加 Peabody运动发育量表中姿势项、移动项增加 10米步行测试时间缩短 |
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研究 | 资格标准 | 随机分配 | 分配隐藏 | 基线相似 | 被试施盲 | 治疗师施盲 | 评估者施盲 | 被试流失率≤ 15% | 意向性分析 | 组间统计比较 | 变异性测量 | 总分 |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Ibrahim等[ | √ | √ | √ | √ | √ | 4 | ||||||
Ali等[ | √ | √ | √ | √ | √ | √ | √ | 6 | ||||
Ei-Shamy[ | √ | √ | √ | √ | √ | √ | √ | √ | √ | 8 | ||
Cheng等[ | √ | √ | √ | √ | √ | 4 | ||||||
Lee等[ | √ | √ | √ | √ | √ | √ | √ | √ | 7 | |||
Ruck等[ | √ | √ | √ | √ | √ | √ | 5 | |||||
Wren等[ | √ | √ | √ | √ | √ | √ | √ | √ | 7 | |||
严善钟等[ | √ | √ | √ | √ | √ | √ | √ | √ | 7 |
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