全身振动训练对脑卒中患者步态的影响

关键词：脑卒中  全身振动  三维步态分析  地面反作用力

Keywords:stroke  whole body vibration  three-dimensional gait analysis  ground reaction force

摘要：

      摘要 目的：利用三维步态分析系统，定量地评价全身振动训练（WBVT）对脑卒中恢复期患者步态的影响。 方法：选择14例脑卒中患者进行WBVT (2组，5min/组，10min，中间间隔1min，频率30Hz，振幅5mm)，于WBVT前及训练后即刻行三维步态分析，收集患者WBVT前后时空参数、关节运动角度以及动力学参数，比较患者WBVT前后各步态参数的差异，应用SPSS 21.0统计软件对患者的步态参数进行统计学分析。 结果：经WBVT后，脑卒中患者患侧时空参数及足蹬地时踝关节跖屈角度、膝关节屈曲角度、踝关节跖屈力矩占体重百分比及向前地面反作用力峰值占体重百分比（AGRF）均改善（P＜0.05）；WBVT前后，患侧AGRF与步速、步长、摆动相百分比均呈正相关（P＜0.05）。WBVT前，患侧AGRF与足蹬地时髋关节屈曲角度呈正相关（P＜0.05），WBVT后，患侧AGRF与足蹬地时踝跖屈角度呈正相关（P＜0.05）。 结论：WBVT可以辅助改善脑卒中患者患足蹬地时即刻步态，长期效果尚待进一步研究。

Abstract:

      Abstract Objective: To quantitatively evaluate the effect of whole body vibration training (WBVT) on the gait of stroke patients in convalescence by using the three-dimensional gait analysis system. Method: Fourteen stroke patients were selected for WBVT (2 groups， 5min/ group， 10min， interval 1min， frequency 30Hz， amplitude 5mm). Three-dimensional gait analysis was performed before and immediately after WBVT training. Spatial and temporal parameters， joint motion Angle and dynamic parameters were collected before and after WBVT.SPSS 21.0 was used to analyze the gait parameters of the patients. Result: After WBVT， the spatial and temporal parameters of the affected limb， the flexion angle of the ankle joint， the flexion angle of the knee joint， the flexion moment of the ankle joint in the percentage of body weight and the percentage of the peak of the reaction force to the front ground (AGRF) were all improved (P<0.05). Before and after WBVT，the AGRF of the affected limb was positively correlated with step speed， step length， and swing period percentage (P<0.05) .Before WBVT， the AGRF of the affected limb was positively correlated with the flexion angle of the hip joint when the foot was pushing on the ground (P<0.05); after WBVT， the AGRF of the affected limb was positively correlated with the flexion angle of the ankle plantar when the foot was pushing on the ground (P<0.05). Conclusion: WBVT can facilitate to improve the immediate gait of stroke patients when pushing on the ground， and the long-term effect remains to be further studied.