足底振动刺激诱发人体特定方向姿势调整的测试系统研究

目的 构建一种能够开展足底皮肤振动刺激对人体姿势控制影响研究的实验测试系统,并验证其有效性。方法 设计制作能够实现振动刺激的机械装置和控制系统,应用生物力学测试方法,于2019年10月2日至6日,对25例健康大学师生开展足底振动刺激实验。选取每位受试者的左足前部、左足后部、右足前部、右足后部、左足、右足、双足前部、双足后部8个振动位置,分别在20 Hz、40 Hz、60 Hz和80 Hz频率下,施加振幅1 mm的振动刺激,对比不同振动条件下的姿势响应情况。结果 足底振动刺激下压力中心响应幅值比与非振动条件下响应幅值有显著性差异(P < 0.05)。结论 测试系统能够对足底不同位置施加不同频率、不同幅值的振动刺激,并且能够采集、分析不同振动条件下受试者压力中心的变化趋势。该系统可以用于足底无毛皮肤振动刺激对于人体姿势控制测试的临床实验研究。     

人体平衡能力的评价系统

平衡是人体一项重要功能,在日常生活中平衡能力对于维持各种姿势、进行各种活动以及对外界干扰产生适宜的反应尤其重要.那么在进行体育运动过程中,平衡能力就更为重要,特别是在技能主导类难度项群的项目中,所以平衡能力的准确测定在国民体质监测、运动选材及平衡能力训练过程中具有现实意义.文章较详细地介绍了目前人体甲衡测试系统的研究现状,得出到目前为止对人体平衡能力的评价仅局限于单一的利用平衡量表或平衡测试仪,还没有几种测试方法的结合或配备其他一些辅助方法来综合反应人体平衡能力,比如步态、足底压力以及下肢肌肉力量等测试等手段,还未形成一个完善、合理和科学评价人体平衡能力的评价体系.     

上肢改良多方向伸展测试的信度与效度分析

目的：进行上肢改良多方向伸展测试(modified multi-directional reach test,mMDRT)的内部一致性研究，并提供一种可能的数据处理方法，为m MDRT在平衡评估中的应用提供基础。方法：应用mMDRT评估健康大学生青年平衡能力，将各方向数据进行内部一致性检验，并分析人体形态学偏倚的影响，进行数据标准化。结果：mMDRT内部一致性良好，各方向最大伸展距离均为高度相关。上肢综合长度与mMDRT各方向数据均高度相关，将最大伸展距离进行标准化处理，转换为个体上肢综合长的倍数，可一定程度上消除人体形态学偏倚的影响。结论：m MDRT内部一致性良好，在其进一步运用时需注意人体形态学偏倚造成的影响。     

全身振动对绝经后妇女平衡能力的影响

目的：通过对绝经后妇女进行16周的振动训练,研究振动刺激对绝经后妇女平衡能力的影响。方法：21例50—63岁绝经后妇女随机分为实验组和对照组,采用Postural Equa平衡分析系统测量平衡能力等各项指标。实验组采用振动干预,对照组不接受任何干预。振动方案为：频率30—45Hz、20min/次,3次/周,连续16周。结果：组内对比,实验组在实验后,在闭眼状态下,压力中心（COP）指标中的Y值、最大摆幅（ML）值、线形图面积（AREA）值都明显低于实验前,分别下降7.33mm、8.33mm、16.67mm（P<0.05）;在睁眼状态下,其他各指标差异不明显。组间对比,实验组与对照组在实验前后,在睁眼和闭眼状态下静态平衡指标COP、TL、ML和AREA也未见有明显改变（P>0.05)。结论：16周的全身振动训练方案可以明显改善绝经期妇女的静态平衡功能。     

全身振动改善脑卒中患者肢体运动功能障碍：目前证据不足

背景：全身振动训练作为新兴的神经肌肉训练方法,经研究发现能有效提高老年人肌力和姿势控制能力。近年来研究者将全身振动训练应用于脑卒中患者,探索其是否能减轻患者的运动功能障碍。目的：阐述全身振动对脑卒中患者患侧肢体肌力、肢体肌张力及平衡与步态的影响国内外研究的进展。方法：通过检索PubMed、EBSCO、Medline等数据库2002年1月至2014年6月与全身振动训练干预脑卒中患者肢体功能障碍的相关研究,选择34篇文献进行分别探讨。结果与结论：全身振动训练干预脑卒中患者具有较强的可行性和安全性。在疗效方面,研究主要关注肌力、肌张力、平衡功能、姿势控制能力,但目前全身振动训练改善脑卒中患者运动功能障碍的证据不足。在具体的振动干预方案方面,振动的类型、频率、振幅、时间暂无公认的标准,也待进一步研究。目前临床疗效观察研究较多,缺乏对全身振动训练影响机制的研究,其疗效有待更多大样本、多中心随机对照实验验证。     

Flexi-bar主动振动训练对脑卒中恢复期患者步行能力及平衡功能的影响

目的：观察使用Flexi-bar主动振动训练对脑卒中恢复期患者步行能力及平衡功能的影响。方法：将43名脑卒中恢复期患者随机分为对照组21例和观察组22例。2组患者均给予常规康复治疗,观察组患者在常规康复治疗的基础上给予Flexi-bar主动振动训练。在治疗前、治疗4周后,采用10m步行测试 (10MWT),起立-行走计时测试(TUGT）及Berg平衡量表(BBS)评估2组患者步行能力及平衡功能。结果：治疗4周后,2组患者10MWT、TUGT值较治疗前明显降低 (P<0.05),BBS明显升高 (P<0.05),且治疗4周后观察组各指标均显著优于对照组水平,组间差异均具有统计学意义 (P<0.05)。结论：Flexi-bar主动振动训练结合常规康复治疗对脑卒中恢复期患者步行能力及平衡功能的改善较为明显。     

中国大学生46例足底压力分布测量

背景：人体的足底压力分布反映了有关足的结构功能及整个身体姿势控制等情况。目的：探讨大学生足底压力参数的分布规律及其足健康的影响因素。设计、时间及地点：调查分析，于2006-10／2007—03在山东理工大学大学生体质健康研究中心进行足底压力测试。对象：随机抽取山东理工大学2005级普通专业大学生46名，男25名，女21名。方法：采用实验法和问卷调查法进行测试。测试时均脱鞋袜，以个人平常步态自然行走，一步法测量两脚各2次动态足底压力，计算足底各个区域的峰力值、达峰力值时间、各区域冲量等指标。测试同时围绕有关足健康的相关问题随之进行问卷调查。主要观察指标：大学生足底各区域最大压力分布、达峰力值时间分布及冲量分布；足内、外翻情况；足健康影响因素分析。结果：足跟内侧平均峰力值最大，其次是第2、3跖骨；第2～5趾和第5跖骨足底平均峰力值较小，男、女分布规律基本一致。足底各区域达峰力值时间按照行走过程中足底接触地面顺序呈依次递增趋势，即足跟〈足弓〈跖骨〈脚趾。行走过程中足底冲量最大的区域主要分布在足跟内侧，最小区域在第2～5趾。行走过程中的受力平衡情况，左足外翻情况比较严重，并且男女生分布规律一致。动态足底压力的改变多考虑与穿鞋类型、足底的皮褶厚度、走路习惯、运动及保健按摩等因素有关。结论：大学生足底压力分布特征与正常人分布特征基本一致，但某些区域存在着性别差异和左右足差异。其中部分学生足部健康意识淡薄，并存存着不同程度的足内、外翻现象。     

穴位TENS对正常年轻人热痛阈特异性抑制作用的研究

目的：探讨经皮神经电刺激疗法（TENS）对人体实验性热痛阈及实验性振动阀的影响，从而阐明TENS作用机理。方法：20名正常人，年龄在20－39岁，随机分为TENS组和空白刺激组，每位受试者左手合谷穴和大鱼际区接受30min，TENS（200us,100Hz,2-3倍感觉阈）或空白刺激，分别采用Medoc TSA 2001和Medoc VSA-300对受试者左手鱼际区的热痛阈和振动阈进行测定，并分析在TENS或空白刺激前的30，20，10min及刺激后0，10，20，30，40，50min记录热痛阈和振动阈，采用逐步回归分析法对结果进行分析。结果：本研究显示与空白刺激相比，30min的TENS治疗后即刻，即0min(P=0.002)和20min(P=0.004)热痛阈显著增高，增高值分别为0．81℃和1．54℃。而同一治疗方案在同一人群中对振动阈无改变。结论：TENS作用于针灸穴位具有镇痛的特异性，而对其他感觉如振动觉无改变。换言之，TENS可能通过激活粗纤维传导，抑制细胞传导的痛觉，从而达到镇痛的作用。     

老年人健身背向走的足底压力与步态特征

摘要 目的：研究健身背向走时的动态足底压力分布,对老年人健身锻炼提出建议。 方法：采用Footscan高频足底压力测试系统检测48名老年人自然正向走及背向走时的动态足底压力分布,对比分析背向走步态特征。 结果：背向走时足底压力-时间曲线呈单峰型。背向走时第2跖骨、第1跖骨、第2—5趾骨处的冲量小于正向走,足跟、第4跖骨、第5跖骨、足弓处的冲量大于正向走,差异具有显著性意义;背向走时第2跖骨、第3跖骨、第4跖骨处的最大压强小于正向走,足跟与第1跖骨处的最大压强大于正向走,差异具有显著性意义;背向走时足底压力中心较正常步行变化范围大。 结论：背向走较正向走可以使足底各部位压力分布均匀,并能锻炼平衡控制能力及肌肉调节能力。     

不同振动条件下的正常人体下肢肌肉表面肌电分析

摘要 目的：通过施加不同条件下的局部振动刺激,探讨局部振动刺激对于正常人体下肢主要肌肉群的影响。利用表面肌电（sEMG）分析的方法探寻局部振动刺激最佳的振动频率与位置。 方法：正常男大学生10名,年龄（23.0±1.7）岁,身高（173.5±4.5）cm,体重（70.4±8.2）kg。分别于屈膝30°半蹲位接受频率为10—50Hz的振动刺激,并采集振动前,振动中的表面肌电。选取左腿股直肌（REC）、半腱肌（SEM）、左腿胫骨前肌（TA）与腓肠肌内侧头（MG）作为试验检测肌肉,分别以左胫骨前肌远端和跟腱为振动刺激点。分析不同条件的振动刺激激活下肢肌群的表面肌电特征。 结果：各种振动条件刺激均引起小腿肌肉放电量增加（P＜0.05)。胫骨前肌的肌电值在两种刺激位置下且在不同频率间差异均有显著性意义（P＜0.05）,但30Hz、40Hz、50Hz间差异无显著性意义。腓肠肌的肌电值在胫前肌刺激位置下各频率间差异无显著性意义,跟腱刺激点下各种频率间均存在显著性差异（P＜0.05）,但30Hz、40Hz、50Hz间差异无显著性意义。各种振动条件刺激对大腿肌肉肌电值影响均无显著性意义。 结论：不同条件的小腿局部振动刺激均引起小腿肌肉放电量增加,未对大腿肌肉产生显著影响。频率30—50Hz为正常人体小腿肌肉最佳的振动刺激频率。振动刺激作用在肌腱位置能有效引起肌肉兴奋,跟腱较胫前肌肌腱位置更易激活小腿肌肉肌群。     

Robot-assisted assessment of vibration perception and localization on the hand

Sensory perception is crucial for motor learning and the control of fine manipulations. However, therapy after stroke still strongly focuses on the training of motor skills. Sensory assessments are often left out or provide only very subjective data from poorly controlled stimuli. This paper presents a vibration detection/localization test with the Robotic Sensory Trainer, a device that focuses entirely on the assessment and training of sensory function of the hand, with the aim of gaining insights into the prevalence and severity of sensory deficits after stroke, and to provide semiobjective data on absolute and difference perception thresholds in patients. An initial feasibility study investigated localization performance and reaction time during the discrimination of vibration stimuli presented in four locations on the dominant and nondominant hands of 13 healthy volunteers. High correct detection rates were observed (mean ± SD of 99.6% ± 0.6%), touch screen PC Robotic Sensory Trainer which were found to be significantly different between stimulus locations on the dominant hand. Average correct detection rates were not statistically different between dominant and nondominant hand. These data will serve as baseline for future measurements on elderly and stroke subjects, and suggest that data from the nonimpaired hand could be used to identify and assess sensory deficits in the affected hand of stroke patients.

Implications for Rehabilitation

• Sensory deficits may limit functional recovery after stroke, are poorly documented and often neglected in current therapeutic programs.

• Clinical sensory assessments are not well standardized, lack sensitivity and suffer from high variability.

• We present a novel device for the semiobjective assessment of hand sensory function, capable of providing vibration, proprioception and pressure stimuli.

• Vibration perception and localization on the hand were tested on 13 healthy subjects to serve as baseline data for future measurements with stroke patients.

     

Effects of whole‐body vibration on heart rate variability: acute responses and training adaptations

Heart rate variability (HRV) is a noninvasive and practical measure of cardiac autonomic nervous system function, mainly the sympathetic and parasympathetic modulations of heart rate. A low HRV has been shown to be indicative of compromised cardiovascular health. Interventions that enhance HRV are therefore beneficial to cardiovascular health. Whole‐body vibration (WBV) training has been proposed as an alternative time‐efficient exercise intervention for the improvement of cardiovascular health. In this review, we discuss the effect of WBV both acute and after training on HRV. WBV training appears to be a useful therapeutic intervention to improve cardiac autonomic function in different populations, mainly through decreases in sympathovagal balance. Although the mechanisms by which WBV training improves symphathovagal balance are not yet well understood; enhancement of baroreflex sensitivity, nitric oxide bioavailability and angiotensin II levels seem to play an important role.     

A systematic review of studies investigating the effects of controlled whole‐body vibration intervention on peripheral circulation

The findings of the published studies investigating the changes in peripheral circulation induced by exposure to whole‐body vibration (WBV) are not consensual or conclusive. Also, those studies did not consider the role of vibration magnitude on the peripheral circulatory responses making the interpretation of the observed findings difficult. We aimed to review the published literature investigating the effects of controlled WBV intervention on peripheral circulation by characterizing the relevant exposure conditions including vibration magnitudes, and ascertain the specific patterns of responses in peripheral circulation of the lower extremity from such exposure. A computerized search was performed in PubMed and Scopus using selected key search terms, and the relevant data were extracted. The vibration magnitude in the included studies frequently exceeded the limit specified in the International Standard ISO 2631‐1 (1997) for such exposure. As observed, exposure to WBV with frequencies ≤30 Hz caused an improvement in peripheral blood flow (BF) and/or skin temperature (ST) of the lower extremity. In contrast, the responses in BF and ST from exposure to WBV of higher frequencies (31 Hz–50 Hz) produced conflicting results. The findings of this review indicate that WBV exposure with relatively lower frequency and magnitude can be safely and effectively used to induce improvements in peripheral circulation. For this purpose, the limits recommended by the ISO 2631‐1 (1997) should be considered till safe and effective vibration‐related parameters are established.     

The acute effects of different whole body vibration amplitudes on the endocrine system of young healthy men: a preliminary study

Whole body vibration (WBV) has been suggested as an alternative form of exercise producing adaptive responses similar to that of resistance training. Very limited information is available on the effects of different vibration parameters on anabolic hormones. In this study, we compared the acute effects of different WBV amplitudes on serum testosterone (T) and insulin growth factor-1 (IGF-1). Nine healthy young recreationally active adult males (age 22 +/- 2 years, height 181 +/- 6.3 cm, weight 77.4 +/- 9.5 kg) voluntarily participated in this randomized controlled (cross-over design) study. The subjects performed 20 sets of 1 min each of WBV exercise in the following conditions: Non-vibration condition (control), low amplitude vibration [low (30 Hz, 1.5 mm peak-to-peak amplitude)] and high amplitude vibration [high (30 Hz, 3 mm peak-to-peak amplitude)]. Blood samples were collected before, after 10 sets, at the end (20th set) and after 24 h of the exercise bout. WBV exercise did not produce significant changes in serum T and IGF-1 either with low or high amplitude when compared with the control condition. The results of this study demonstrate that a single session of WBV exposure with a frequency of 30 Hz and amplitudes of 1.5 and 3 mm does not noticeably alter serum T and IGF-1 levels.     

去卵巢骨质疏松大鼠骨组织和骨髓细胞FoxO1蛋白在全身垂直振动条件下的变化

背景：FoxO1蛋白参与多种多样的细胞和生理过程,包括细胞增殖与凋亡、活性氧的反应、长寿、癌症、细胞周期和代谢的调节等。研究认为振动负荷能促进新陈代谢,延缓肌肉疲劳,加速骨适应性重建。
　　目的：进一步验证全身垂直振动对去卵巢骨质疏松大鼠骨组织和骨髓细胞叉头框转录因子 O 亚族1(FoxO1)蛋白表达的影响。
　　方法：将36只健康3月龄雌性SD大鼠,按体质量分层后随机分为假手术组、去卵巢静止组和去卵巢振动组。在手术后第11周,对去卵巢振动组大鼠实施7周每天不间断的全身垂直振动治疗,2次/d,每次振动训练15 min,间隔10 min,振动频率为90 Hz,振动幅度为0.5 mm。于末次处理结束24-48 h内,游离各组大鼠第5腰椎、右侧股骨和胫骨,用双能X射线骨密度仪检测右股骨和第5腰椎的离体骨密度,用Western blot检测右胫骨近端和骨髓细胞FoxO1蛋白的表达。
　　结果与结论：骨密度检测结果显示,与去卵巢静止组比较,去卵巢振动组大鼠股骨远端和近端以及第5腰椎骨密度显著增加,而股骨中段无显著变化。Western blot检测结果显示：FoxO1蛋白在胫骨组织中不表达,但在骨髓细胞中表达。与假手术组比较,去卵巢静止组大鼠骨髓细胞FoxO1蛋白表达水平无显著变化;与去卵巢静止组比较,去卵巢振动组大鼠骨髓细胞FoxO1蛋白表达水平显著下降。结果表明,全身垂直振动能抑制FoxO1蛋白在去卵巢大鼠骨髓细胞中的表达。     

The Effect of Whole Body Vibration on Ankle Range of Motion and the H-reflex

Background and Purpose

Limited research suggests that an effect of whole body vibration (WBV) on the central nervous system (CNS) is suppression. An indirect measure used to assess CNS level of activation is the Soleus H-reflex. If true suppression does occur, other factors such as range of motion may be impacted. The purpose of this study was to examine the impact of WBV on H-reflex amplitude and passive ankle dorsiflexion.

Subjects and Methods

Twenty-seven healthy volunteers between the ages of 21-41 participated. Subjects were randomly assigned to a control group (n=13) or WBV group (n=14). H-reflex and ankle dorsiflexion measures were assessed before and after a three minute WBV perturbation (40 μHz, amplitude 2-4 mm). These measurements were repeated every five minutes up to twenty minutes following the intervention.

Results

The H-reflex amplitude showed a significant decrease (p<.05) between pre-test and initial post-test for both groups. The H-reflex returned to baseline within five minutes following the intervention. The dorsiflexion range of motion showed significant interaction (p<.05). All changes were less than 5 degrees; therefore, no clear clinical impact was evident.

Conclusions

The observed decrease in H-reflex amplitude immediately following WBV agreed with previous research indicating a lower level of CNS activation. However, since the control group also showed this change, WBV does not appear to be a key cause of suppression. Range of motion was not clinically significant for either group.     

机械振动排痰在ICU肺部感染患者排痰中的效果观察

目的:比较机械振动排痰法与传统手工叩击排痰法在ICU肺部感染患者排痰中的应用效果。方法:将40例合并肺部感染的患者随机等分为观察组和对照组,观察组应用振动排痰仪进行机械振动排痰,对照组采用传统手工叩击排痰。3 d后比较两组患者动脉血氧饱和度(SaO2)、动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)及呼吸频率(R)的变化。结果:观察组SaO2,PaO2,PaCO2及呼吸频率的改善情况明显优于对照组(P0.05)。结论:机械振动排痰效果优于传统手工叩击排痰,值得临床推广应用。     

A Feasibility Study of an Integrated System Using a Force Plate and a Plantar Vibrotactile Stimulator for Fostering Postural Control in the Elderly

ABSTRACT

In this feasibility study, we aimed to test the feasibility of a force plate and plantar vibrotactile stimulator as a measurement tool. A total of 24 elderly subjects (mean: 75.8 years), and 22 young adult subjects (24.3 years) participated. The subjects stood barefoot on the stimulator placed on the force plate, and they tried to move their center of pressure (COP) to reach the border of the predetermined target range, and finally maintained within the border. As a result, both groups were able to control their COP position within the target range. The elderly, as compared with the young adults, showed a decreased ability to control the COP as expected. This tool could be very useful in future studies of interventions to improve balance.     

输血时茂菲氏滴壶内液面高度与红细胞损伤的研究

输血时，护士往往对操作是否正规、滴数是否适当以及输血后有无反应等方面较为重视，却忽视了茂菲氏滴壶内血平面调节是否适宜的问题。作者对此进行了研究。结果表明：茂菲氏滴壶内血平面调至２／３即正常状态时，红细胞损坏率明显降低。调至１／４状态时，红细胞损坏率较２／３状态时高１１．５５％。提示：由于振荡而致红细胞活力受损，应引起重视。     

复合振动预防去势大鼠骨质疏松的实验研究

目的：观察低强度复合振动对去势SD雌性大鼠生长期骨密度的影响。方法：4月龄SD雌性未育大鼠48只随机分为正常对照组（假手术组）、去势对照组以及4个去势振动组，每组8只。两对照组不作振动干预，4个振动组分别接振不同参数振动，干预时间13周。比较大鼠体重，腰椎、股骨骨密度，骨转换标志物（血清骨钙素、碱性磷酸酶、非前列腺酸性磷酸酶、Ⅰ型胶原C端肽）值。结果：实验开始后除正常对照组外，其余各组体重均明显增加。各组股骨骨密度均增加．差异无显著性意义,振动3、4组与正常对照组较去势对照组腰椎骨密度显著性增加。骨转换标志物各组差异无显著性意义。结论：一定的复合振动可以增加去势SD大鼠腰椎骨密度，具有潜在的预防骨质疏松作用。