《中国康复理论与实践》 ›› 2026, Vol. 32 ›› Issue (10): 1143-1153.doi: 10.3969/j.issn.1006-9771.2026.00.004

• 循证研究 • 上一篇    下一篇

不同振动频率的全身振动训练对脑卒中患者平衡和步行功能影响的Meta分析

车芙蓉1, 潘义1, 祁森洁1, 温晓妮2()   

  1. 1 西安体育学院研究生部, 陕西西安市 710068
    2 西安体育学院运动与健康科学学院, 陕西西安市 710068
  • 收稿日期:2026-07-01 修回日期:2026-08-03 接受日期:2026-08-05 出版日期:2026-10-25 发布日期:2026-08-21
  • 通讯作者: 温晓妮(1973-),女,汉族,陕西渭南市人,博士,教授,主要研究方向:慢性病与老年病康复。E-mail: weniweni@163.com
  • 作者简介:车芙蓉(1999-),女,汉族,陕西渭南市人,硕士研究生,主要研究方向:慢性病与老年病康复。
  • 基金资助:
    国家重点基础研究发展计划项目(2020YFC2006904)

Effects of whole body vibration training at different vibration frequencies on balance and gait in stroke patients: a meta-analysis

Che Furong1, Pan Yi1, Qi Senjie1, Wen Xiaoni2()   

  1. 1 Graduate Department, Xi'an Physical Education University, Xi'an, Shaanxi 710068, China
    2 School of Sports and Health Sciences, Xi'an Physical Education University, Xi'an, Shaanxi 710068, China
  • Received:2026-07-01 Revised:2026-08-03 Accepted:2026-08-05 Published:2026-10-25 Online:2026-08-21
  • Supported by:
    National Program on Key Basic Research Plan(2020YFC2006904)

摘要:

目的 评价不同振动频率的全身振动训练(WBV)对脑卒中患者平衡和步行功能的疗效。

方法 计算机检索中国知网、维普、万方数据库、中国生物医学数据库、PubMed、Embase和Cochrane Library数据库,收集建库至2026年4月关于WBV改善脑卒中后平衡和步行功能的随机对照试验(RCT)。以Berg平衡量表(BBS)、功能性步行量表(FAC)和计时起立-行走测试(TUGT)为结局指标,采用Cochrane 5.1.0手册推荐的RCT偏倚风险评估工具和PEDro量表对所纳入文献进行质量评价,采用Stata 18.0进行Meta分析。

结果 共纳入22篇RCT,涉及1 335例患者,PEDro量表评分为5~9分。Meta分析显示,WBV训练后脑卒中患者的BBS评分(WMD = 4.761, 95%CI 3.220~6.302, P < 0.001)、FAC分级(WMD = 0.537, 95%CI 0.239~0.835, P < 0.001)均显著优于对照组,TUGT时间明显缩短(WMD = -2.329, 95%CI -3.889~-0.769, P = 0.003)。亚组分析显示,低频(≤ 20 Hz) WBV在BBS、FAC和TUGT方面优于对照组(P < 0.05),而高频(> 20 Hz)未达显著性水平(P > 0.05);低频WBV的FAC分级明显优于高频(Q = 8.070, P= 0.005),高低频亚组间BBS和TUGT比较无显著性差异(P> 0.05);Meta回归提示频率并非异质性的主要来源,总干预次数和病程可能是潜在影响因素;不良反应轻微且均见于高频组。

结论 WBV能有效改善脑卒中后平衡和步行功能,基于当前有限证据,低频(≤ 20 Hz) WBV在疗效和安全性方面均优于高频;同时应重视训练总量的累积效应,结合患者病程选择最佳干预时机。

关键词: 脑卒中, 全身振动训练, 振动频率, 姿势平衡, 步行, Meta分析

Abstract:

Objective To systematically evaluate the effect of whole body vibration training (WBV) at different vibration frequencies on balance and walking function in individuals with stroke.

Methods Randomized controlled trials (RCT) about the effect of WBV on post-stroke balance and walking function were retrieved from CNKI, VIP, Wanfang Data, CBM, PubMed, Embase and Cochrane Library databases from inception to April, 2026. Outcome measures included Berg Balance Scale (BBS), Functional Ambulation Category (FAC), and Timed Up and Go Test (TUGT). The methodological quality of the included studies was appraised using the Cochrane Risk of Bias Tool and the PEDro scale. Meta-analysis was performed using Stata 18.0.

Results A total of 22 RCT comprising 1 335 stroke patients were included, with PEDro scores ranging from five to nine. Meta-analysis demonstrated that compared with control interventions, WBV significantly improved BBS scores (WMD = 4.761, 95%CI 3.220 to 6.302, P < 0.001) and FAC scores (WMD = 0.537, 95%CI 0.239 to 0.835, P < 0.001), and significantly reduced the time of TUGT (WMD = -2.329, 95%CI -3.889 to -0.769, P = 0.003). Subgroup analyses revealed that low-frequency WBV (≤ 20 Hz) produced significant improvement in both balance and walking function relative to controls, whereas high-frequency WBV (> 20 Hz) did not reach statistical significance. Low-frequency WBV intervention was superior to high-frequency WBV in FAC scores (Q = 8.070, P= 0.005), whereas no statistically significant difference was observed between the low- and high-frequency subgroups in BBS and TUGT (P > 0.05). Meta-regression suggested that vibration frequency was not the primary source of heterogeneity; rather, the total number of training sessions and time since stroke might be potential influencing factors. Adverse events were mild and occurred exclusively in the high-frequency group.

Conclusion WBV can effectively improve post-stroke balance and walking function. Based on the limited available evidence, low-frequency WBV (≤ 20 Hz) is super to high-frequency WBV in both efficacy and safety. In addition, attention should be paid to the cumulative effect of total training volume, and the timing of intervention should be tailored to the patient's disease duration.

Key words: stroke, whole body vibration training, vibration frequency, postural balance, gait, meta-analysis

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