体外冲击波缓解老年帕金森病患者局部肌张力与促进运动功能的随机对照研究

doi:10.3969/j.issn.1003-9198.2026.07.013

摘要/Abstract

摘要： 目的探讨体外冲击波(ESWT)对老年PD患者小腿三头肌肌张力以及下肢运动功能的影响。方法自2024年12月至2025年12月,收集50例在南京医科大学第一附属医院就诊的小腿三头肌肌张力升高的老年PD患者,随机分为试验组和对照组,每组各25例。试验组给予1次ESWT治疗,干预部位为双侧小腿三头肌,对照组仅给予假刺激1次。干预前及干预结束后10 min内进行踝关节背屈改良Ashworth量表(MAS)评估、10 m步行测试(10MWT)、起立-行走计时测试(TUGT);同时使用表面肌电图采集电信号,并计算小腿三头肌于静息状态下的均方根值(RMS)。结果治疗后,试验组MAS分级、10MWT与TUGT结果均较对照组改善(P＜0.001),且腓肠肌内侧头(P=0.026)、腓肠肌外侧头(P=0.008)及比目鱼肌(P=0.003)的静息RMS低于对照组。结论 ESWT治疗具有缓解老年PD患者小腿三头肌肌张力的即刻效应,可以改善踝关节周围肌肉张力,增加坐、站、行走的运动能力。

关键词: 帕金森病, 肌痉挛, 体外冲击波治疗, 表面肌电图, 运动功能

Abstract: Objective To investigate the efficacy of a single session of extracorporeal shock wave therapy (ESWT) in alleviating triceps surae muscle tone and improving lower limb motor function in elderly patients with Parkinson’s disease. Methods From December 2024 to December 2025, 50 elderly patients with Parkinson’s disease and elevated triceps surae muscle tone at the First Affiliated Hospital of Nanjing Medical University were enrolled in this study. They were randomly allocated into a research group (n=25) and a control group (n=25). The research group received a single session of ESWT applied to the bilateral triceps surae muscles, while the control group received a single session of sham stimulation. Before the intervention and within 10 minutes after intervention, the Modified Ashworth Scale (MAS) for ankle dorsiflexion, the 10-Meter Walk Test (10MWT), and the Timed Up and Go test (TUGT) were assessed. Simultaneously, surface electromyography signals were recorded. The root mean square (RMS) value of the triceps surae at rest was used to evaluate changes in electrophysiological muscle activity. Results The MAS grade for ankle dorsiflexion, 10MWT speed, and TUGT time significantly improved in the research group than those in the control group (P＜0.001). Furthermore, the resting RMS of the medial gastrocnemius (P=0.026), lateral gastrocnemius (P=0.008), and soleus muscles (P=0.003) significantly reduced. Conclusions A single session of ESWT demonstrates an immediate effect in alleviating triceps surae muscle tone in elderly patients with Parkinson’s disease. It can effectively improve peri-ankle muscle tone and enhance functional mobility related to sit-to-stand and walking.

Key words: Parkinson’s disease, muscle spasticity, extracorporeal shock wave therapy, surface electromyography, motor function

中图分类号:

R 493

刘铭洁, 张玉玲, 孙婉婷, 马姝玥, 曾兰婷, 鲁俊, 许光旭. 体外冲击波缓解老年帕金森病患者局部肌张力与促进运动功能的随机对照研究[J]. 实用老年医学, 2026, 40(7): 714-719.

LIU Mingjie, ZHANG Yuling, SUN Wanting, MA Shuyue, ZENG Lanting, LU Jun, XU Guangxu. Randomized controlled trial on extracorporeal shock wave therapy for focal muscle hypertonia and motor function in elderly patients with Parkinson’s disease[J]. Practical Geriatrics, 2026, 40(7): 714-719.

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