Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review

Case Report: Targeted plasticity in spinal cord injury-the role of focal muscle vibration and neurocognitive rehabilitation in adaptative synaptic change along sensory and motor circuit

Purpose

The purpose of this case was to investigate objectively and quantitatively the effects of the application of repeated focal muscle vibration (fMV) associated with neurocognitive exercise on a 46-year-old patient with spastic paraparesis secondary to the surgical removal of a C5-C6 ependymoma.

Methods

We have evaluated gait parameters, spasticity, and pain with clinical scales. We have applied focal muscle vibration on quadriceps femoris, hamstrings, gastrocnemius, and iliopsoas muscles bilaterally. A total of 30 sessions of fMV treatment of 80 min each was carried out over 30 consecutive days.

Results

After the whole treatment period, the patient showed an overall improvement in scores on the same assessment scales administered at admission. The gait analysis evaluation showed a reduction in stride time bilaterally, an increase in average walking speed, increased cadence, and a slight increase in step length.

Conclusion

The improvements obtained have highlighted the relevance of the fMV application associated to physiotherapy in the field of neurological rehabilitation, particularly emphasizing the interest in increasing the number of sessions correlated with more durable clinical improvements over time. Results obtained have shown to persist for several months after discharge, allowing the patient to improve walking and to have greater autonomy in daily activities.

Effects of closed kinetic chain exercises on balance and gait in people with multiple sclerosis: A randomized controlled trial

INTRODUCTION

Balance and gait impairments are among the most common consequences of multiple sclerosis (MS). A closed kinetic chain enhances balance and gait abilities in people with multiple sclerosis (PwMS). This study aims to compare the effectiveness of an integrated Telko and conventional physical therapy (CPT) intervention versus CPT alone on gait and balance in PwMS.

METHODS

Twenty-six PwMS were enrolled in the trial, and they were randomized to either the combined Telko and CPT experimental group (n = 13) or the CPT alone control group (n = 13). All participants underwent 15-min sessions of CPT three times a week for four weeks. Additionally, participants in the experimental group received a 15-min Telko training session after each CPT session. Outcome measures consisted of the Berg Balance Scale (BBS), the 6-Minute Walk Test (6MWT), and the Timed Up and Go (TUG) assessment.

RESULTS

Twenty-four PwMS completed the study. The PwMS in the combined Telko and CPT experimental group exhibited significant improvements in balance, functional capacity, gait speed, and mobility following the intervention (P < 0.05). In the CPT group, PwMS also experienced significant improvements in functional capacity (P < 0.05). The between-group analysis revealed no significant differences among the outcome measures (P > 0.05).

CONCLUSIONS

The combined Telko and CPT intervention did not demonstrate superiority over CPT alone in improving balance and gait in PwMS. Further experimental studies are necessary to fully understand the effects of a closed kinetic chain for lower extremities on the balance and gait of individuals with PwMS.

Virtual reality for balance and mobility rehabilitation following traumatic brain injury: A systematic review of randomized controlled trials

BACKGROUND

Balance and mobility deficits are most prevalent impairments in patients with traumatic brain injury (TBI). The evidence has proposed that rehabilitation plays an important role in improving balance and mobility post-TBI. Virtual reality (VR) is a computer technology that provides immersed users to generate feedback such as visual, audio, and haptic.

OBJECTIVE

This review aimed to examine the effects of the VR treatment intervention on balance and mobility in patients with TBI and to define the most effective VR treatment protocol.

METHODS

SCOPUS, PEDro, PubMed, REHABDATA, EMBASE, and the web of science were searched for experimental trials examining the impacts of VR training on balance and mobility in patients with TBI from inception until July 2022. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies.

RESULTS

Five randomized controlled trials (RCTs) met the inclusion criteria. The PEDro scores ranged from 6 to 8, with a median of 6. A total of 157 patients with TBI were included in this review, 31.2% of whom were females. The findings showed that VR intervention is not superior to traditional physiotherapy interventions in improving balance and mobility post- TBI.

CONCLUSIONS

The preliminary findings showed that the influence of VR on the balance and mobility ability in patients with TBI is promising. Combining VR with other concurrent rehabilitation interventions may show more significant improvements in balance and mobility compared to VR interventions alone. The optimal VR treatment protocol remains unclear. Further randomized controlled trials are strongly needed.