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Saito H, Kobayashi H, Oba K, Hamaya Y. Impact of Focal Muscle Vibration on Flaccid Upper Limb Motor Paralysis following Acute Brain Disease: A Case Study. Case Rep Neurol Med 2024; 2024:2469074. [PMID: 38957779 PMCID: PMC11219211 DOI: 10.1155/2024/2469074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 04/13/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024] Open
Abstract
Focal muscle vibration (FMV) is increasingly being recognized as a rehabilitative therapy for enhancing motor function in central nervous system (CNS) diseases, particularly in patients with fine motor control deficits stemming from CNS damage. Brain lesions from these diseases disrupt the motor networks, necessitating novel rehabilitation strategies. By applying vibrations to muscles, FMV stimulates sensory fibers to induce cortical activity and kinesthetic illusions. While initial studies have highlighted FMV's role in reducing spasticity, recent evidence points to its potential in treating motor paralysis. However, prior research has been limited by the lack of acute-phase studies and a focus on patients with minimal muscle contraction capability. This report aimed to explore FMV's efficacy on upper limb motor function in patients with flaccid motor paralysis immediately after acute CNS diseases. We report the case of a septuagenarian male with a brain abscess in the right parietal lobe, leading to flaccid motor paralysis. Rehabilitation included 28 sessions of occupational and physical therapy that incorporated FMV. Significant improvements were observed in upper extremity function, with moderate to very large effect sizes, while lower limb function showed lesser improvement without adverse effects. This case suggests the utility of FMV in enhancing upper-limb motor function after acute CNS injuries, potentially serving as a supplementary therapy for spontaneous recovery. This report contributes to emerging evidence on FMV's benefits in acute flaccid motor paralysis, expanding the documented therapeutic scope.
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Affiliation(s)
- Hirotaka Saito
- Department of Rehabilitation MedicineSt. Marianna University School of Medicine Hospital, Kawasaki, Japan
- Department of Rehabilitation MedicineDokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Haruka Kobayashi
- Department of Rehabilitation MedicineDokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Kodai Oba
- Department of Rehabilitation MedicineDokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | - Yosuke Hamaya
- Department of Rehabilitation MedicineDokkyo Medical University Saitama Medical Center, Koshigaya, Japan
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2
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Camerota F, Toscano M, Di Piero V, Celletti C. A commentary on 'Focal vibration in dysphagia: A technological treatment for severe acquired brain injury rehabilitation'. J Oral Rehabil 2024; 51:909-910. [PMID: 38151863 DOI: 10.1111/joor.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/24/2023] [Accepted: 12/11/2023] [Indexed: 12/29/2023]
Affiliation(s)
- F Camerota
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Rome, Italy
| | - M Toscano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - V Di Piero
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
| | - C Celletti
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Rome, Italy
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Pfenninger C, Zeghoudi N, Bertrand MF, Lapole T. Effects of prolonged vibration to the flexor carpi radialis muscle on intracortical excitability. Sci Rep 2024; 14:8475. [PMID: 38605084 PMCID: PMC11009410 DOI: 10.1038/s41598-024-59255-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
Prolonged local vibration (LV) can induce neurophysiological adaptations thought to be related to long-term potentiation or depression. Yet, how changes in intracortical excitability may be involved remains to be further investigated as previous studies reported equivocal results. We therefore investigated the effects of 30 min of LV applied to the right flexor carpi radialis muscle (FCR) on both short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). SICI and ICF were measured through transcranial magnetic stimulation before and immediately after 30 min of FCR LV (vibration condition) or 30 min of rest (control condition). Measurements were performed during a low-intensity contraction (n = 17) or at rest (n = 7). No significant SICI nor ICF modulations were observed, whether measured during isometric contractions or at rest (p = 0.2). Yet, we observed an increase in inter-individual variability for post measurements after LV. In conclusion, while intracortical excitability was not significantly modulated after LV, increased inter-variability observed after LV may suggest the possibility of divergent responses to prolonged LV exposure.
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Affiliation(s)
- Clara Pfenninger
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Narimane Zeghoudi
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Mathilde Fiona Bertrand
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Thomas Lapole
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France.
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Lin L, Qing W, Huang Y, Ye F, Rong W, Li W, Jiao J, Hu X. Comparison of Immediate Neuromodulatory Effects between Focal Vibratory and Electrical Sensory Stimulations after Stroke. Bioengineering (Basel) 2024; 11:286. [PMID: 38534560 DOI: 10.3390/bioengineering11030286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 03/28/2024] Open
Abstract
Focal vibratory stimulation (FVS) and neuromuscular electrical stimulation (NMES) are promising technologies for sensory rehabilitation after stroke. However, the differences between these techniques in immediate neuromodulatory effects on the poststroke cortex are not yet fully understood. In this research, cortical responses in persons with chronic stroke (n = 15) and unimpaired controls (n = 15) were measured by whole-brain electroencephalography (EEG) when FVS and NMES at different intensities were applied transcutaneously to the forearm muscles. Both FVS and sensory-level NMES induced alpha and beta oscillations in the sensorimotor cortex after stroke, significantly exceeding baseline levels (p < 0.05). These oscillations exhibited bilateral sensory deficiency, early adaptation, and contralesional compensation compared to the control group. FVS resulted in a significantly faster P300 response (p < 0.05) and higher theta oscillation (p < 0.05) compared to NMES. The beta desynchronization over the contralesional frontal-parietal area remained during NMES (p > 0.05), but it was significantly weakened during FVS (p < 0.05) after stroke. The results indicated that both FVS and NMES effectively activated the sensorimotor cortex after stroke. However, FVS was particularly effective in eliciting transient involuntary attention, while NMES primarily fostered the cortical responses of the targeted muscles in the contralesional motor cortex.
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Affiliation(s)
- Legeng Lin
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China
| | - Wanyi Qing
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China
| | - Yanhuan Huang
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China
| | - Fuqiang Ye
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China
| | - Wei Rong
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Waiming Li
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Xiaoling Hu
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
- Research Institute for Smart Ageing (RISA), The Hong Kong Polytechnic University, Hong Kong, China
- University Research Facility in Behavioral and Systems Neuroscience (UBSN), The Hong Kong Polytechnic University, Hong Kong, China
- Joint Research Centre for Biosensing and Precision Theranostics, The Hong Kong Polytechnic University, Hong Kong, China
- Research Centre on Data Science and Artificial Intelligence, The Hong Kong Polytechnic University, Hong Kong, China
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5
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Shen X, Yu Y, Xiao H, Ji L, Wu J. Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study. Front Neurosci 2023; 17:1281160. [PMID: 38192508 PMCID: PMC10773788 DOI: 10.3389/fnins.2023.1281160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024] Open
Abstract
Objective The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects. Methods Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients. Results Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs. Conclusion FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.
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Affiliation(s)
- Xianshan Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Yang Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Han Xiao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Leilei Ji
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Jianxian Wu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
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Tariq N, Khan Z, Veqar Z. Effect of Whole-Body Vibration on Balance or Proprioception in Nonspecific Chronic Low Back Pain: A Systematic Review. J Chiropr Med 2023; 22:284-293. [PMID: 38205229 PMCID: PMC10774621 DOI: 10.1016/j.jcm.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 04/17/2023] [Accepted: 04/28/2023] [Indexed: 01/12/2024] Open
Abstract
Objective This systematic review aimed to investigate the effect of whole-body vibration (WBV) on balance or proprioception for patients with nonspecific chronic low back pain (NSCLBP). Methods A comprehensive search was conducted using 5 databases-PubMed, Web of Science, Cochrane Library, Science Direct, and Physiotherapy Evidence Database-from inception to January 2022. Randomized clinical trials that examined the efficacy of WBV on balance or proprioception in patients with NSCLBP were incorporated. The methodological quality of each included study was assessed using the Physiotherapy Evidence Database scale. Results Our search strategy yielded 5309 articles, of which 7 published randomized clinical trials (313 patients) met the inclusion criteria. Three of the 4 included studies that investigated balance reported significant improvements after WBV, of which 2 were of high methodological quality. The remaining 3 studies investigating proprioception also showed significant improvements after WBV intervention. Conclusion Although some studies seem to provide promising results regarding the efficacy of WBV or WBV combined with exercise in improving balance and proprioception in patients with NSCLBP, at present, no definite conclusions can be drawn due to article heterogeneity and lack of clinical trials.
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Sajedifar M, Fakhari Z, Naghdi S, Nakhostin Ansari N, Honarpisheh R, Nakhostin-Ansari A. Comparison of the immediate effects of plantar vibration of both feet with the plantar vibration of the affected foot on balance in patients with stroke: Preliminary findings. J Bodyw Mov Ther 2023; 36:45-49. [PMID: 37949597 DOI: 10.1016/j.jbmt.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 04/29/2023] [Accepted: 06/02/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Plantar vibration is one of the strategies to enhance balance in stroke patients. This study compared the effects of the plantar vibration of both feet and the plantar vibration of the most affected side in patients with stroke. METHODS This study was a single-blind clinical trial. Post-stroke patients with balance impairment were enrolled in the study and underwent two treatment sessions with a one-week interval. They received both feet's plantar vibration in one session and plantar vibration of the most affected side in the other session (frequency 100 Hz, 5 min). Mini-BESTest, Modified Modified Ashworth Scale (MMAS), and Semmes-Weinstein monofilament examination (SWME) were used to evaluate balance, spasticity, and plantar sensation, before and after the treatment sessions. RESULTS Ten patients with a mean age of 52.9 (SD = 5.48) years were enrolled in the study. Mini-BESTest scores of balance and plantar flexor muscle spasticity were significantly improved after both feet plantar vibration and plantar vibration of the more affected side. There was no significant difference between the effectiveness of both sides plantar vibration and the most affected side plantar vibration. There were no significant improvements in SWME sensory scores after plantar vibration of either both sides or the most affected side. CONCLUSION Plantar vibration of both sides had no additional benefits in this group of patients with chronic stroke. Plantar vibration of more affected side can be used for improving balance and plantar flexor spasticity post-stroke. The Plantar vibration had no effects on the affected foot sensibility.
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Affiliation(s)
- Mahdieh Sajedifar
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Fakhari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Soofia Naghdi
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran; Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Noureddin Nakhostin Ansari
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; Research Center for War-affected People, Tehran University of Medical Sciences, Tehran, Iran; Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Roshanak Honarpisheh
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Chaltron C, Sherman DA, Pamukoff DN, Bazett-Jones DM, Glaviano NR, Norte GE. Whole-body vibration reduces hamstrings neuromuscular function in uninjured individuals. Phys Ther Sport 2023; 60:17-25. [PMID: 36640639 DOI: 10.1016/j.ptsp.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 01/06/2023] [Accepted: 01/07/2023] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Despite the growing use of whole-body vibration (WBV) to enhance quadriceps neuromuscular function, the hamstrings-specific response is unclear among those without neuromuscular impairment, which is important to inform performance-based recommendations. Our objective was to determine the immediate and prolonged effects of WBV on hamstrings and quadriceps neuromuscular function in uninjured individuals. DESIGN Crossover. SETTING Laboratory. PARTICIPANTS Nineteen, recreationally active individuals performed WBV and control exercise protocols, consisting of six 1-min repetitions of isometric squats, on separate days in a randomized order. MAIN OUTCOME MEASURES Electromyographic (EMG) amplitude, antagonist-to-agonist co-activation, rate of torque development, and peak torque of the hamstrings and quadriceps were measured pre-, immediately post-, and 20 min post-condition. Percentage change scores were calculated from baseline to each post-measurement. RESULTS A condition main effect indicated that WBV reduced agonist semitendinosus EMG amplitudes more than the control (-12.1% vs. -1.5%, p < .001). Antagonist vastus medialis EMG amplitudes were reduced immediately, but not 20 min following WBV (-7.1% vs. 3.5%, p < .001). CONCLUSIONS WBV induced an inhibitory effect on medial hamstrings activity during knee flexion contraction in a majority of our sample, yet this response was not uniformly observed and its functional relevance remains unclear in an uninjured population.
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Affiliation(s)
- Cale Chaltron
- University of Kentucky, Athletics Department, Lexington, KY, 40506, United States.
| | - David A Sherman
- Live4 Physical Therapy and Wellness Advising, 525 Massachusetts Ave, Suite 206B, Acton, MA, 01720, United States; Boston University, Department of Physical Therapy and Athletic Training, 635 Commonwealth Avenue, Boston, MA, 02215, United States.
| | - Derek N Pamukoff
- Western University, School of Kinesiology, 1151 Richmond St, London, ON, N6A 3K7, UK.
| | - David M Bazett-Jones
- University of Toledo (study Site), Department of Exercise and Rehabilitation Sciences, 2801 W. Bancroft St., Health and Human Services, 2505H, Mail Stop 119, Toledo, OH, 43606, United States.
| | - Neal R Glaviano
- University of Connecticut, Department of Kinesiology, 2095 Hillside Rd, U-1110, Storrs, CT, 06269, United States.
| | - Grant E Norte
- University of Toledo (study Site), Department of Exercise and Rehabilitation Sciences, 2801 W. Bancroft St., Health and Human Services, 2505H, Mail Stop 119, Toledo, OH, 43606, United States.
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Chen YL, Jiang LJ, Cheng YY, Chen C, Hu J, Zhang AJ, Hua Y, Bai YL. Focal vibration of the plantarflexor and dorsiflexor muscles improves poststroke spasticity: a randomized single-blind controlled trial. Ann Phys Rehabil Med 2022; 66:101670. [PMID: 35940478 DOI: 10.1016/j.rehab.2022.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/23/2022] [Accepted: 02/15/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Post-stroke spasticity is a cause of gait dysfunction and disability. Focal vibration (FV) of agonist-antagonist upper limb muscle pairs reduces flexor spasticity; however, its effects on ankle plantarflexor spasticity are uncertain. OBJECTIVE To assess the effects of focal vibration administered by a trained operator to the ankle plantarflexor and dorsiflexor muscles on post-stroke lower limb spasticity. METHODS A randomized, single-blind controlled trial of 64 participants with stroke and plantarflexor spasticity assigned to 3 groups by centralized, computer-generated randomization (1:1:1): 1) physiotherapy alone (CON), 2) physiotherapy+gastrocnemius vibration (FV_GM) and 3) physiotherapy+tibialis anterior vibration (FV_TA). Physiotherapists and assessors were blinded to group assignment. The experimental groups underwent 15, 20-min vibration sessions at 40 Hz. We performed evaluations at baseline and after the final treatment: Modified Ashworth Scale (MAS), Clonus scale, Functional Ambulation Categories (FAC), Fugl-Meyer Assessment - Lower Extremity (FMA_LE), Modified Barthel Index (MBI), and electromyography and ultrasound elastography. Primary outcome was remission rate (number and proportion of participants) of the MAS. RESULTS MAS remission rate was higher in FV_GM and FV_TA than CON groups (CON vs. FV_GM: p=0.009, odds ratio 0.15 [95% confidence interval 0.03-0.67]; CON vs. FV_TA: p=0.002, 0.12 [0.03-0.51]). Remission rate was higher in the experimental than CON groups for the Clonus scale (CON vs. FV_GM: p<0.001, OR 0.07 [95% CI 0.01-0.31]; CON vs. FV_TA: p=0.006, 0.14 [95% CI 0.03-0.61]). FAC remission rate was higher in the FV_TA than the CON (p=0.009, 0.18 [0.05-0.68]) and FV_GM (p=0.014, 0.27 [0.07-0.99]) groups. Ultrasound variables of the paretic medial gastrocnemius decreased more in FV_GM than CON and FV_TA groups (shear modulus: p=0.006; shear wave velocity: p=0.008). CONCLUSIONS Focal vibration reduced post-stroke spasticity of the plantarflexor muscles. Vibration of the tibialis anterior improved ambulation more than vibration of the gastrocnemius or physiotherapy alone. Gastrocnemius vibration may reduce spasticity by changing muscle stiffness.
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Affiliation(s)
- Ying-Lun Chen
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China; Department of Rehabilitation Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Liu-Jun Jiang
- Department of Rehabilitation Medicine, Huashan North Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yang-Yang Cheng
- Department of Rehabilitation Medicine, Huashan North Hospital, Fudan University, Shanghai, People's Republic of China
| | - Chan Chen
- Department of Rehabilitation Medicine, Huashan North Hospital, Fudan University, Shanghai, People's Republic of China
| | - Jian Hu
- Department of Rehabilitation Medicine, Huashan North Hospital, Fudan University, Shanghai, People's Republic of China
| | - An-Jing Zhang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China
| | - Yan Hua
- Department of Rehabilitation Medicine, Huashan North Hospital, Fudan University, Shanghai, People's Republic of China.
| | - Yu-Long Bai
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, People's Republic of China.
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Kennouche D, Varesco G, Espeit L, Féasson L, Souron R, Rozand V, Millet GY, Lapole T. Acute effects of quadriceps muscle versus tendon prolonged local vibration on force production capacities and central nervous system excitability. Eur J Appl Physiol 2022; 122:2451-2461. [PMID: 36001143 DOI: 10.1007/s00421-022-05028-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE The present study aimed to directly compare the effects of 30 min muscle (VIBmuscle) vs. tendon (VIBtendon) local vibration (LV) to the quadriceps on maximal voluntary isometric contraction (MVIC) and rate of torque development (RTD) as well as on central nervous system excitability (i.e. motoneuron and cortical excitability). METHODS Before (PRE) and immediately after (POST) LV applied to the quadriceps muscle or its tendon, we investigated MVIC and RTD (STUDY #1; n = 20) or vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) electromyography responses to thoracic electrical stimulation (TMEPs; motoneuron excitability) and transcranial magnetic stimulation (MEPs; corticospinal excitability) (STUDY #2; n = 17). MEP/TMEP ratios were further calculated to quantify changes in cortical excitability. RESULTS MVIC decreased at POST (P = 0.017) without any difference between VIBtendon and VIBmuscle, while RTD decreased for VIBtendon (P = 0.013) but not VIBmuscle. TMEP amplitudes were significantly decreased for all muscles (P = 0.014, P < 0.001 and P = 0.004 for VL, VM and RF, respectively) for both LV sites. While no changes were observed for MEP amplitude, MEP/TMEP ratios increased at POST for VM and RF muscles (P = 0.009 and P = 0.013, respectively) for both VIBtendon and VIBmuscle. CONCLUSION The present results suggest that prolonged muscle and tendon LV are similarly effective in modulating central nervous system excitability and decreasing maximal force. Yet, altered explosive performance after tendon but not muscle LV suggests greater neural alterations when tendons are vibrated.
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Affiliation(s)
- Djahid Kennouche
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France
| | - Giorgio Varesco
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France
| | - Loïc Espeit
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France
| | - Léonard Féasson
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France.,Unité de Myologie, Centre Référent Maladies Neuromusculaires - Euro-NMD, Centre Hospitalier Universitaire de Saint-Etienne, 42055, Saint Etienne, France
| | - Robin Souron
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France.,UFR STAPS de Toulon, Unité de Recherche IAPS (N°201723207F), UFR STAPS de Toulon, Toulon, France
| | - Vianney Rozand
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France
| | - Guillaume Y Millet
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France.,Institut Universitaire de France (IUF), Paris, France
| | - Thomas Lapole
- Univ Lyon, UJM-Saint-Etienne, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, F-42023, Saint-Etienne, France.
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11
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Zhang M, Wei J, Wu X. Effects of whole-body vibration training on lower limb motor function and neural plasticity in patients with stroke: protocol for a randomised controlled clinical trial. BMJ Open 2022; 12:e060796. [PMID: 35768103 PMCID: PMC9240887 DOI: 10.1136/bmjopen-2022-060796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Lower limb motor dysfunction is common in patients with stroke, and usually caused by brain neural connectivity disorder. Previous studies have shown that the whole-body vibration training (WBVT) significantly improves the lower limb motor function in patients with stroke and may promote nerve remodelling. The prior purpose of this study is to explore effects of WBVT on lower limb motor function and neuroplasticity in patients with stroke. METHODS A single-blind randomised controlled trial will be conducted. Sixty patients with stroke will be recruited and allocated randomly to WBVT, routine rehabilitation training (RRT) and control group (CG). The WBVT and RRT interventions will be implemented as five 25 min sessions weekly for continuous 12 weeks; the CG will remain daily habitual living styles and routine treatments, in community or hospital, and will also receive telephone follow-up and health-related lectures. Transcranial magnetic stimulation will be used to assess neural plasticity while lower limb motor function is assessed using indicators of strength, walking ability and joint activity. The assessments will be conducted at the period of baseline, week 6, week 12 as well as on 4 and 8 weeks, respectively, after intervention completion. ETHICS AND DISSEMINATION This study has been approved by the Shanghai University of Sport Research Ethics Committee (102772021RT067) and will provide data on the effects of WBVT relative to RRT in terms of the improvement of stroke patients' lower limb motor function and neural plasticity. The results of this study will be disseminated via publications in peer-reviewed journals and presentations at international conference. TRIAL REGISTRATION NUMBER ChiCTR2200055143.
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Affiliation(s)
| | - Jianing Wei
- School of Psychology, Shanghai University of Sport, Shanghai, China
| | - Xueping Wu
- Shanghai University of Sport, Shanghai, China
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12
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Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study. BIOLOGY 2022; 11:biology11020268. [PMID: 35205134 PMCID: PMC8869153 DOI: 10.3390/biology11020268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 11/24/2022]
Abstract
Simple Summary Physical activity is often recommended as part of the management of chronic low back pain, which is one of the most common musculoskeletal disorders. Vibrating exercise equipment is used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using vibrating exercise equipment in women with chronic low back pain. Here, 92 women aged 49–80 years were assigned to one of two groups: the experimental and the control group. The intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles’ bioelectrical activity, the lumbar range of motion and pain intensity were measured in all participants at baseline and after 10 weeks. Compared with baseline measures, there was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement, rest at maximum flexion, extension movement and rest in a prone position; an increase in the lumbar range of motion and a decrease in pain intensity following a program of physical activity with vibrating exercise equipment. No significant changes were found in intergroup comparisons; however, physical activity with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and decreasing pain and erector spinae muscle activity in people with chronic low back pain. Abstract Background: Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders. Physical activity (PA) is often recommended as part of the management of CLBP, but to date, no one particular exercise has been shown to be superior. Vibrating exercise equipment (VEE) is widely available and used despite little scientific evidence to support its effectiveness in the prevention and treatment of musculoskeletal problems. The aim of this study was to evaluate the efficiency of using VEE compared with sham-VEE in women with CLBP. Methods: A randomized (1:1 randomization scheme) single-blinded sham-controlled intervention study was conducted. Through simple randomization, 92 women aged 49–80 years were assigned to one of two groups: VEE (the experimental group) and sham-VEE (the control group). The VEE and sham-VEE intervention consisted of aerobic exercises with specific handheld equipment. Both groups performed physical activity twice weekly for 10 weeks. The erector spinae muscles’ bioelectrical activity (using an eight-channel electromyograph MyoSystem 1400L), lumbar range of motion (Schober’s test) and pain intensity (visual analog scale) were measured in all participants at baseline and after 10 weeks. Results: There was a significant decrease in the bioelectrical activity of the erector spinae muscles during flexion movement (left: Me = 18.2 before; Me = 14.1 after; p = 0.045; right: Me = 15.4 before; Me = 12.6 after; p = 0.010), rest at maximum flexion (left: Me = 18.1 before; Me = 12.5 after; p = 0.038), extension movement (right: Me = 21.8 before; Me = 20.2 after; p = 0.031) and rest in a prone position (right: Me = 3.5 before; Me = 3.2 after; 0.049); an increase in lumbar range of motion (Me = 17.0 before; Me = 18.0 after; p = 0.0017) and a decrease in pain intensity (Me = 4.0 before; Me = 1.0 after; p = 0.001) following a program of PA in the VEE group. Conclusions: No significant changes were found in intergroup comparisons. The beneficial changes regarding decreased subjective pain sensation in the VEE and sham-VEE groups may be due to participation in systematic physical activity. However, PA with vibrating exercise equipment could be a prospective strategy for increasing lumbar range of motion and for decreasing pain and erector spinae muscle activity in people with CLBP.
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13
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Manzo N, Celletti C, Conte A, Camerota F. Comment to paper by Moggio et al “vibration therapy role in neurological diseases rehabilitation: an umbrella review of systematic reviews”. Disabil Rehabil 2022; 44:4947-4948. [DOI: 10.1080/09638288.2022.2030810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Claudia Celletti
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Piazza Aldo Moro 3,00185 Rome, Italy
| | - Antonella Conte
- IRCCS NEUROMED, 18, 86077 Pozzilli (IS), Pozzilli, Italy
- Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation, Umberto I University Hospital, Piazza Aldo Moro 3,00185 Rome, Italy
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14
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Miyara K, Etoh S, Kawamura K, Maruyama A, Kuronita T, Ohwatashi A, Shimodozono M. Effects of lower limb segmental muscle vibration on primary motor cortex short-latency intracortical inhibition and spinal excitability in healthy humans. Exp Brain Res 2021; 240:311-320. [PMID: 34724095 DOI: 10.1007/s00221-021-06257-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 10/23/2021] [Indexed: 12/19/2022]
Abstract
We examined the effects of lower limb segmental muscle vibration (SMV) on intracortical and spinal excitability in 13 healthy participants (mean age: 34.9 ± 7.8 years, 12 males, 1 female). SMV at 30 Hz was applied to the hamstrings, gastrocnemius, and soleus muscles for 5 min. Paired-pulse transcranial magnetic stimulation protocols were used to investigate motor-evoked potential (MEP) amplitude, short-interval intracortical inhibition (SICI) and short-interval intracortical facilitation (SICF) from the abductor hallucis muscle (AbdH). These assessments were compared to the results of a control experiment (i.e., non-vibration) in the same participants. F-waves were evaluated from the AbdH on the right (vibration side) and left (non-vibration side) sides, and we calculated the ratio of the F-wave amplitude to the M-response amplitude (F/M ratio). These assessments were obtained before, immediately after, and 10, 20, and 30 min after SMV. For SICI, there was no change immediately after SMV, but there was a decrease over time (before vs. 30 min after, p = 0.021; immediately after vs. 30 min after, p = 0.015). There were no changes in test MEP amplitude, SICF, or the F/M ratio. SMV causes a gradual decrease in SICI over time perhaps owing to long-term potentiation. The present results may have implications for the treatment of spasticity.
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Affiliation(s)
- Kodai Miyara
- Department of Rehabilitation, Kagoshima University Hospital, 8-35-1, Sakuragaoka, Kagoshima-city, Kagoshima, 890-8520, Japan. .,Doctoral Program, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.
| | - Seiji Etoh
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kentaro Kawamura
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Atsuo Maruyama
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Takehiro Kuronita
- Master's Program, Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihiko Ohwatashi
- Faculty of Medicine, Course of Physical Therapy, School of Health Sciences, Kagoshima University, Kagoshima, Japan
| | - Megumi Shimodozono
- Department of Rehabilitation and Physical Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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15
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de Andrade BZ, Zazula MF, Bittencourt Guimarães AT, Sagae Schneider SC, Boaretto ML, Felicio Poncio AC, Hoff Nunes Maciel JI, de Oliveira CMT, Costa RM, Flor Bertolini GR, Chasko Ribeiro LDF. Whole-body vibration promotes lipid mobilization in hypothalamic obesity rat. Tissue Cell 2021; 68:101456. [PMID: 33202347 DOI: 10.1016/j.tice.2020.101456] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVES This study aimed to analyze the effect of whole-body vibration (WBV) on metabolic parameters using the monosodium l-glutamate (MSG) model of obesity. METHOD MSG-obese rats that were exposed to WBV on a vibrating platform with 60 Hz frequency, 2 mm amplitude, three times/week, 10 min/day, during eight weeks (from postnatal day (PN) 80 to PN136). Blood glucose, creatine kinases (CK and CK-MB) and lipid profile through plasma and liver levels of lipids and lipoproteins were evaluated. Morphology and oxidative stress of adipose and hepatic tissues were further evaluated. RESULTS When performing a WBV exercise, animals showed contrasting metabolic responses. Vibration Control group (CTL-WBV) presented a reduction in CK and liver triacylglycerol, an increase in glucose, lactate, total cholesterol, liver cholesterol, and LDL while MSG Vibration group (MSG-WBV) showed an increase in total triacylglycerol, VLDL, lactate, CK, liver cholesterol, additional liver lipid peroxidation and LDL, total cholesterol and CKMB reduction. CONCLUSION Even although the MSG is a model of impacting injury, the metabolic demand of WBV exercise was able to induce mobilization of substrates, highlighting the lipid mobilization in obese animals, it should be used as a metabolic rehabilitation tool in patients with metabolic diseases, such as obesity and diabetes.
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Affiliation(s)
| | - Matheus Felipe Zazula
- Department of Cell Biology, Federal University of Paraná, Curitiba, PR, 81530-000, Brazil
| | | | | | - Mariana Laís Boaretto
- Bioscience and Health Graduate Program, State University of Western Paraná, Cascavel, PR, 85819-110, Brazil
| | - Ana Claudia Felicio Poncio
- Bioscience and Health Graduate Program, State University of Western Paraná, Cascavel, PR, 85819-110, Brazil
| | | | | | - Rose Meire Costa
- Bioscience and Health Graduate Program, State University of Western Paraná, Cascavel, PR, 85819-110, Brazil
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Toscano M, Ricci M, Celletti C, Paoloni M, Ruggiero M, Viganò A, Jannini TB, Altarocca A, Liberatore M, Camerota F, Di Piero V. Motor Recovery After Stroke: From a Vespa Scooter Ride Over the Roman Sampietrini to Focal Muscle Vibration (fMV) Treatment. A 99mTc-HMPAO SPECT and Neurophysiological Case Study. Front Neurol 2020; 11:567833. [PMID: 33281704 PMCID: PMC7705992 DOI: 10.3389/fneur.2020.567833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023] Open
Abstract
Focal repetitive muscle vibration (fMV) is a safe and well-tolerated non-invasive brain and peripheral stimulation (NIBS) technique, easy to perform at the bedside, and able to promote the post-stroke motor recovery through conditioning the stroke-related dysfunctional structures and pathways. Here we describe the concurrent cortical and spinal plasticity induced by fMV in a chronic stroke survivor, as assessed with 99mTc-HMPAO SPECT, peripheral nerve stimulation, and gait analysis. A 72-years-old patient was referred to our stroke clinic for a right leg hemiparesis and spasticity resulting from a previous (4 years before) hemorrhagic stroke. He reported a subjective improvement of his right leg's spasticity and dysesthesia that occurred after a30-min ride on a Vespa scooter as a passenger over the Roman Sampietrini (i.e., cubic-shaped cobblestones). Taking into account both the patient's anecdote and the current guidelines that recommend fMV for the treatment of post-stroke spasticity, we then decided to start fMV treatment. 12 fMV sessions (frequency 100 Hz; amplitude range 0.2–0.5 mm, three 10-min daily sessions per week for 4 consecutive weeks) were applied over the quadriceps femoris, triceps surae, and hamstring muscles through a specific commercial device (Cro®System, NEMOCOsrl). A standardized clinical and instrumental evaluation was performed before (T0) the first fMV session and after (T1) the last one. After fMV treatment, we observed a clinically relevant motor and functional improvement, as assessed by comparing the post-treatment changes in the score of the Fugl-Meyer assessment, the Motricity Index score, the gait analysis, and the Ashworth modified scale, with the respective minimal detectable change at the 95% confidence level (MDC95). Data from SPECT and peripheral nerve stimulation supported the evidence of a concurrent brain and spinal plasticity promoted by fMV treatment trough activity-dependent changes in cortical perfusion and motoneuron excitability, respectively. In conclusion, the substrate of post-stroke motor recovery induced by fMV involves a concurrently acting multisite plasticity (i.e., cortical and spinal plasticity). In our patient, operant conditioning of both cortical perfusion and motoneuron excitability throughout a month of fMV treatment was related to a clinically relevant improvement in his strength, step symmetry (with reduced limping), and spasticity.
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Affiliation(s)
- Massimiliano Toscano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Maria Ricci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Marco Paoloni
- Department of Physical Medicine and Rehabilitation, "Sapienza" University of Rome, Rome, Italy
| | - Marco Ruggiero
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | | | - Tommaso B Jannini
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alberto Altarocca
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Mauro Liberatore
- Department of Radiological, oncological and pathological Sciences - Radiometabolic Division, Umberto I Hospital, Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
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Avvantaggiato C, Casale R, Cinone N, Facciorusso S, Turitto A, Stuppiello L, Picelli A, Ranieri M, Intiso D, Fiore P, Ciritella C, Santamato A. Localized muscle vibration in the treatment of motor impairment and spasticity in post-stroke patients: a systematic review. Eur J Phys Rehabil Med 2020; 57:44-60. [PMID: 33111513 DOI: 10.23736/s1973-9087.20.06390-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION During the last decades, many studies have been carried out to understand the possible positive effects of vibration therapy in post-stroke rehabilitation. In particular, the use of localized muscle vibration (LMV) seems to have promising results. The aim of this systematic review was to describe the use of LMV in post-stroke patients to improve motor recovery, reducing spasticity and disability in both upper and lower limb. EVIDENCE ACQUISITION A search was conducted on PubMed, Scopus, Pedro and REHABDATA electronic database. Only randomized controlled trials have been included, excluding no-localized vibratory treatments and other pathological conditions. Fourteen studies met the inclusion criteria and were included in this review. EVIDENCE SYNTHESIS Collectively, the studies involved 425 stroke patients. Most studies included chronic stroke patients (ten) and treated only the upper limb (eleven). There is evidence that LMV therapy is effective in reducing spasticity and improving motor recovery, especially when associated with conventional physical therapy. CONCLUSIONS LMV may be a feasible and safe tool to be integrated into traditional and conventional neurorehabilitation programs for post-stroke patients to reduce spasticity. Analysis of the available clinical trials do not allow us to indicate vibration therapy as effective in functional motor recovery, despite some studies showed encouraging results. Further studies, with larger size of homogeneous patients and with a shared methodology are needed to produce more reliable data, especially on the lower limb.
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Affiliation(s)
- Christian Avvantaggiato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy.,Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy
| | - Roberto Casale
- OPUS Medica Persons, Care and Research (PC&R), Piacenza, Italy
| | - Nicoletta Cinone
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Salvatore Facciorusso
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Antonio Turitto
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Lucia Stuppiello
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Verona, Italy
| | - Maurizio Ranieri
- Department of Basic Sciences, Neuroscience and Sense Organs, Aldo Moro University, Bari, Italy
| | - Domenico Intiso
- Department of Neuro-Rehabilitation IRCCS, Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Pietro Fiore
- Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Ciritella
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Andrea Santamato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy -
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