Neck muscle vibration produces diverse responses in balance and gait speed between individuals with and without neck pain

Cervical Spine Vibration Modifies Oculomotor Function in Young Adults with Traumatic Brain Injury

OBJECTIVE

The purpose of this study was to investigate if vibrational interference of spinal proprioception affects oculomotor function, visual attention and processing, and selective attention in individuals with mild traumatic brain injury (mTBI) compared to healthy age-matched controls.

METHODS

This study was a parallel design, single-session intervention with 20 young adults with mTBI and 20 age-matched controls. Each completed a battery of computerized eye-tracking assessments (CEAs), including egocentric localization, fixational stability, smooth pursuit, saccades, Stroop, and the vestibulo-ocular reflex (VOR), and then had their cervical spine function (flexion-relaxation ratio) recorded at baseline. Spinal vibration (100 Hz) was applied to the cervical spine and the CEA battery was repeated. CEA outcomes were compared to baseline and between mTBI and control groups.

RESULTS

Following cervical vibration, significant pre to post-differences were seen in both the mTBI and control group for egocentric localization, fixation stability, pursuit, saccades, Stroop, and VOR. At baseline, there was a significant difference between the mTBI and control groups across many CEA measures, with the mTBI group performing more poorly in egocentric localization, pursuit, saccades, Stroop, and VOR. The mTBI group also had a poorer flexion-relaxation ratio than the control group.

CONCLUSION

Cervical spine vibration improved cognitive and oculomotor performance in the mTBI group for VOR, Stroop, and pursuit, but had mixed effects on the control group. These findings suggest that some optometric mTBI symptoms may result from spinal or proprioceptive dysfunction, as altering proprioceptive input appears to positively impact visual outcomes.

The Role of the Cervical Spine in Dizziness

The neck can be implicated in dizziness via several, separate, discreet mechanisms. Proprioceptive cervicogenic dizziness (CGD) is the most common and reflects the cervical spine's important role, along with visual and vestibular input, for sensorimotor control. Impaired cervical proprioception can lead to symptoms such as dizziness, unsteadiness, visual disturbances, and altered sensorimotor control, and treatment directed toward cervical musculoskeletal and sensorimotor control is efficacious to improve this in individuals with cervical musculoskeletal disorders. Despite this, CGD is difficult to diagnose. Many people present with both neck pain and dizziness, and often the onset of both follows head and neck trauma, but neither necessarily implicate the neck as the cause of dizziness. Further, people often present with mixed forms of dizziness. Thus, rather than diagnosing CGD, it might be more important to consider the potential for the neck to have no (nil, co-morbid cervical condition) or some (minor, major, or compensatory) role in dizziness. Determining the precise role of the cervical spine role in dizziness requires a skilled interview and examination for cervical musculoskeletal and related sensorimotor impairments and relevant testing of other potential causes. A combination and cluster of test outcomes in addition to comparing responses to specific tests when the cervical afferents are stimulated and not stimulated will be important. Considering the role of the neck in dizziness will allow a balanced approach in assessment and management to allow timely, effective intervention to be provided to the large number of individuals presenting with neck pain and dizziness (Supplemental Digital Content, available at: http://links.lww.com/JNPT/A484 ).

Different Factors Influencing Postural Stability during Transcutaneous Electrical Stimulation of the Cervical Spinal Cord

Transcutaneous spinal cord stimulation (tSCS) is a promising noninvasive alternative to epidural stimulation. However, further studies are needed to clarify how tSCS affects postural control. The aim of this study was to investigate the effect of transcutaneous cervical spinal cord stimulation on postural stability in healthy participants via computerized stabilization. The center of pressure and the frequency spectrum of the statokinesiogram were assessed in 14 healthy volunteers under tSCS conditions with frequencies of 5 Hz or 30 Hz, subthreshold or suprathreshold stimulus strength, open or closed eyes, and hard or soft surfaces in various combinations. The results revealed that not all the changes in the center of the pressure oscillations reached statistical significance when the tSCS was used. However, tSCS at a frequency of 30 Hz with a suprathreshold stimulus strength improved postural stability. The use of subthreshold or suprathreshold tSCS at 5 Hz led to a shift of 60% of the signal power to the low-frequency range, indicating activation of the vestibular system. With tSCS at 30 Hz, the vestibular component remained dominant, but a decrease in the proportion of high-frequency oscillations was observed, which is associated with muscle proprioception. Thus, transcutaneous electrical stimulation of the cervical spinal cord may be an effective method for activating spinal cord neural networks capable of modulating postural control.

Effect of Local Vibration Therapy on Pain, Joint Position Sense, Kinesiophobia, and Disability in Cervical Disc Herniation: A Randomized Controlled Trial

Background/Objectives: Vibration therapy approaches are an effective and safe treatment option for musculoskeletal disorders. This study examines the effects of vibration therapy using a percussion massage gun (PMG) on joint position sense, range of motion, pain, functionality, and kinesiophobia in individuals with cervical disc herniation (CDH). Methods: This single-blind randomized controlled trial involved 44 CDH patients divided into a Vibration Group (VG) and a Conventional Group (CG). The CG underwent a standard physiotherapy treatment heat application, Transcutaneous Electrical Nerve Stimulation (TENS), and exercises for range of motion and strengthening. VG received conventional therapy augmented with vibration therapy (VT) via a PMG. Joint position sense (JPS) using the Laser Pointer Assisted Angle Repetition Test; pain intensity with the Visual Analog Scale, kinesiophobia with the Tampa Scale for Kinesiophobia, and cervical dysfunction with the Neck Disability Index were assessed. Results: Both groups showed statistically significant improvements in pain, kinesiophobia, disability, and proprioception after treatment (p < 0.05). When comparing the difference values between groups, the VG was found to be more effective than the CG in the parameters of VAS activity (p = 0.013). The CG had more improvement in JPS neck left rotation than the VG (p = 0.000). Conclusions: VT, when combined with conventional physiotherapy, is effective in improving pain, proprioception, and functionality in individuals with CDH. These findings support the inclusion of VT as a beneficial adjunct therapy. Further research with larger sample sizes and longer follow-ups is recommended to validate these results and explore the long-term effects of VT on CDH.

Immediate effects of local muscle vibration on static and dynamic balance control in individuals with chronic ankle instability

OBJECTIVES

To investigate the immediate effects of local muscle vibration (LMV) on static and dynamic balance control in individuals with and without chronic ankle instability (CAI).

DESIGN

Quasi-experimental study.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-six individuals with CAI and 26 healthy controls.

MAIN OUTCOME MEASURES

Center of pressure variables (mean total velocity and displacement in anteroposterior (AP) and mediolateral (ML) directions) during single-leg standing with eyes open and eyes closed and also reach distances in anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the modified star excursion balance test (MSEBT) were assessed before and after LMV.

RESULTS

Statistical analyses showed a significant decrease in mean total velocity and displacement in AP direction from before to after LMV in eyes open condition for both individuals with CAI (p = 0.025, p = 0.041, respectively) and healthy controls (p = 0.001, p = 0.003, respectively). Similar results were observed in eyes closed condition for both individuals with CAI (p < 0.001, p < 0.001, respectively) and healthy controls (p = 0.040, p = 0.014, respectively). The results also showed increased reach distances in ANT (p < 0.001), PM (p < 0.001), and PL directions (p < 0.001) in all participants after LMV.

CONCLUSION

Our results suggest that LMV may be a useful tool in rehabilitation of static and dynamic balance deficits in individuals with CAI.

Acute effects of muscle vibration on elbow joint position sense in healthy young men: A randomized trial

BACKGROUND

The study aimed to investigate and compare the acute effects of 2 local vibration frequencies (63 Hz vs 42 Hz frequencies) applied to the biceps brachii muscles on the elbow joint position sense (JPS) in healthy young men.

METHODS

A 3-arm parallel-group design with randomization of participants was used. Forty-five healthy young men aged 19 to 30 years were randomly assigned to 3 groups: to receive 63 Hz (n = 15) in experimental group 1 (EG1) or 42 Hz (n = 15) in experimental group 2 (EG2) or sham vibration in the control group (n = 15). Participants in the EG1 and EG2 received 5 bouts of 1-minute vibration exposure to the biceps brachii muscle, with a 1-minute rest between the bouts. In control group, sham vibration was applied with the same duration and interval as in EG1 and EG2. The active elbow joint position error was selected as an outcome measure to assess elbow JPS. The target angle and the angle reproduced were measured using a Universal Goniometer. The difference between the target and the reproduced angles was calculated to determine active elbow joint position error. Measurements were made before the vibration application and right after it.

RESULTS

No statistically significant difference was observed in the JPS of the elbow joint over time in any group (P = .625). No statistically significant differences were observed between the 33 groups in the JPS of the elbow (P = .075).

CONCLUSION

There was no acute effect of vibration of the biceps brachii muscle at 63 and 42 Hz on active elbow JPS in healthy adults.

The impact of neck pain on gait health: a systematic review and meta-analysis

BACKGROUND

Evidence exists demonstrating the negative impacts of chronic musculoskeletal pain on key measures of gait. Despite neck pain being the second most common musculoskeletal pain condition, there is a paucity of evidence exploring the impacts of neck pain specifically on these outcomes. The aims of this work were to systematically review the current evidence of the associations between chronic neck pain and measures of gait health and to conduct meta-analysis for quantitative assessment of the effect sizes under different walking conditions.

METHODS

Systematic review was conducted following PRISMA guidelines. Databases searched included MEDLINE, Embase, Web of Science, CINAHL, and PEDro. Eligible study designs included observational studies consisting of an exposure group with chronic neck pain and control group without chronic neck pain and primary outcomes relating to gait health. For outcomes amenable to meta-analysis, a random-effects model was used to derive summary estimates of Hedge's g depicted graphically with forest plots. Other gait outcomes were narratively summarized. Risk of bias was also assessed.

RESULTS

The original search yielded 1918 articles; 12 met final eligibility criteria including 10 cross-sectional studies. Outcomes were grouped first by the five domains of gait: pace, rhythm, asymmetry, variability, and postural control; and second by the tested walking conditions. Meta-analyses for gait speed revealed large effect-sizes indicating that individuals with chronic neck pain had slower measures of gait and lower measures of cadence. Gait outcomes that were narratively summarized supported these findings.

CONCLUSION

The quantitative and qualitative findings of this systematic review and meta-analysis suggest a negative impact of CNNP on measures of gait health, particularly gait speed, under various walking conditions. However, broad interpretation of these results should be cautious. Testing gait under dual task conditions may be particularly sensitive to the impact of CNNP, and future work is needed to better understand how pain disrupts this important functionality of the locomotor system. Additionally, consideration should be made to assess measures of variability and investigate these relationships in the older adult population.

The association between contact sport exposure and cervical sensorimotor dysfunction: a scoping review of implications for future musculoskeletal injury risk

BACKGROUND

While morphological changes to the cervical spine have been observed for over 40 years in response to contact sport participation, little is known about the secondary effects of the cervical impairment on future musculoskeletal injury and disability.

OBJECTIVES AND DESIGN

A scoping review was performed to discuss the relationship between contact sport participation and morphological changes to the cervical spine. Moreover, the correlation between morphological changes in the musculoskeletal structures of the cervical spine and resultant deficits in cervical sensorimotor and neuromotor function are discussed. Lastly, how alterations in cervical sensorimotor function may affect overall risk of musculoskeletal injury is discussed.

METHODS

The scientific literature was searched in PubMed, Sport Discus, and Web of Science pertaining to contact-sport athletes and/or cervical pathology and the cervicocephalic network. The Asksey and O'Malley's framework and PRISMA for Scoping Reviews were used to conduct and report the following review. Included articles were grouped into three categories: (1) Morphological changes to the cervical spine in contact sport athletes. (2) The role of the neuromotor pathways of the cervical spine in maintenance of postural tone and coordination of the extremities. (3) The correlation between altered cervical sensorimotor function and a resultant increase in musculoskeletal injury risk.

RESULTS

Our search identified 566 documents, of which 405 underwent full-text screening, resulting in 54 eligible studies for the review. Widespread cervical sensorimotor dysfunction was observed in contact sport athletes. Independently, cervical sensorimotor function was demonstrated to play a critical role in postural control and limb coordination. However, limited research exists exploring the interaction between contact sport participation and altered cervical sensorimotor function, as well as an associated increase in musculoskeletal injury risk.

CONCLUSIONS

Limited evidence exists linking cervical injury and/or observed deficits in cervical sensorimotor and neuromotor function to musculoskeletal injury risk. Longitudinal studies combining imaging measures (e.g., MRI, DEXA), cervical functional test, and prospective injury risk are needed to further explore the correlation between resultant cervical sensorimotor deficits following contact sport impacts and future musculoskeletal injury risk.

The short-term effect of a myofascial protocol versus light touch applied to the cervical spine towards the prevention of balance disorders in the elderly: protocol of a randomised controlled trial

Background

Falling is a major trauma that can occur with aging, leading to very significant psychological and physical health effects with financial and societal consequences. It is therefore essential to explore therapeutic treatments that can reduce this risk. Some recognized effective treatments exist, concerning in particular the re-education of the muscles of the lower limbs. However, to our knowledge, none of them focus on the cervical spine although the latter is located at an essential physiological crossroads. Manual therapy, which has already demonstrated its impact on pain and balance parameters in the elderly, could be a painless and non-invasive tool of choice in addressing this problem.

Methods

Interventional study (not related to a health product), monocentric, prospective, controlled, randomized double-blind (patient and evaluator performing the measurements). The experiment will take place over three measurement periods on D0, D7 and D21. On D0 subjects will be randomized in 2 groups: experimental and placebo group. Both groups will be assessed on: Short Physical Performance Battery test score, walking speed, lower limb strength, balance, heart rate variability and cervical spine strength and mobility. Then the experimental group will receive a myofascial release protocol applied to the cervical spine and the placebo group will receive a placebo light touch protocol. The intervention will be followed by the same measurements as before. This schedule will be reproduced on D7. On D21, only one assessment will be done.

Discussion

This study started in 2020 but could not go beyond the inclusion phase due to the COVID pandemic. It is envisaged that recruitment could resume during 2022.

Trial registration: Registered by the Comité de Protection des Personnes—Sud Méditerranée; under the title “Prévention des troubles de l’équilibre chez le senior: influence de la thérapie manuelle appliquée au rachis sur les paramètres statiques et dynamiques», n° 19.12.27.47.259 in date of February 4, 2020.

Registered by ClinicalTrials.gov ID: NCT05475652; under the title « The Influence of Manual Therapy Applied to the Cervical Spine in the Prevention of Balance Disorders in the Elderly (ManEq)”.

Visual, Vestibular, and Proprioceptive Dependency of the Control of Posture in Chronic Neck Pain Patients

Sensory reweighting of postural control was compared in participants with and without neck pain. Center of pressure variables of 60 volunteers, the same in each group, were calculated under four standing conditions: (a) eyes open, neutral head posture; (b) foam interface, eyes open; (c) cervical extension, eyes open; and (d) cervical extension, eyes closed. All center of pressure variables except anterior posterior range/velocity increased significantly in Condition 2 compared with Conditions 1 and 3 (p < .001) and in Condition 4 compared with Conditions 1 and 3. The mediolateral range/velocity and path length in both groups, anterior posterior range in patients, and center of pressure area in the control group were significantly different between Conditions 2 and 4 (p < .001). No overweighting was observed on the vestibular or visual afferents in patients. Compensatory strategies seem to lie within the proprioceptive system.

Sport-Specific Habitual Adaptations in Neck Kinesthetic Functions Are Related to Balance Controlling Mechanisms

Whilst the importance of trunk, lower and upper extremities for the efficiency of maintaining body sway is well documented, the effects of cervical spine function have been seldom investigated. Afferent information from high density proprioceptors located in the cervical spine can alter postural balance, however the effects of sport’s specific habitual adaptation on balance performance have not yet been investigated. Twenty-seven taekwondo fighters and thirty controls performed unilateral balance tasks while facing forward and during neck torsion balance test while standing on the force plate. Neck kinesthesia was measured with the Head-to-Neutral Relocation test and the Butterfly test with motion-inertial unit. Differences between balance tasks were analyzed using two-way ANOVA. Additionally, correlations between body sway parameters and neck kinesthesia were studied using Pearson correlation coefficient. No differences were found between forward facing and neck torsion balance tasks in taekwondo fighters. However, correlations were found between balance on the non-preferred leg and neck kinesthesia. On the contrary, healthy individuals presented with statistically significant differences between both balance tasks and correlations between balance and neck kinesthesia. Taekwondo fighters seem to present with habitual adaptations in balance control, that differ from non-trained individuals.

Effects of local vibration and cervical stabilization exercises on balance, joint position sense, and isometric muscle performance in young adults: A randomized controlled study

BACKGROUND: Cervical stabilization exercises and local vibration may improve proprioception and balance and prevent musculoskeletal problems. OBJECTIVE: To compare the effects of local vibration and cervical stabilization exercises on balance, cervical joint position sense, and muscle performance in healthy participants. METHODS: Forty-eight healthy male participants without neck pain were included. The participants were randomly divided into three groups: a home exercise program lasting eight weeks to the cervical stabilization group; 60 s of vibration to the neck muscles of the local vibration group and a control group. Balance, joint position sense, and muscle performance were evaluated twice in all subjects, before and after the intervention. RESULTS: Joint position sense error values were decreased in both the local vibration and cervical stabilization groups. Balance was improved (p< 0.001) in the local vibration group while improvement in muscle performance parameters was only seen in the cervical stabilization group (p< 0.05). CONCLUSIONS: The methods used in the present study may be used for improving the proprioceptive and vestibular components of balance in individuals with musculoskeletal problems such as cervical disc herniation, cervical spondylosis, or neck pain. However, given the limitations, much more research is needed to firmly establish these recommendations.

Short-term effects of spinal thrust joint manipulation on postural sway in patients with chronic mechanical neck pain: a randomized controlled trial

PURPOSE

Our aim was to compare the efficacy of spinal manipulation of the upper cervical spine (C1-C2) on postural sway in patients with chronic mechanical neck pain with the application of a combination of cervical (C3-C4), cervicothoracic (C7-T1) and thoracic spine (T5-T6) thrust joint manipulation.

METHODS

One hundred eighty-six (n = 186) individuals with chronic mechanical neck pain were randomised to receive an upper cervical spine manipulation (n = 93) or three different spinal manipulation techniques applied to the cervical spine, cervicothoracic joint and thoracic spine (n = 93). Measures included the assessment of stabilometric parameters using the Medicapteurs S-Plate platform. Secondarily, neck pain was analysed using the Numeric Pain Rating Scale.

RESULTS

We observe a decrease in the length of the centre of pressure path, average speed, medio-lateral and antero-posterior displacement with statistically significant results (p < 0.05) in the upper cervical manipulation group. Both interventions are equally effective in reducing neck pain after fifteen days (p < 0.001).

CONCLUSION

The application of upper cervical thrust joint manipulation is more effective in improving stabilometric parameters in patients with chronic mechanical neck pain. Trial registration: The study was registered in the Australian and New Zealand Clinical Trial Registry (no. ACTRN12619000546156).Implications for rehabilitationPatients who suffer from neck pain exhibit increased postural sway than asymptomatic subjects.Both spinal manipulation treatments applied in this study are equally effective in reducing neck pain.Spinal manipulation treatment on the upper cervical spine improves postural stability parameters.

Handgrip strength correlates with walking in lumbar spinal stenosis

PURPOSE

To examine the relationship between handgrip strength and leg extension power, walking speed, and intermittent claudication for lumbar spinal stenosis (LSS) using computed tomography.

METHODS

We examined patients who underwent laminectomy for LSS from June 2015 through March 2018. Before spine surgery, we evaluated walking distance, handgrip strength, leg extension power (LEP), 10-m walk test (time and steps), psoas muscle index (PMI), and the area of both total and multifidus muscle using plain computed tomography imaging at the third lumbar level. Handgrip strength was compared with comorbidities including anemia, diabetes, hypertension, marital status, etc. RESULTS: There were 183 patients (55 female, 128 male) with a mean age of 70.5 years. Handgrip strength significantly correlated with LEP (P < 0.001, r = 0.723), walking speed (P < 0.001, r = - 0.269), 10-m walking test (steps) (P < 0.001, r = - 0.352), area of skeletal muscle at L3 level (P < 0.001, r = 0.469), area of psoas muscle (P < 0.001, r = 0.380), PMI (P < 0.001, r = 0.253), and intermittent claudication. Age, height, and weight were correlated with handgrip strength, but BMI was not correlated. Handgrip strength was significantly reduced by anemia, hypertension, and single marital status.

CONCLUSIONS

The more handgrip strength patients with LSS have, the more LEP, the faster walking speed, the greater area of psoas and skeletal muscle, the fewer steps for a 10-m walk they have, and the longer walking distance. Age, height, and weight were associated with handgrip strength, but BMI has no association. Low handgrip strength was related to comorbidities including anemia, hypertension, and marital status.

Effects of tandem walk and cognitive and motor dual- tasks on gait speed in individuals with chronic idiopathic neck pain: a preliminary study

Introduction: Gait impairment has been associated with neck pain. It is relevant to understand the possible influence of narrow-based walk and an attention-demanding secondary task on gait performance in neck pain.Purpose: To investigate the effects of tandem walk and cognitive and motor dual-tasks on gait speed in persons with chronic idiopathic neck pain (CINP) compared with controls.Methods: A cross-sectional study. Thirty participants with CINP and 30 asymptomatic controls participated in the study. Gait speed was assessed using a timed 10-m walk test at a comfortable pace under four conditions: (1) comfortable walk (as reference); (2) tandem walk (single task); (3) cognitive dual-task walking; and (4) motor dual-task walking. Dual-task interference was calculated.Results: There was no difference in comfortable gait speed between groups (p= 0.40). The CINP group had slower gait speed during the tandem walk than controls (p= 0.02). The dual-task interference on gait speed was not different between groups (p = 0.67 for cognitive, p = 0.93 for motor).Conclusion: Participants with CINP had impaired gait stability during tandem walk. An attention-demanding secondary task did not influence gait speed in individuals with CINP compared to controls. The study suggests that tandem walk could be considered as an assessment tool and part of rehabilitation for neck pain.

Multimodal Sensory Stimulation of the Masseter Muscle Reduced Precision but Not Accuracy of Jaw-Opening Movements

A functional integration between the trigeminal and craniocervical sensorimotor systems has been demonstrated, with simultaneous jaw and head–neck movements during jaw opening–closing. We previously showed that pain induction in the masseter muscle increased the relative contribution of the neck component of integrated jaw–neck movements. Induced pain or manipulation of proprioception by vibration did not affect accuracy during a jaw-opening task in men. It is not known how multimodal sensory stimulation, with a combination of pain induction and vibration, affects jaw-opening accuracy and precision. The aim was to investigate how jaw–neck movements, and specifically accuracy and precision of jaw-opening, are affected during concomitant nociceptive and proprioceptive stimulation of the masseter muscle. Twenty-one healthy men performed jaw-opening to a target position, defined as 75% of individual maximum jaw opening, during control (Ctr), vibration of masseter muscles (Vib), pain induction in the masseter (Pain), and concomitant vibration and pain induction in the masseter muscle (VibPain). Simultaneous jaw and head movements were recorded with an optoelectronic system and amplitudes calculated for each jaw opening–closing cycle. Accuracy of jaw movements was defined as the achievement of the target position. Precision of jaw movements was defined as the cycle-to-cycle variability from the mean of cycles 2–10 (coefficient of variation, CV). Differences between the trials were analyzed with Friedman’s test, Dunn’s test, and Benjamini–Hochberg correction. There were no significant differences between the trials for jaw movement amplitudes. For head movements, amplitudes for cycles 2–10 were larger during Pain compared to Ctr and Vib (both p = 0.034), and larger during VibPain compared to Ctr (p = 0.034) and Vib (p = 0.035). There were no differences in accuracy of jaw movements between the trials. For precision of jaw movements, the cycle-to-cycle variability was larger during VibPain compared to Ctr (p = 0.027) and Vib (p = 0.018). For integrated jaw–neck motor strategy, there was a difference between pain and non-pain trials, but no differences between unimodal and multimodal stimulation trials. For achievement of jaw-opening to a target position, the results show no effect on accuracy, but a reduced precision of jaw movements during combined proprioceptive and nociceptive multimodal stimulation.

The effects of muscle vibration on gait control: a review

Background: The purpose of the review is to summarize the literature surrounding the use of muscle vibration as it relates to modifying human gait. Methods: After a brief introduction concerning historical uses and early research identifying the effect of vibration on muscle activation, we reviewed 32 articles that used muscle vibration during walking. The review is structured to address the literature within four broad categories: the effect of vibration to 'trigger' gait-like lower limb motions, the effect of vibration on gait control of healthy individuals and individuals with clinical conditions in which gait disorders are a prominent feature, and the effect of vibration training protocols on gait. Results: The acute effects of vibration during gait involving healthy participants is varied. Some authors reported differences in segmental kinematic and spatiotemporal measures while other authors reported no differences in these outcome measures. The literature involving participants with clinical conditions revealed that vibration consistently had a significant impact on gait, suggesting vibration may be an effective rehabilitation tool. All of the studies that used vibration therapy over time reported significant improvement in gait performance. Conclusions: This review highlights the difficulties in drawing definitive conclusions as to the impact of vibration on gait control, partly because of differences in walking protocols, site of vibration application, and outcome measures used across different investigative teams. It is suggested that the development of common investigative methodologies and outcome measures would accelerate the identification of techniques that may provide optimal rehabilitation protocols for individuals experiencing disordered gait control.