Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients: A proof-of-principle study

Noma, Tomokazu; Matsumoto, Shûji; Shimodozono, Megumi; Etoh, Seiji; Kawahira, Kazumi

doi:10.2340/16501977-0946

Cited by 86 publications

(89 citation statements)

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“…550 Vibration applied to spastic muscle groups might be considered to reduce spasticity transiently, but it is not effective for long-term reduction of spastic hypertonia. [551][552][553] Injection of botulinum toxin is used commonly to treat upper limb spasticity in patients with stroke and is recommended in several recent review articles and previously published guidelines as an important tool in the comprehensive management of poststroke spastic hypertonia. 149,[554][555][556][557] Injections of botulinum toxin A can reduce spasticity significantly as measured by the Ashworth scale.…”

Section: Spasticitymentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,046

840

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e98Purpose-The aim of this guideline is to provide a synopsis of best clinical practices in the rehabilitative care of adults recovering from stroke. Methods-Writing group members were nominated by the committee chair on the basis of their previous work in relevant topic areas and were approved by the American Heart Association (AHA) Stroke Council's Scientific Statement Oversight Committee and the AHA's Manuscript Oversight Committee. The panel reviewed relevant articles on adults using computerized searches of the medical literature through 2014. The evidence is organized within the context of the AHA framework and is classified according to the joint AHA/American College of Cardiology and supplementary AHA methods of classifying the level of certainty and the class and level of evidence. The document underwent extensive AHA internal and external peer review, Stroke Council Leadership review, and Scientific Statements Oversight Committee review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results-Stroke rehabilitation requires a sustained and coordinated effort from a large team, including the patient and his or her goals, family and friends, other caregivers (eg, personal care attendants), physicians, nurses, physical and occupational therapists, speech-language pathologists, recreation therapists, psychologists, nutritionists, social workers, and others. Communication and coordination among these team members are paramount in maximizing the effectiveness

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Section: Spasticitymentioning

confidence: 99%

Guidelines for Adult Stroke Rehabilitation and Recovery

Winstein¹,

Stein²,

Arena

et al. 2016

Stroke

2,046

840

View full text Add to dashboard Cite

show abstract

“…The vibration location varied in previous studies that reported a positive effect of vibration on spasticity and related functional impairment. Noma et al [12,19] reported that vibration to the volar side of the fingers, palm, wrist flexor tendon, and muscle belly of the biceps brachii had antispastic effects in the hemiplegic upper limbs of stroke patients. Marconi et al [13,20] suggested that muscle belly stimulation of the flexor carpi radialis and biceps brachii resulted in improving spasticity and motor function with a parallel change in intracortical inhibition.…”

Section: Discussionmentioning

confidence: 99%

“…Vibratory stimulation is a strong proprioceptive stimulus and can reach both the primary somatosensory and motor cortices [37,38,39] and change the intracortical inhibitory circuit [40]. Several studies proposed that the vibration in patients with spasticity can lead to the redistribution of intracortical synapses related to supraspinal motoneuron excitability control, and the effects would be correlated with long-term functional improvement [17,18,19,20]. Vibration can also mechanically mobilize the muscle and connective tissue to alleviate stiffness and contracture.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Differential Electrophysiological Effects of the Focal Vibrator on the Tendon and Muscle Belly in Healthy People

et al. 2014

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ObjectiveTo investigate the electrophysiological effects of focal vibration on the tendon and muscle belly in healthy people.MethodsThe miniaturized focal vibrator consisted of an unbalanced mass rotating offset and wireless controller. The parameters of vibratory stimulation were adjusted on a flat rigid surface as 65 µm at 70 Hz. Two consecutive tests on the different vibration sites were conducted in 10 healthy volunteers (test 1, the Achilles tendon; test 2, the muscle belly on the medial head of the gastrocnemius). The Hoffman (H)-reflex was measured 7 times during each test. The minimal H-reflex latency, maximal amplitude of H-reflex (Hmax), and maximal amplitude of the M-response (Mmax) were acquired. The ratio of Hmax and Mmax (HMR) and the vibratory inhibition index (VII: the ratio of the Hmax after vibration and Hmax before vibration) were calculated. The changes in parameters according to the time and site of stimulation were analyzed using the generalized estimating equation methods.ResultsAll subjects completed the two tests without serious adverse effects. The minimal H-reflex latency did not show significant changes over time (Wald test: χ2=11.62, p=0.07), and between the two sites (χ2=0.42, p=0.52). The changes in Hmax (χ2=53.74, p<0.01), HMR (χ2=20.49, p<0.01), and VII (χ2=13.16, p=0.02) were significant over time with the adjustment of sites. These parameters were reduced at all time points compared to the baseline, but the decrements reverted instantly after the cessation of stimulation. When adjusted over time, a 1.99-mV decrease in the Hmax (χ2=4.02, p=0.04) and a 9.02% decrease in the VII (χ2=4.54, p=0.03) were observed when the muscle belly was vibrated compared to the tendon.ConclusionThe differential electrophysiological effects of focal vibration were verified. The muscle belly may be the more effective site for reducing the H-reflex compared to the tendon. This study provides the neurophysiological basis for a selective and safe rehabilitation program for spasticity management with focal vibration.

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“…The procedure of applying the vibratory stimulator was that the biceps brachii and flexor carpi radialis in the affected side were placed on the heads of the vibratory stimulators and tied together by straps. Two kg of weights were put on the neck portion of the vibratory stimulators to fix the location of stimulation during the operation9 ) . Box and block test (BBT) was used for hand dexterity.…”

Section: Methodsmentioning

confidence: 99%

Effects of repeated vibratory stimulation of wrist and elbow flexors on hand dexterity, strength, and sensory function in patients with chronic stroke: a pilot study

Choi

2017

J Phys Ther Sci

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[Purpose] The aim of this study was to investigate the effects of repeated vibratory stimulation to muscles related to hand functions on dexterity, strength, and sensory function in patients with chronic stroke. [Subjects and Methods] A total of 10 stroke patients with hemiplegia participated in this study. They were divided into two groups: a) Experimental and b) Control, with five randomly selected subjects for each group. The experimental group received vibratory stimulation, while the control group received the traditional physical therapy. Both interventions were performed for 30 minutes each session, three times a week for four weeks. [Results] There was a significant within-group improvement in the box and block test results in both groups for dexterity. Grip strength improved in both groups but the improvement was not statistically significant. [Conclusion] The vibratory stimulation activated the biceps brachii and flexor carpi radialis, which increased dexterity to grasp and lift the box and block from the surface. Therefore, repeated vibratory stimulation to muscles related to hand functions improved hand dexterity equality to the traditional physical therapy in patients with chronic stroke.

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Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients: A proof-of-principle study

Abstract: The direct application of vibratory stimuli has anti-spastic effects in the hemiplegic upper limbs of post-stroke patients.

Cited by 86 publications

References 0 publications

Guidelines for Adult Stroke Rehabilitation and Recovery

Guidelines for Adult Stroke Rehabilitation and Recovery

Evaluating the Differential Electrophysiological Effects of the Focal Vibrator on the Tendon and Muscle Belly in Healthy People

Effects of repeated vibratory stimulation of wrist and elbow flexors on hand dexterity, strength, and sensory function in patients with chronic stroke: a pilot study

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