Effect of Focal Muscle Vibration on Calf Muscle Spasticity: A Proof‐of‐Concept Study

Seo, Han Gil; Oh, Byung Mo; Leigh, Ja Ho; Chun, Changmook; Park, Cheol; Kim, Choong Hyun

doi:10.1016/j.pmrj.2016.03.004

Cited by 18 publications

(11 citation statements)

References 34 publications

(63 reference statements)

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“…Lukashevich and Likhachev [ 17 ] studied focal vibration for its ability to reduce poststroke spasticity in 13 volunteers and found that 80 hz and 0.3 amplitude focal vibrations on gastrocnemius muscle reduce maximum amplitudes of H-reflex and M-response as the reflectors of calf muscle spasticity. Another study [ 18 ] about the upper extremity function, spasticity, and grip strength in subjects with poststroke hemiplegia indicated that the use of whole body vibration training combined with task-related training improves arm function, strength, and spasticity. The intervention group had more benefits after 4 weeks of training on the mentioned issues than the control group and the WBV group alone also in accordance with our study.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Whole Body Vibration Therapy on Spasticity and Disability of the Patients with Poststroke Hemiplegia

Alp

Efe

Adalı

et al. 2018

Rehabilitation Research and Practice

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Objective To determine if whole body vibration therapy (WBV) effectively improves functional outcome in patients with poststroke hemiplegia. Materials and Methods In this single-blind RCT, WBV group (n = 10) had 40 hz frequency/4 mm amplitude vibration during 5 minutes/session, 3 days a week, for a duration of 4 weeks. The control group (n = 11) had no vibration therapy for the same duration while standing on the same platform. Patients in both of the groups did 15 minutes of stretching and active range of motion exercises before the intervention. Outcome measures were Modified Ashworth Scale (MAS), Functional Independence Measurement (FIM), and Timed 10-Meter Walk Test (10 mWT). Results Only 10 mWT improved at the 1st week (p = 0.002), 1st month (p < 0.001), and 3rd month (p < 0.001) in favor of the intervention group. There was positive correlation also between 10 mWT and ankle spasticity (p < 0.001, r = 0.931). Conclusion This study suggests that WBV therapy may be a complementary therapy in gait rehabilitation and functional outcome of the patients with calf muscle spasticity.

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Section: Discussionmentioning

confidence: 99%

The Impact of Whole Body Vibration Therapy on Spasticity and Disability of the Patients with Poststroke Hemiplegia

Alp

Efe

Adalı

et al. 2018

Rehabilitation Research and Practice

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“…Growing research is proposing segmental muscle vibration (MV) as being a powerful tool for the treatment of focal spasticity in post-stroke patients [ 14 – 15 ]. Mechanical devices deliver low-amplitude/high-frequency vibratory stimuli to specific muscles [ 16 – 17 ], thus offering strong proprioceptive inputs by activating the neural pathway from muscle spindle annulospiral endings to Ia-fiber, dorsal column–medial lemniscal pathway, the ventral posterolateral nucleus of the thalamus (and other nuclei of the basal ganglia), up to the primary somatosensory area (postcentral gyrus and posterior paracentral lobule of the parietal lobe), and the primary motor cortex [ 18 – 19 ]. At the cortical network level, proprioceptive inputs can alter the excitability of the corticospinal pathway by modulating intracortical inhibitory and facilitatory networks within primary sensory and motor cortex, and affecting the strength of sensory inputs to motor circuits [ 20 – 22 ].…”

Section: Introductionmentioning

confidence: 99%

Is two better than one? Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function: A pilot randomized controlled trial

et al. 2017

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Even though robotic rehabilitation is very useful to improve motor function, there is no conclusive evidence on its role in reducing post-stroke spasticity. Focal muscle vibration (MV) is instead very useful to reduce segmental spasticity, with a consequent positive effect on motor function. Therefore, it could be possible to strengthen the effects of robotic rehabilitation by coupling MV. To this end, we designed a pilot randomized controlled trial (Clinical Trial NCT03110718) that included twenty patients suffering from unilateral post-stroke upper limb spasticity. Patients underwent 40 daily sessions of Armeo-Power training (1 hour/session, 5 sessions/week, for 8 weeks) with or without spastic antagonist MV. They were randomized into two groups of 10 individuals, which received (group-A) or not (group-B) MV. The intensity of MV, represented by the peak acceleration (a-peak), was calculated by the formula (2πf)2A, where f is the frequency of MV and A is the amplitude. Modified Ashworth Scale (MAS), short intracortical inhibition (SICI), and Hmax/Mmax ratio (HMR) were the primary outcomes measured before and after (immediately and 4 weeks later) the end of the treatment. In all patients of group-A, we observed a greater reduction of MAS (p = 0.007, d = 0.6) and HMR (p<0.001, d = 0.7), and a more evident increase of SICI (p<0.001, d = 0.7) up to 4 weeks after the end of the treatment, as compared to group-B. Likewise, group-A showed a greater function outcome of upper limb (Functional Independence Measure p = 0.1, d = 0.7; Fugl-Meyer Assessment of the Upper Extremity p = 0.007, d = 0.4) up to 4 weeks after the end of the treatment. A significant correlation was found between the degree of MAS reduction and SICI increase in the agonist spastic muscles (p = 0.004). Our data show that this combined rehabilitative approach could be a promising option in improving upper limb spasticity and motor function. We could hypothesize that the greater rehabilitative outcome improvement may depend on a reshape of corticospinal plasticity induced by a sort of associative plasticity between Armeo-Power and MV.

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“…The vibrations are believed to initiate muscle contractions by stimulating muscle spindles and alpha motor neurons [4]. The direct vibratory stimulation of muscles may reduce spasticity by influencing the Ia afferent fibers of the muscle spindle, which inhibit the monosynaptic reflex [1216]. Therefore, the H max /M max ratio of the H reflex is significantly decreased, together with clinical spasticity associated with the hypersensitive muscle stretch reflex [11].…”

Section: Discussionmentioning

confidence: 99%

Immediate Effect of a Single Session of Whole Body Vibration on Spasticity in Children With Cerebral Palsy

Park

Choi

et al. 2017

Ann Rehabil Med

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ObjectiveTo investigate the immediate effect of a single session of whole body vibration (WBV) on lower extremity spasticity in children with cerebral palsy (CP).MethodsSeventeen children with spastic CP were included. A single session of WBV was administered: 10-minute WBV, 1-minute rest, and 10-minute WBV. The effects of WBV were clinically assessed with the Modified Ashworth Scale (MAS) and Modified Tardieu Scale (MTS) before and immediately, 30 minutes, 1 hour, 2 hours, 3 hours, and 4 hours after WBV.ResultsSpasticity of the ankle plantarflexor, as assessed by MAS and MTS scores, was reduced after WBV. Post-hoc analysis demonstrated that, compared to baseline, the MAS significantly improved for a period of 1 hour after WBV, and the R1 and R2–R1 of the MTS significantly improved for a period of 2 hours after WBV.ConclusionA single session of WBV improves spasticity of ankle plantarflexors for 1–2 hours in children with CP. Future studies are needed to test whether WBV is an effective preparation before physiotherapy and occupational therapy.

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Effect of Focal Muscle Vibration on Calf Muscle Spasticity: A Proof‐of‐Concept Study

Abstract: II.

Cited by 18 publications

References 34 publications

The Impact of Whole Body Vibration Therapy on Spasticity and Disability of the Patients with Poststroke Hemiplegia

The Impact of Whole Body Vibration Therapy on Spasticity and Disability of the Patients with Poststroke Hemiplegia

Is two better than one? Muscle vibration plus robotic rehabilitation to improve upper limb spasticity and function: A pilot randomized controlled trial

Immediate Effect of a Single Session of Whole Body Vibration on Spasticity in Children With Cerebral Palsy

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