Effectiveness of local muscle vibration in treating post-stroke spasticity

Local/ focal muscle vibration (FMV) is a non-invasive technique that in various studies has shown a positive effect on upper limb spasticity after stroke. However, different protocols used do not allow for comparisons between studies. It is still unclear, for example, whether agonistic or antagonistic muscles should be treated with local vibrotherapy to obtain better results in the treatment of spasticity. Therefore, Italian researchers from the IRCCS Don Carlo Gnocchi Foundation compared the effect of spastic upper limb FMV administered to flexor or extensor muscles on the severity of spasticity in patients with subacute stroke.

• FMV administered to the flexors produced similar effects as FMV administered to the extensors, reducing the spasticity of the diseased limb.
• FMV had no effect on muscle strength at the studied time points, whether it was administered to flexors or extensors.
• A statistically significant reduction in the time required to complete the task was observed one month after the administration of FMV to both flexors and extensors.

Prepared on the basis of:

Efficacy of focal muscular vibration in the treatment of upper limb spasticity in subjects with stroke outcomes: randomized controlled trial. Aprile I et al. J Biol Regul Homeost Agents. 2020 Sep-Oct;34(5 Suppl. 3):1-9. Technology in Medicine.

Study population

The study involved 28 patients with subacute stroke, mean age 64.3 ± 13.8 years.

Test procedure

The patients were randomly divided into two groups: A and B. All patients were given FMV for the spastic upper limb, except that group A – for the flexor muscles, and group B – for the extensor muscles. The effect on spasticity was assessed using the Modified Ashworth Scale (MAS). The motor function of the upper limb was also studied using instrumental-robotic analysis, as well as muscle strength using the Motricity Index (MI). Patients were subjected to FMV for three consecutive days. The measurements were performed: before the application of vibrotherapy (T0), one week (T1) and one month (T2) after its completion.

Results

Within each group (A and B), statistically significant changes in MAS were found in three joints: shoulder, elbow and wrist. The MI did not change over time in either group. No statistically significant differences were found in the analysis between the groups. With regard to instrumental-robotic analyzes, a statistically significant shortening of the time required to perform the task (task duration) was found in both groups in T2.

Comment

The presented research has shown that local vibrotherapy can improve muscle tone and spastic functionality of the upper limb in post-stroke patients, regardless of the administration of vibrations to agonist or antagonist muscles.

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