Antispastic effect of vibration on upper limbs in post-stroke patients

The aim of the present work of Japanese scientists from the University of Kagoshima was to investigate the therapeutic vibration potential to inhibit upper limb spasticity in hemiplegic stroke patients.

• 5-minute vibration (91 Hz, 1 mm) improved the parameters of the F wave and MAS results, showing a significant reduction in spasticity immediately after its administration, as well as 30 minutes later.

Prepared on the basis of:

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 T, Matsumoto S, Shimodozono M et al. J Rehabil Med. 2012 Apr;44(4):325-30.

Study population

Thirty-six stroke patients with spastic upper limbs hospitalized at Kagoshima University were recruited for the study.

Test procedure

The procedure for a randomized and controlled trial was performed. Patients were randomly assigned to 3 groups:

• control – rest (n = 12),
• stretching (n = 12) or
• group of direct application of vibratory stimulation (DAVS; n = 12).

After relaxing in the supine position for 30 minutes, all subjects received appropriate interventions for 5 minutes. Subjects in the control group rested in a relaxed supine position only. Subjects from the stretching group lay down with maximum extension of their elbows, wrists and fingers. In the DAVS group, vibration-generating devices (Thrive MD-01; Thrive Co., Ltd, Japan) were used to stimulate the hand, forearm and arm.

Before, immediately after and 30 min after each intervention, the results of the Modified Ashworth Scale (MAS – assessing spasticity) and F wave parameters (assessing neuronal activity) were analyzed.

Use of vibration in the study

Parameters of the applied vibrations: frequency 91 Hz, amplitude 1 mm. Vibrations were given in the supine position. All upper limb flexor muscles were stimulated simultaneously.

Results

The control group did not show any significant changes in the parameters tested. Similarly, the stretch group, although there was a tendency to reduce the amplitude of the F wave immediately after the intervention, but not 30 minutes later. In the DAVS group, a meaningful  improvement (statistically significant in relation to the other groups) in the parameters of the F wave and MAS results was observed immediately after the intervention and 30 minutes later.

Comment

The presented results provide good evidence for the antispasmodic effect of vibration therapy. The action of vibrational stimuli on the spastic upper limbs of post-stroke patients reduced spasticity, and the effectiveness of vibrotherapy was not due to stretching.

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