Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review.

Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.

Focal Muscle Vibration and Physical Exercise in Postmastectomy Recovery: An Explorative Study.

Background. Physical activity initiation and maintenance are particular challenges in the postmastectomy recovery and in particular Dragon Boat racing seems to be a useful sport activity. The aim of this study was to evaluate the role of focal muscle vibration as a proprioceptive input to improve upper limb functioning in a group of "paddlers" patients. Methods. A group of paddlers has been evaluated before vibratory treatment (T0), immediately after therapy (T1), after one week (T2), and after one month (T3) with DASH questionnaire, Body Image Scale, McGill pain questionnaire, Constant Scale, and Short Form 36 questionnaire. Results. Fourteen patients showed a significant reduction in disability score (p = 0,001) using DASH scale, an improvement of upper limb function (p = 0,001) using the Constant scale, and a reduction of pain (p = 0,007) at the McGill pain questionnaire. The Mental Composite Score of the Short Form 36 questionnaire showed significant results (p = 0,04) while no significant results had been found regarding the physical mental score (p = 0,08). Conclusion. Focal muscle vibration may be a useful treatment in a postmastectomy recovery of upper limb functionality.

Focal Muscle Vibration Improves Gait in Parkinson's Disease: A Pilot Randomized, Controlled Trial.

BACKGROUND: In Parkinson's disease (PD), gait disorders lead to increased risk of falls and patients' reduced participation and independence. Several observations suggest that a single session of focal muscle vibration (fMV) applied to trunk or lower limb muscles during gait may improve several gait variables in patients with PD. The possible long-term beneficial effects of repetitive sessions of fMV (r-fMV) on gait of patients with PD have been investigated. METHODS: A randomized, controlled trial study has been conducted in an outpatient rehabilitation department. Twenty patients with PD diagnosis have been randomized in two groups: "real" or "sham" r-fMV application to quadriceps and paraspinal muscles in patients with PD. Gait was evaluated with objective gait analysis, and a number of variables, including velocity, step length, stride length, percentage of stance, double support duration, cadence, swing velocity, and step width, have been measured. Gait analysis was performed before and 24 hours and 1 and 3 weeks after r-fMV. RESULTS: After real, but not sham, r-fMV, patients with PD had significant gait improvement as a result of increased walking velocity and stride length. The r-fMV-induced beneficial after effects lasted at least 1 week after the end of stimulation. CONCLUSIONS: Data emerging from our pilot randomized, controlled trial study suggest that r-fMV may improve gait disorders in patients with PD. r-fMV might be a feasible, safe approach for possibly improving gait disorders in patients with PD and might enhance the impact of specific rehabilitation programs in PD.

Focal muscle vibration as a possible intervention to prevent falls in elderly women: a pragmatic randomized controlled trial.

BACKGROUNDS: Different and new approaches have been proposed to prevent the risk of falling of elderly people, particularly women. AIMS: This study investigates the possibility that a new protocol based on the focal mechanical muscle vibration may reduce the risk of falling of elderly women. METHODS: A pragmatic randomized controlled triple-blind trial with a 6-month follow-up after intervention randomized 350 women (mean age 73.4 years + 3.11), members of local senior citizen centers in Rome, into two groups: vibrated group (VG) and control group (CG). For VG participants a mechanical vibration (lasting 10 min) was focally applied on voluntary contracted quadriceps muscles, three times a day during three consecutive days. CG subjects received a placebo vibratory stimulation. Subjects were tested immediately before (T0) and 30 (T1) and 180 (T2) days after the intervention with the Performance-Oriented Mobility Assessment (POMA) test. All subjects were asked not to change their lifestyle during the study. CG underwent sham vibratory treatment. RESULTS: While CG did not show any statistically significant change of POMA at T1 and T2, VG revealed significant differences. At T2, ≈47% of the subjects who completed the study obtained the full score on the POMA test and ≈59% reached the full POMA score. CONCLUSIONS: The new protocol seems to be promising in reducing the risk of falling of elderly subjects.

Long-lasting effects of neck muscle vibration and contraction on self-motion perception of vestibular origin.

OBJECTIVE: To show that neck proprioceptive input can induce long-term effects on vestibular-dependent self-motion perception. METHODS: Motion perception was assessed by measuring the subject's error in tracking in the dark the remembered position of a fixed target during whole-body yaw asymmetric rotation of a supporting platform, consisting in a fast rightward half-cycle and a slow leftward half-cycle returning the subject to the initial position. Neck muscles were relaxed or voluntarily contracted, and/or vibrated. Whole-body rotation was administered during or at various intervals after the vibration train. The tracking position error (TPE) at the end of the platform rotation was measured during and after the muscle conditioning maneuvers. RESULTS: Neck input produced immediate and sustained changes in the vestibular perceptual response to whole-body rotation. Vibration of the left sterno-cleido-mastoideus (SCM) or right splenius capitis (SC) or isometric neck muscle effort to rotate the head to the right enhanced the TPE by decreasing the perception of the slow rotation. The reverse effect was observed by activating the contralateral muscle. The effects persisted after the end of SCM conditioning, and slowly vanished within several hours, as tested by late asymmetric rotations. The aftereffect increased in amplitude and persistence by extending the duration of the vibration train (from 1 to 10min), augmenting the vibration frequency (from 5 to 100Hz) or contracting the vibrated muscle. Symmetric yaw rotation elicited a negligible TPE, upon which neck muscle vibrations were ineffective. CONCLUSIONS: Neck proprioceptive input induces enduring changes in vestibular-dependent self-motion perception, conditional on the vestibular stimulus feature, and on the side and the characteristics of vibration and status of vibrated muscles. This shows that our perception of whole-body yaw-rotation is not only dependent on accurate vestibular information, but is modulated by proprioceptive information related to previously experienced position of head with respect to trunk. SIGNIFICANCE: Tonic proprioceptive inflow, as might occur as a consequence of enduring or permanent head postures, can induce adaptive plastic changes in vestibular-dependent motion sensitiveness. These changes might be counteracted by vibration of selected neck muscles.

Motor performance changes induced by muscle vibration.

The possibility that mechanical stimulation of selected muscles can act directly on the nervous system inducing persistent changes of motor performances was explored. On the basis of literature, stimulating parameters were chosen to stimulate the central nervous system and to avoid muscle fibre injuries. A sinusoidal mechanical vibration was applied, for three consecutive days, on the quadriceps muscle in seven subjects that performed a muscular contraction (VC). The same stimulation paradigm was applied on seven subjects in relaxed muscle condition (VR) and seven subjects were not treated at all (NV). Two sessions (PRE and POST) of isometric and isotonic tests were performed separated for 21 days, in all studied groups 7 days before and 15 days after stimulation, whilst an isokinetic test was performed on VC only. In the isometric test, the time of force development showed a significant decrease only in VC (POST vs PRE mean 27.8%, P < 0.05). In the isotonic test, the subjects' had to perform a fatiguing leg extension against a load. In this condition, the fatigue resistance increased greatly in VC (mean 40.3%, P < 0.001), increased slightly in VR and there was no difference in NV. In Isokinetic test, at several angular velocities, significantly less time was required to reach the force peak (mean 20.2% P < 0.05). The findings could be ascribed to plastic changes in proprioceptive processing, leading to an improvement in knee joint control. Such action delineates a new tool in sports training and in motor rehabilitation.

Repeated exposure to pyrrolidine-dithiocarbamate induces peripheral nerve alterations in rats.

Pyrrolidine-dithiocarbamate (PDTC), a synthetic compound widely used in cell biological investigations, recently attracted considerable interest as a putative anticancer agent. However, different dithiocarbamates have previously shown to cause neurological symptoms and morphological alterations in peripheral nerves. The purpose of the present study was to determine whether a 15-day oral administration with low doses of PDTC may produce adverse effects in peripheral nerves of rats. Female Wistar rats were assigned to receive PDTC [0.1, 0.5 or 1.0mmol/(kg body weight/day)] by gavage for 15 days. Reduced conduction velocity was observed by electrophysiological analysis in tibial nerves of treated animals, accompanied by a marked decrease in Shwann cell S100-protein expression determined by immunohistochemistry. Electron microscopy evaluation revealed marked myelin degeneration in the fibers of treated animals. In particular, both morphological and electrophysiological data suggested an impairment of large, fast conducting fibers, whereas the smallest and slowest ones remained intact. However, the activity of plasma and liver alkaline-phosphatase, an enzymic marker of hepatic dithiocarbamate toxicity, was not altered by the treatment. The total contents of the redox-active metal copper increased in tibial nerves of treated rats and was accompanied by raised levels of lipid peroxidation products. This finding suggests a role for oxidative stress in the development of PDTC-induced pathological and functional alterations of tibial nerves. The observation that a 15-day treatment with low doses of PDTC causes functional and morphological derangement of peripheral nerves advices against the possible use of this compound as a chemopreventive agent against cancer.