Segmental muscle vibration improves upper limb functional ability after stroke

One of the common complications after stroke is functional impairment of the upper limb. Effective methods of combating this ailment are constantly being researched. One of them is the administration of segmental muscle vibration (SMV) to activate cortical motor excitability. The aim of the presented work of Italian scientists was to analyze the effect of supervised physical therapy (SPT) or combined SPT-SMV therapy on the fitness and motor skills of hemiparetic upper limb after stroke.

• Both tested therapies (SPT alone or SPT-SMV) improved the mobility and the range of mobility and strength of the elbow muscles.
• The muscle tone in the elbow joint of the paresis hand improved significantly only after the combined SPT-SMV therapy.

Prepared on the basis of:

Effect of segmental muscle vibration on upper extremity functional ability poststroke: A randomized controlled trial. Annino G, Alashram AR, Alghwiri AA et al. Medicine (Baltimore). 2019 Feb;98(7):e14444.

Study population

34 post-stroke patients (29 men) aged 68.6 ± 9.3 years participated in the study.

Test procedure

Patients were randomly assigned to the control group (SPT; n = 17) or the test group (SPT combined with SMV (SPT-SMV; n = 17). All patients received 3 SPT sessions per week for 8 weeks. A single SPT session lasted 30 minutes and included manual resistance exercises and functional training for the paresis upper limb. The SPT-SMV group additionally received SMV at the end of each SPT session.

The pre/ post intervention analysis included assessment of mobility by Barthel index (BI), assessment of the level of muscle spasticity by modified Ashworth scale, manual muscle tests and range of motion (ROM) goniometry.

Use of vibration in the study

SMV (frequency 30 Hz and amplitude 2 mm) was applied perpendicularly along the muscle fibers of the triceps for 5 minutes.

Results

Both after SPT and after SPT-SMV, elbow BI and ROM as well as elbow muscle strength improved.

The muscle tone in the elbow joint of the paresis hand improved significantly only in the SPT-SMV group.

Comment

As shown in the presented study, SPT may improve the functional capacity of the upper limb poststroke, which may benefit by adding SMV therapy. In addition, combining SMV to SPT can further improve muscle tone and reduce spasticity.

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