Promoting post-stroke recovery through focal or whole body vibration: criticisms and prospects from a narrative review

Abstract

Objective Several focal muscle vibration (fMV) and whole body vibration (WBV) protocols have been designed to promote brain reorganization processes in patients with stroke. However, whether fMV and WBV should be considered helpful tools to promote post-stroke recovery remains still largely unclear. Methods We here achieve a comprehensive review of the application of fMV and WBV to promote brain reorganization processes in patients with stroke. By first discussing the putative physiological basis of fMV and WBV and then examining previous observations achieved in recent randomized controlled trials (RCT) in patients with stroke, we critically discuss possible strength and limitations of the currently available data. Results We provide the first systematic assessment of fMV studies demonstrating some improvement in upper and lower limb functions, in patients with chronic stroke. We also confirm and expand previous considerations about the rather limited rationale for the application of current WBV protocols in patients with chronic stroke. Conclusion Based on available information, we propose new recommendations for optimal stimulation parameters and strategies for recruitment of specific stroke populations that would more likely benefit from future fMV or WBV application, in terms of speed and amount of post-stroke functional recovery.

Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study

“…Vibration provides a strong proprioceptive stimulus [ 13 ] which can improve body balance and gait re-education in older adults [ 14 , 15 ], and can reduce pain by stimulating the afferent alpha and beta motoneurons and inhibiting nociceptive pain fibers [ 16 ]. Vibration stimuli have been shown to lead to improvements in muscle strength [ 17 ] and muscle mass [ 18 , 19 ], a reduction in obesity [ 20 ], and an improvement of gait in neurological patients [ 21 , 22 ]. Moreover, vibration can be applied directly (local vibration) to the muscle [ 17 , 23 ] or indirectly using vibrating platforms (e.g., whole-body vibration, WBV).…”

Focal Muscle Vibration for Stroke Rehabilitation: A Review of Vibration Parameters and Protocols

“…The limitations of the aforementioned intervention strategies are their sustainability due to one or more of these challenges: the requirement of trained and licensed professionals to administer the right dose to ensure safety; lack of precision and accuracy of intervention; lack of consensus among the findings; lack of sufficient evidence to establish the effectiveness of the intervention strategies; awareness of and access to existing intervention strategies; the cost of administration; and other similar disparities [21][22][23][24]. One intervention strategy that has the potential for sustainable stroke rehabilitation is the use of mechanical vibration as a therapeutic intervention known as vibration therapy (VT) [25][26][27][28][29]. According to Murillo et al (2014), VT as an intervention in rehabilitation can be dated back to 1969, when Hagbarth and Eklund observed tonic vibration reflex (TVR) in which the application of vibratory stimulus resulted in agonist muscle contraction and antagonist relaxation.…”

“…This afferent pathway produces involuntary contraction in the vibrated muscle (that is, a tonic vibration reflex, TVR) and inhibits the antagonist muscle [30,31]. The effect of VT on the human body depends on the characteristics of the vibration applied, such as type of vibration (vertical, horizontal, or multidirectional), frequency, amplitude, and the protocol [27]. The effects also depend on the characteristics of the person, such as age, gender, and health condition [26,27].…”

“…The effect of VT on the human body depends on the characteristics of the vibration applied, such as type of vibration (vertical, horizontal, or multidirectional), frequency, amplitude, and the protocol [27]. The effects also depend on the characteristics of the person, such as age, gender, and health condition [26,27].…”

Motor Recovery After Stroke: From a Vespa Scooter Ride Over the Roman Sampietrini to Focal Muscle Vibration (fMV) Treatment. A 99mTc-HMPAO SPECT and Neurophysiological Case Study

“…Focal repetitive muscle vibration (fMV) is a safe and welltolerated intervention, easy to perform at the bedside, and able to promote motor recovery both in acute (11) and chronic stroke patients (12)(13)(14)(15).…”