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Alashram AR. Combined robot-assisted therapy virtual reality for upper limb rehabilitation in stroke survivors: a systematic review of randomized controlled trials. Neurol Sci 2024:10.1007/s10072-024-07628-z. [PMID: 38837113 DOI: 10.1007/s10072-024-07628-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Upper limb impairments are among the most common consequences following a stroke. Recently, robot-assisted therapy (RT) and virtual reality (VR) have been used to improve upper limb function in stroke survivors. OBJECTIVES This review aims to investigate the effects of combined RT and VR on upper limb function in stroke survivors and to provide recommendations for researchers and clinicians in the medical field. METHODS We searched PubMed, SCOPUS, REHABDATA, PEDro, EMBASE, and Web of Science from inception to March 28, 2024. Randomized controlled trials (RCTs) involving stroke survivors that compared combined RT and VR interventions with either passive (i.e., sham, rest) or active (i.e., traditional therapy, VR, RT) interventions and assessed outcomes related to upper limb function (e.g., strength, muscle tone, or overall function) were included. The Cochrane Collaboration tool was used to evaluate the methodological quality of the included studies. RESULTS Six studies were included in this review. In total, 201 patients with stroke (mean age 57.84 years) were involved in this review. Four studies were considered 'high quality', while two were considered as 'moderate quality' on the Cochrane Collaboration tool. The findings showed inconsistent results for the effects of combined RT and VR interventions on upper limb function poststroke. CONCLUSION In conclusion, there are potential effects of combined RT and VR interventions on improving upper limb function, but further research is needed to confirm these findings, understand the underlying mechanisms, and assess the consistency and generalizability of the results.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Ammam, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Combined noninvasive brain stimulation virtual reality for upper limb rehabilitation poststroke: A systematic review of randomized controlled trials. Neurol Sci 2024; 45:2523-2537. [PMID: 38286919 DOI: 10.1007/s10072-024-07360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
Upper limb impairments are common consequences of stroke. Noninvasive brain stimulation (NIBS) and virtual reality (VR) play crucial roles in improving upper limb function poststroke. This review aims to evaluate the effects of combined NIBS and VR interventions on upper limb function post-stroke and to provide recommendations for future studies in the rehabilitation field. PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. Randomized controlled trials (RCTs) encompassed patients with a confirmed stroke diagnosis, administrated combined NIBS and VR compared with passive (i.e., rest) or active (conventional therapy), and included at least one outcome assessing upper limb function (i.e., strength, spasticity, function) were selected. The quality of the included studies was assessed using the Cochrane Collaboration tool. Seven studies met the eligibility criteria. In total, 303 stroke survivors (Mean age: 61.74 years) were included in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," while two were categorized as "moderate quality". There are mixed findings for the effects of combined NIBS and VR on upper limb function in stroke survivors. The evidence for the effects of combined transcranial direct current stimulation and VR on upper limb function post-stroke is promising. However, the evidence regarding the effects of combined repetitive transcranial magnetic stimulation and VR on upper limb function is limited. Further randomized controlled trials with long-term follow-up are strongly warranted.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Zhang S, Zeng N, Wu S, Wu HH, Kong MW. Research progress in spasmodic torticollis rehabilitation treatment. World J Clin Cases 2024; 12:1205-1214. [PMID: 38524504 PMCID: PMC10955543 DOI: 10.12998/wjcc.v12.i7.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/31/2023] [Accepted: 02/06/2024] [Indexed: 02/29/2024] Open
Abstract
Spasmodic torticollis (ST) is a focal dystonia that affects adults, causing limited muscle control and impacting daily activities and quality of life. The etiology and curative methods for ST remain unclear. Botulinum toxin is widely used as a first-line treatment, but long-term usage can result in reduced tolerance and adverse effects. Rehabilitation therapy, with its minimal side effects and low potential for harm, holds significant clinical value. This article explores the effectiveness of adjunctive therapies, including exercise therapy, transcranial magnetic stimulation, shockwave therapy, neuromuscular electrical stimulation, vibration therapy, electromyographic biofeedback, and acupuncture, in the treatment of ST. The aim is to provide clinicians with additional treatment options and to discuss the efficacy of rehabilitation therapy for ST.
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Affiliation(s)
- Shuang Zhang
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Ni Zeng
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Shuang Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Hui-Hui Wu
- Department of Rehabilitation, The Affiliated Hospital of Guizhou Medical University, Guiyang 550018, Guizhou Province, China
| | - Mo-Wei Kong
- Department of Cardiology, Guiqian International General Hospital, Guiyang 550018, Guizhou Province, China
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Alashram AR, Janada Q, Ghrear T. Noninvasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials. PM R 2024; 16:268-277. [PMID: 37574913 DOI: 10.1002/pmrj.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/29/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To investigate the effects of noninvasive brain stimulation (NIBS) on spasticity in people with multiple sclerosis (PwMS). LITERATURE SURVEY We searched PubMed, SCOPUS, MEDLINE, REHABDATA, PEDro, CINAHL, AMED, and Web of Science until December 2022. METHODOLOGY Studies were selected if they included PwMS, used transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) as a main intervention, and were randomized controlled trials (RCTs) including at least one outcome measure evaluating spasticity. Two researchers individually screened the selected studies. The study's quality was assessed using the Cochrane Collaborations tool. The researchers decided that the meta-analysis was not possible because the treatment interventions varied among the selected studies. SYNTHESIS In total, 147 studies were reviewed. Of them, nine studies met the eligibility criteria and included 193 PwMS (mean age = 43.2 years), 54.4% of whom were female. Eight studies were considered "high" quality and one was considered "moderate" quality. Seven studies that used rTMS demonstrated a significant decrease in spasticity in PwMS after the intervention. The remaining studies that provided tDCS did not show meaningful effects. CONCLUSIONS The evidence for the influences of rTMS on spasticity in PwMS is promising. The evidence for the impact of tDCS on spasticity in PwMS was limited. Further RCTs with long-term follow-ups are encouraged.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Qusai Janada
- Department of Physiotherapy, Middle East University, Amman, Jordan
| | - Tamara Ghrear
- Department of Physiotherapy, Middle East University, Amman, Jordan
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Takeuchi K, Takebayashi T, Hanioka D, Okita Y, Shimada S. Comparison of tendon and muscle belly vibratory stimulation in the treatment of post-stroke upper extremity spasticity: a retrospective observational pilot study. Sci Rep 2024; 14:4151. [PMID: 38378862 PMCID: PMC10879534 DOI: 10.1038/s41598-024-54815-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 02/16/2024] [Indexed: 02/22/2024] Open
Abstract
Previous studies have reported the effects of vibratory stimulation (VS) therapy in reducing upper extremity spasticity after stroke. However, the effective location of the VS in patients with stroke remains unclear. This study aimed to determine the VS location that is most effective in reducing post-stroke finger and wrist flexor spasticity. We enrolled 27 consecutive patients with stroke and upper extremity spasticity in this retrospective observational study. The participants received stretching, tendon vibration, and muscle belly vibration for 5 min over a period of 3 days. To evaluate spasticity, we assessed the Modified Ashworth Scale score before and immediately after each treatment and immediately after voluntary finger flexion. Participants who received tendon vibration showed greater improvement in flexor tone in the fingers than participants who received stretching and muscle belly vibration (P < 0.05 and < 0.001, respectively). Participants who underwent VS showed no significant improvement in the wrist flexor tone compared to those who underwent stretching. Our results suggest that the tendon may be the most effective location for treating spasticity of the finger flexor muscles and that VS may not significantly improve spasticity of the wrist flexors more than stretching.
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Affiliation(s)
- Kenta Takeuchi
- Department of Rehabilitation, Itami Kousei Neurosurgical Hospital, 1-300-1, Nishino, Itami, Hyogo, Japan.
- Department of Occupational Therapy, Graduate School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka, Japan.
| | - Takashi Takebayashi
- Department of Occupational Therapy, Graduate School of Comprehensive Rehabilitation, Osaka Metropolitan University, Osaka, Japan
| | - Daiki Hanioka
- Department of Rehabilitation, Tsukazaki Hospital, Himeji, Japan
| | - Yuho Okita
- Soaring Health Sport, Wellness & Community Centre, Melbourne, Australia
| | - Shinichi Shimada
- Department of Neurosurgery, Itami Kousei Neurosurgical Hospital, Itami, Japan
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Shen X, Yu Y, Xiao H, Ji L, Wu J. Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study. Front Neurosci 2023; 17:1281160. [PMID: 38192508 PMCID: PMC10773788 DOI: 10.3389/fnins.2023.1281160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024] Open
Abstract
Objective The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects. Methods Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients. Results Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs. Conclusion FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.
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Affiliation(s)
- Xianshan Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Yang Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Han Xiao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Leilei Ji
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Jianxian Wu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
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Aurelian S, Ciobanu A, Cărare R, Stoica SI, Anghelescu A, Ciobanu V, Onose G, Munteanu C, Popescu C, Andone I, Spînu A, Firan C, Cazacu IS, Trandafir AI, Băilă M, Postoiu RL, Zamfirescu A. Topical Cellular/Tissue and Molecular Aspects Regarding Nonpharmacological Interventions in Alzheimer's Disease-A Systematic Review. Int J Mol Sci 2023; 24:16533. [PMID: 38003723 PMCID: PMC10671501 DOI: 10.3390/ijms242216533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/09/2023] [Accepted: 11/09/2023] [Indexed: 11/26/2023] Open
Abstract
One of the most complex and challenging developments at the beginning of the third millennium is the alarming increase in demographic aging, mainly-but not exclusively-affecting developed countries. This reality results in one of the harsh medical, social, and economic consequences: the continuously increasing number of people with dementia, including Alzheimer's disease (AD), which accounts for up to 80% of all such types of pathology. Its large and progressive disabling potential, which eventually leads to death, therefore represents an important public health matter, especially because there is no known cure for this disease. Consequently, periodic reappraisals of different therapeutic possibilities are necessary. For this purpose, we conducted this systematic literature review investigating nonpharmacological interventions for AD, including their currently known cellular and molecular action bases. This endeavor was based on the PRISMA method, by which we selected 116 eligible articles published during the last year. Because of the unfortunate lack of effective treatments for AD, it is necessary to enhance efforts toward identifying and improving various therapeutic and rehabilitative approaches, as well as related prophylactic measures.
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Affiliation(s)
- Sorina Aurelian
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Gerontology and Geriatrics Clinic Division, St. Luca Hospital for Chronic Illnesses, 041915 Bucharest, Romania
| | - Adela Ciobanu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania
| | - Roxana Cărare
- Faculty of Medicine, University of Southampton, Southampton SO16 7NS, UK;
| | - Simona-Isabelle Stoica
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Aurelian Anghelescu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Midwifery and Nursing, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania
| | - Vlad Ciobanu
- Computer Science Department, Politehnica University of Bucharest, 060042 Bucharest, Romania;
| | - Gelu Onose
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Constantin Munteanu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
- Faculty of Medical Bioengineering, University of Medicine and Pharmacy “Grigore T. Popa”, 700115 Iași, Romania
| | - Cristina Popescu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Ioana Andone
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Aura Spînu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Carmen Firan
- NeuroRehabilitation Compartment, The Physical and Rehabilitation Medicine & Balneology Clinic Division, Teaching Emergency Hospital of the Ilfov County, 022104 Bucharest, Romania;
| | - Ioana Simona Cazacu
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Andreea-Iulia Trandafir
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Mihai Băilă
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Ruxandra-Luciana Postoiu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- NeuroRehabilitation Clinic Division, Teaching Emergency Hospital “Bagdasar-Arseni”, 041915 Bucharest, Romania; (S.-I.S.); (A.A.); (I.S.C.)
| | - Andreea Zamfirescu
- Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 020022 Bucharest, Romania; (S.A.); (A.C.); (C.P.); (I.A.); (A.S.); (A.-I.T.); (M.B.); (R.-L.P.); (A.Z.)
- Gerontology and Geriatrics Clinic Division, St. Luca Hospital for Chronic Illnesses, 041915 Bucharest, Romania
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Seim C, Chen B, Han C, Vacek D, Wu LS, Lansberg M, Okamura A. Relief of post-stroke spasticity with acute vibrotactile stimulation: controlled crossover study of muscle and skin stimulus methods. Front Hum Neurosci 2023; 17:1206027. [PMID: 37706171 PMCID: PMC10497102 DOI: 10.3389/fnhum.2023.1206027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 08/02/2023] [Indexed: 09/15/2023] Open
Abstract
Background Prior work suggests that vibratory stimulation can reduce spasticity and hypertonia. It is unknown which of three predominant approaches (stimulation of the spastic muscle, antagonist muscle, or cutaneous regions) most reduces these symptoms. Objective Determine which vibrotactile stimulation approach is most effective at reducing spastic hypertonia among post-stroke patients. Methods Sham-controlled crossover study with random assignment of condition order in fourteen patients with post-stroke hand spasticity. All patients were studied in four conditions over four visits: three stimulation conditions and a sham control. The primary outcome measure was the Modified Ashworth Scale, and the secondary outcome measure was the Modified Tardieu Scale measured manually and using 3D motion capture. For each condition, measures of spastic hypertonia were taken at four time points: baseline, during stimulation, after stimulation was removed, and after a gripping exercise. Results A clinically meaningful difference in spastic hypertonia was found during and after cutaneous stimulation of the hand. Modified Ashworth and Modified Tardieu scores were reduced by a median of 1.1 (SD = 0.84, p = 0.001) and 0.75 (SD = 0.65, p = 0.003), respectively, during cutaneous stimulation, and by 1.25 (SD = 0.94, p = 0.001) and 0.71 (SD = 0.67, p = 0.003), respectively, at 15 min after cutaneous stimulation. Symptom reductions with spastic muscle stimulation and antagonist muscle stimulation were non-zero but not significant. There was no change with sham stimulation. Conclusions Cutaneous vibrotactile stimulation of the hand provides significant reductions in spastic hypertonia, compared to muscle stimulation. Clinical trial registration www.ClinicalTrials.gov, identifier: NCT03814889.
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Affiliation(s)
- Caitlyn Seim
- Stanford University Department of Mechanical Engineering, Stanford, CA, United States
| | - Bingxian Chen
- Stanford University Department of Bioengineering, Stanford, CA, United States
| | - Chuzhang Han
- Stanford University Department of Mechanical Engineering, Stanford, CA, United States
| | - David Vacek
- Stanford University Department of Mechanical Engineering, Stanford, CA, United States
| | - Laura Song Wu
- Stanford University Department of Mechanical Engineering, Stanford, CA, United States
| | - Maarten Lansberg
- Stanford University Department of Neurology and Neurological Sciences, Stanford, CA, United States
| | - Allison Okamura
- Stanford University Department of Mechanical Engineering, Stanford, CA, United States
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Shirato R, Shimanuki R, Shoji T, Mugikura M. Inhibitory Effects of Prolonged Focal Muscle Vibration on Maximal Grip Strength and Muscle Activity of Wrist and Extrinsic Finger Flexor Muscles. J Chiropr Med 2023; 22:107-115. [PMID: 37346243 PMCID: PMC10280089 DOI: 10.1016/j.jcm.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 03/14/2023] [Accepted: 03/20/2023] [Indexed: 06/23/2023] Open
Abstract
Objective The objective of this study was to identify effective stimulus time by quantifying the inhibitory effects of focal muscle vibration (FMV) on maximal grip strength and muscle activities of the wrist and extrinsic finger flexors. Methods A randomized repeated-measures design was used in this study. A total of 22 healthy volunteers (mean age, 20.9 years) participated. An FMV of 86 Hz was applied to the anterior surface of the distal forearm under the following 3 conditions: no FMV (control), 5-minute FMV, and 10-minute FMV. Maximal grip strength was measured before and after FMV. The muscle activities of the flexor digitorum superficialis, flexor digitorum profundus (FDP), and flexor carpi ulnaris were simultaneously recorded using surface electromyography. Discomfort and complications following FMV were also assessed. Results Compared with the control group, a significant decrease in muscle activity was observed in both the flexor digitorum superficialis and flexor carpi ulnaris after 5 and 10 minutes of FMV. In contrast, there was no significant decrease in the maximal grip strength or FDP muscle activity after either FMV condition. The discomfort was significantly higher immediately after both FMV conditions than in the control group, but it decreased 15 minutes after FMV, indicating no significant difference among the 3 conditions. Redness and/or swelling were observed in 13.6% and 36.3% of the participants after 5 and 10 minutes of FMV, respectively. Conclusion Five-minute FMV to the distal forearm could be a useful therapeutic method with few complications. However, the FMV in this area alone was not sufficient to suppress the muscle activity of the FDP located in the deep layer.
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Affiliation(s)
- Rikiya Shirato
- Department of Rehabilitation, Faculty of Healthcare and Science, Hokkaido Bunkyo University, Eniwa, Japan
| | - Ren Shimanuki
- Department of Occupational Therapy, Tokeidai Memorial Hospital, Sapporo, Japan
| | - Towa Shoji
- Department of Rehabilitation, Hokkaido Saiseikai Midori-no-Sato, Otaru, Japan
| | - Masaki Mugikura
- Department of Rehabilitation, Hanakawa Hospital, Ishikari, Japan
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Alashram AR, Annino G. A Novel Neurorehabilitation Approach for Neural Plasticity
Overstimulation and Reorganization in Patients with Neurological
Disorders. PHYSIKALISCHE MEDIZIN, REHABILITATIONSMEDIZIN, KURORTMEDIZIN 2023. [DOI: 10.1055/a-2004-5836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AbstractNeurological disorders are those that are associated with impairments in the
nervous system. These impairments affect the patient’s activities of
daily living. Recently, many advanced modalities have been used in the
rehabilitation field to treat various neurological impairments. However, many of
these modalities are available only in clinics, and some are expensive. Most
patients with neurological disorders have difficulty reaching clinics. This
review was designed to establish a new neurorehabilitation approach based on the
scientific way to improve patients’ functional recovery following
neurological disorders in clinics or at home. The human brain is a network, an
intricate, integrated system that coordinates operations among billions of
units. In fact, grey matter contains most of the neuronal cell bodies. It
includes the brain and the spinal cord areas involved in muscle control, sensory
perception, memory, emotions, decision-making, and self-control. Consequently,
patients’ functional ability results from complex interactions among
various brain and spinal cord areas and neuromuscular systems. While white
matter fibers connect numerous brain areas, stimulating or improving non-motor
symptoms, such as motivation, cognitive, and sensory symptoms besides motor
symptoms may enhance functional recovery in patients with neurological
disorders. The basic principles of the current treatment approach are
established based on brain connectivity. Using motor, sensory, motivation, and
cognitive (MSMC) interventions during rehabilitation may promote neural
plasticity and maximize functional recovery in patients with neurological
disorders. Experimental studies are strongly needed to verify our theories and
hypothesis.
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Affiliation(s)
- Anas R. Alashram
- Department of Physiotherapy, Middle East University, Amman,
Jordan
- Applied Science Research Center, Applied Science Private
University
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor
Vergata”, Rome, Italy
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11
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Alashram AR, Annino G, Romagnoli C, Raju M, Padua E. Proprioceptive Focal Stimulation (Equistasi ®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review. Proc Inst Mech Eng H 2023; 237:179-189. [PMID: 36515387 DOI: 10.1177/09544119221141945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Gait and postural deficits are the most common impairments in patients with Parkinson's Disease (PD). These impairments often reduce patients' quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata," Rome, Italy
| | - Cristian Romagnoli
- Sport Engineering Lab, Department Industrial Engineering, University of Rome "Tor Vergata," Rome, Italy.,Science and Culture of Well-being and Lifestyle, "Alma Mater" University, Bologna, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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12
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Alashram AR, Padua E, Aburub A, Raju M, Annino G. Transcranial direct current stimulation for upper extremity spasticity rehabilitation in stroke survivors: A systematic review of randomized controlled trials. PM R 2023; 15:222-234. [PMID: 35286007 DOI: 10.1002/pmrj.12804] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the effects of transcranial direct current stimulation (tDCS) on upper extremity spasticity after stroke and to define the most effective tDCS parameters. LITERATURE SURVEY Systematic review in the following databases: PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases. Studies up to June 2020 were included. METHODOLOGY Studies were included if the sample was composed of individuals with stroke, the intervention followed a tDCS intervention (alone or combined with another intervention), and the study was a randomized controlled trial including at least one measurement assessing upper extremity spasticity. Two authors independently screened the included studies. Conflicting decisions between authors were resolved by discussion with the third author. The methodological quality was assessed using the Cochrane Collaboration's tool. The authors determined that the meta-analysis was not feasible due to the heterogeneity in the protocols among the included studies. SYNTHESIS After the screening of 1204 records, a total of seven studies met the specified inclusion criteria and involved 320 participants (mean age = 60.3), 31.1% of whom were females. Patients with ischemic stroke comprised 77.2% of the total patients, and 42.2% were with right hemispheric stroke. Six studies exhibited "high" quality and one exhibited "moderate" quality. Five of the selected studies that combined the tDCS intervention and other traditional interventions showed a significant reduction in upper extremity spasticity after stroke following tDCS intervention. The other two studies that delivered tDCs alone did not show a significant difference. CONCLUSIONS The evidence for the effect of tDCS on upper extremity spasticity after stroke was limited. The optimal tDCS treatment dosage remains unclear. Additional studies with large sample sizes and long-term follow-up are strongly warranted.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Aseel Aburub
- Department of Physiotherapy, Isra University, Amman, Jordan
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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13
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Pfenninger C, Grosboillot N, Digonet G, Lapole T. Effects of prolonged local vibration superimposed to muscle contraction on motoneuronal and cortical excitability. Front Physiol 2023; 14:1106387. [PMID: 36711014 PMCID: PMC9877338 DOI: 10.3389/fphys.2023.1106387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023] Open
Abstract
Introduction: Acute effects of prolonged local vibration (LV) at the central nervous system level have been well investigated demonstrating an altered motoneuronal excitability with a concomitant increase in cortical excitability. While applying LV during isometric voluntary contraction is thought to optimize the effects of LV, this has never been addressed considering the acute changes in central nervous system excitability. Materials and Methods: In the present study, nineteen healthy participants were engaged in four randomized sessions. LV was applied for 30 min to the relaxed flexor carpi radialis muscle (VIBRELAXED) or during wrist flexions (i.e. intermittent contractions at 10% of the maximal voluntary contraction: 15 s ON and 15 s OFF; VIBCONTRACT). A control condition and a condition where participants only performed repeated low-contractions at 10% maximal force (CONTRACT) were also performed. For each condition, motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation and cervicomedullary evoked potentials (CMEPs) elicited by corticospinal tract electrical stimulation were measured before (PRE) and immediately after prolonged LV (POST) to investigate motoneuronal and corticospinal excitability, respectively. We further calculated the MEP/CMEP ratio as a proxy of cortical excitability. Results: No changes were observed in the control nor CONTRACT condition. At POST, CMEP decreased similarly in VIBRELAXED (-32% ± 42%, p < .001) and VIBCONTRACT (-41% ± 32%, p < .001). MEP/CMEP increased by 110% ± 140% (p = .01) for VIBRELAXED and by 120% ± 208% (p = .02) for VIBCONTRACT without differences between those conditions. Discussion: Our results suggest that LV to the flexor carpi radialis muscle, either relaxed or contracted, acutely decreases motoneuronal excitability and induces some priming of cortical excitability.
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Affiliation(s)
- Clara Pfenninger
- Laboratoire Interuniversitaire de Biologie de la Motricité, Lyon 1, Université Savoie Mont-Blanc, Université Jean Monnet Saint-Etienne, Saint-Étienne, France
| | - Nathan Grosboillot
- Laboratoire Interuniversitaire de Biologie de la Motricité, Lyon 1, Université Savoie Mont-Blanc, Université Jean Monnet Saint-Etienne, Saint-Étienne, France,HAVAE EA6310, Faculty of Science and Technology, University of Limoges, Limoges, France
| | - Guillaume Digonet
- University Lyon, UCBL-Lyon 1, Laboratoire Interuniversitaire de Biologie de la Motricité, EA 7424, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Thomas Lapole
- Laboratoire Interuniversitaire de Biologie de la Motricité, Lyon 1, Université Savoie Mont-Blanc, Université Jean Monnet Saint-Etienne, Saint-Étienne, France,*Correspondence: Thomas Lapole,
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14
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Alashram AR, Padua E, Annino G. Effects of Brain-Computer Interface Controlled Functional Electrical Stimulation on Motor Recovery in Stroke Survivors: a Systematic Review. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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15
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Sambe AY, Silva JKMD, Pellizzari CCDA, Valenciano PJ. Efeitos da vibração do tendão muscular no equilíbrio após acidente vascular cerebral: revisão sistemática. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22007629032022pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
RESUMO Após o acidente vascular cerebral (AVC), as pessoas apresentam combinações complexas de déficits sensoriais, motores, cognitivos e emocionais que podem afetar o equilíbrio estático e dinâmico. O objetivo do estudo foi compilar e resumir as principais características e achados de protocolos utilizados em pesquisas que investigaram os efeitos da vibração no tendão muscular no equilíbrio estático e dinâmico em adultos com AVC. Trata-se de uma revisão sistemática, registrada na PROSPERO (CRD42022303874), em que foram realizadas buscas nas bases de dados PubMed, Cochrane, LILACS, SciELO, MEDLINE, Science Direct e PEDro, durante o mês de janeiro de 2022, por meio da combinação de palavras-chave relacionadas a “stroke”, “balance”, “muscle tendon vibration” e “randomized controlled trial”. A qualidade metodológica foi avaliada através da escala PEDro. Foram identificados 1.560 estudos, dos quais 11 foram incluídos, publicados entre 1994 e 2020, envolvendo 242 adultos pós-AVC. Apenas cinco estudos utilizaram a vibração como intervenção e verificaram melhora no equilíbrio estático e dinâmico. Seis estudos analisaram a interferência da vibração no controle postural, observando que o equilíbrio foi afetado durante a aplicação da vibração e que os indivíduos precisaram de mais tempo para se recuperar ou não sofreram diferenças significativas. Verificou-se que os efeitos da vibração do tendão muscular podem melhorar o equilíbrio em pessoas com AVC e influenciar o controle postural através de mecanismos proprioceptivos da vibração. Entretanto, são necessários mais estudos de alta qualidade metodológica para atingir um consenso em relação aos protocolos de tratamento com vibração do tendão muscular e sua recomendação na prática clínica.
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16
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Sambe AY, Silva JKMD, Pellizzari CCDA, Valenciano PJ. Effects of muscle tendon vibration on balance after stroke: systematic review. FISIOTERAPIA E PESQUISA 2022. [DOI: 10.1590/1809-2950/22007629032022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
ABSTRACT After cerebrovascular accident (CVA), people have complex combinations of sensory, motor, cognitive, and emotional deficits, which can affect static and dynamic balance. This study aimed to compile and summarize the main features and findings of protocols used in research that investigated the effects of muscle tendon vibration on static and dynamic balance in adults with stroke. This is a systematic review, registered in PROSPERO (CRD42022303874), in which searches were performed in the databases PubMed, Cochrane, LILACS, SciELO, MEDLINE, Science Direct, and PEDro, during the month of January 2022, using the combination of keywords related to “stroke,” “balance,” “muscle tendon vibration,” “randomized controlled trial.” Methodological quality was assessed using the PEDro scale. A total of 1,560 studies were identified, 11 of which were included, between the years 1994 to 2020, involving 242 post-stroke adults. Only five studies used vibration as an intervention and found an improvement in static and dynamic balance. Six studies analyzed the interference of vibration on postural control, showing that balance was affected during the application of vibration and that individuals needed more time to recover or did not experience significant differences. We found that the effects of muscle tendon vibration may be able to improve balance in people with stroke and influence postural control by proprioceptive mechanisms of vibration. However, more studies of high methodological quality are needed to reach a consensus regarding muscle tendon vibration treatment protocols and their recommendation in clinical practice.
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17
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Zhang Y, Xu P, Deng Y, Duan W, Cui J, Ni C, Wu M. Effects of vibration training on motor and non-motor symptoms for patients with multiple sclerosis: A systematic review and meta-analysis. Front Aging Neurosci 2022; 14:960328. [PMID: 36034149 PMCID: PMC9415382 DOI: 10.3389/fnagi.2022.960328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/01/2022] [Indexed: 11/15/2022] Open
Abstract
Background Vibration therapy is one of the rehabilitation programs that may be effective in treating both motor and non-motor symptoms in Multiple Sclerosis patients. We conducted a comprehensive systematic review and meta-analysis to assess the effects of vibration therapy on motor and non-motor symptoms (functional mobility, balance, walking endurance, gait speed, fatigue, and quality of life) of this population. Methods A systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Physiotherapy Evidence Database, Scopus, Google Search Engine, and the China National Knowledge Infrastructure (CNKI). Two reviewers independently assessed the study quality. Results Fourteen studies with 393 participants were finally included in the meta-analysis. The pooled results showed that vibration therapy had a significant advantage over the control intervention in improving balance function [mean difference (MD) = 2.04, 95% confidence interval (CI): 0.24-3.84, P = 0.03], and walking endurance (SMD = 0.34, 95% CI: 0.07-0.61, P = 0.01). Meanwhile, the degree of disability subgroup analysis revealed that the Expanded Disability Status Scale (EDSS) score (3.5-6) significantly improved functional mobility (MD: -1.18, 95% CI: -2.09 to 0.28, P = 0.01) and balance function (MD: 3.04, 95% CI: 0.49-5.59, P = 0.02) compared with the control group, and the EDSS (0-3.5) were more beneficial in walking endurance. The duration subgroup analysis indicated a significant difference in the effect of the duration (<4 weeks) on enhancing walking endurance (SMD: 0.46, 95% CI: 0.04-0.87, P = 0.03). However, no significant improvement was found in functional mobility, gait speed, fatigue, and quality of life. Conclusion Vibration therapy may improve balance function and walking endurance, and the degree of disability and duration of intervention may affect outcomes. The evidence for the effects of vibration therapy on functional mobility, gait speed, fatigue, and quality of life remains unclear. More trials with rigorous study designs and a larger sample size are necessary to provide this evidence. Systematic Review Registration PROSPERO, https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022326852.
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Affiliation(s)
| | | | | | | | | | | | - Ming Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
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18
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Kolbaşı EN, Huseyinsinoglu BE, Bayraktaroğlu Z. Effect of upper limb focal muscle vibration on cortical activity: A systematic review with a focus on primary motor cortex. Eur J Neurosci 2022; 56:4141-4153. [PMID: 35673835 DOI: 10.1111/ejn.15731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
This systematic review aimed to investigate the effects of upper extremity focal muscle vibration (FMV) on cortical activity. A systematic literature search was conducted for articles published in English in the SCOPUS, PEDro, PUBMED, REHABDATA, MEDLINE, and Web of Science databases. Eighteen studies (6 controlled and 12 experimental studies) were included in the systematic review. A total of 264 individuals (20 to 68 years) participated in the studies. The outcome of this review showed that FMV might have contradictory effects on cortical areas: (a) Reduction of cortical activity in the primary motor cortex (M1) and somatosensory cortex (S1), (b) no changes in the cortical activity of M1, and (c) increased cortical activity of M1 and S1. These effects may depend on different factors such as frequency and amplitude of FMV, vibration exposure time, and muscle status. However, no single factor can definitely be accounted for the variance.
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Affiliation(s)
- Esma Nur Kolbaşı
- Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey.,Institute of Graduate Studies, Physiotherapy and Rehabilitation Department, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burcu Ersoz Huseyinsinoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Zübeyir Bayraktaroğlu
- Department of Physiology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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19
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Influence of 40 Hz and 100 Hz Vibration on SH-SY5Y Cells Growth and Differentiation-A Preliminary Study. Molecules 2022; 27:molecules27103337. [PMID: 35630814 PMCID: PMC9143216 DOI: 10.3390/molecules27103337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: A novel bioreactor platform of neuronal cell cultures using low-magnitude, low-frequency (LMLF) vibrational stimulation was designed to discover vibration influence and mimic the dynamic environment of the in vivo state. To better understand the impact of 40 Hz and 100 Hz vibration on cell differentiation, we join biotechnology and advanced medical technology to design the nano-vibration system. The influence of vibration on the development of nervous tissue on the selected cell line SH-SY5Y (experimental research model in Alzheimer’s and Parkinson’s) was investigated. (2) Methods: The vibration stimulation of cell differentiation and elongation of their neuritis were monitored. We measured how vibrations affect the morphology and differentiation of nerve cells in vitro. (3) Results: The highest average length of neurites was observed in response to the 40 Hz vibration on the collagen surface in the differentiating medium, but cells response did not increase with vibration frequency. Also, vibrations at a frequency of 40 Hz or 100 Hz did not affect the average density of neurites. 100 Hz vibration increased the neurites density significantly with time for cultures on collagen and non-collagen surfaces. The exposure of neuronal cells to 40 Hz and 100 Hz vibration enhanced cell differentiation. The 40 Hz vibration has the best impact on neuronal-like cell growth and differentiation. (4) Conclusions: The data demonstrated that exposure to neuronal cells to 40 Hz and 100 Hz vibration enhanced cell differentiation and proliferation. This positive impact of vibration can be used in tissue engineering and regenerative medicine. It is planned to optimize the processes and study its molecular mechanisms concerning carrying out the research.
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20
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Alashram AR, Padua E, Romagnoli C, Raju M, Annino G. Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2022; 27:e1945. [PMID: 35279915 DOI: 10.1002/pri.1945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/17/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders. OBJECTIVES This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders. METHODS PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders. CONCLUSIONS The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Isra University, Amman, Jordan.,Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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21
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Weizman Y, Tirosh O, Fuss FK, Tan AM, Rutz E. Recent State of Wearable IMU Sensors Use in People Living with Spasticity: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22051791. [PMID: 35270937 PMCID: PMC8914967 DOI: 10.3390/s22051791] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 05/02/2023]
Abstract
Spasticity is a disabling characteristic of neurological disorders, described by a velocity-dependent increase in muscle tone during passive stretch. During the last few years, many studies have been carried out to assess spasticity using wearable IMU (inertial measurements unit) sensors. This review aims to provide an updated framework of the current research on IMUs wearable sensors in people living with spasticity in recent studies published between 2017 and 2021. A total of 322 articles were screened, then finally 10 articles were selected. Results show the lack of homogenization of study procedures and missing apparatus information in some studies. Still, most studies performed adequately on measures of reporting and found that IMUs wearable data was successful in their respective purposes and goals. As IMUs estimate translational and rotational body motions, we believe there is a strong potential for these applications to estimate velocity-dependent exaggeration of stretch reflexes and spasticity-related characteristics in spasticity. This review also proposes new directions of research that should be challenged by larger study groups and could be of interest to both researchers as well as clinicians. The use of IMUs to evaluate spasticity is a promising avenue to provide an objective measurement as compared to non-instrumented traditional assessments.
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Affiliation(s)
- Yehuda Weizman
- Department of Health and Medical Sciences, School of Health Sciences, Hawthorn Campus, Swinburne University of Technology, Melbourne 3122, Australia; (O.T.); (A.M.T.)
- Correspondence: ; Tel.: +61-3921-45320
| | - Oren Tirosh
- Department of Health and Medical Sciences, School of Health Sciences, Hawthorn Campus, Swinburne University of Technology, Melbourne 3122, Australia; (O.T.); (A.M.T.)
| | - Franz Konstantin Fuss
- Chair of Biomechanics, Faculty of Engineering Science, University of Bayreuth, D-95440 Bayreuth, Germany;
| | - Adin Ming Tan
- Department of Health and Medical Sciences, School of Health Sciences, Hawthorn Campus, Swinburne University of Technology, Melbourne 3122, Australia; (O.T.); (A.M.T.)
| | - Erich Rutz
- Department of Orthopaedics, The Royal Children’s Hospital, Melbourne 3052, Australia;
- Murdoch Children’s Research Institute, MCRI, Parkville, Melbourne 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne 3052, Australia
- Medical Faculty, University of Basel, 4001 Basel, Switzerland
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22
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Alashram AR, Padua E, Raju M, Romagnoli C, Annino G. Transcutaneous spinal cord stimulation effects on spasticity in patients with spinal cord injury: A systematic review. J Spinal Cord Med 2021:1-8. [PMID: 34855565 DOI: 10.1080/10790268.2021.2000200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Spasticity is one of the most prevalent impairments following spinal cord injury (SCI). It can lead to a decrease in the patient's functional level. Transcutaneous spinal cord stimulation (tSCS) has demonstrated motor function improvements following SCI. No systematic reviews were published examining the influences of tSCS on spasticity post-SCI. OBJECTIVES This review aimed to investigate the effects of tSCS on spasticity in patients with SCI. METHODS PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched until June 2021. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. RESULTS Six studies met the inclusion criteria. Five studies were pilot studies, and one was a case series. The scores on the PEDro scale ranged from two to four, with a median score of four. The results showed heterogenous evidence for the effects of tSCS on spasticity reduction post-SCI. CONCLUSIONS TSCS appears safe and well-tolerated intervention in patients with SCI. The evidence for the effectiveness of tSCS on spasticity in chronic SCI patients is limited. Further randomized controlled studies are strongly needed to study the effects of tSCS on patients with SCI.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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23
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Moggio L, de Sire A, Marotta N, Demeco A, Ammendolia A. Vibration therapy role in neurological diseases rehabilitation: an umbrella review of systematic reviews. Disabil Rehabil 2021; 44:5741-5749. [PMID: 34225557 DOI: 10.1080/09638288.2021.1946175] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To summarize the findings and evaluate the role of vibratory therapy in the rehabilitation of neurological diseases. METHODS We systematically research PubMed, Scopus, Embase, Physiotherapy Evidence Database (PEDro), Web of Science, and Cochrane library databases from the inception until November 2020. We included studies that compared whole-body vibration (WBV) or focal muscle vibration (FMV) with placebo, sham, or another form of exercise in neurological disease rehabilitation in children and adults that result in motor impairments and disability. RESULTS We included 16 systematic reviews with good methodological quality evaluated using the Joanna Briggs Institute Umbrella Review Assessment and Review of Information appraisal tool. In stroke patients, WBV appears to play a role in improving gait and balance, while FMV is more effective in reducing spasticity. In multiple sclerosis and cerebral palsy, no evidence suggested that vibration therapy increases some patient outcomes. CONCLUSION WBV and FMV appear to play a considerable role in reducing spasticity and improving gait, balance, and motor function in stroke patients. By contrast, vibration therapy seems to be unable to reduce spasticity in multiple sclerosis and cerebral palsy. Also, correct use parameters for this therapy could not be defined.IMPLICATIONS FOR REHABILITATIONBased on the growing number of systematic reviews, this umbrella review aimed to summarize the findings and evaluate the role of vibration therapy in the rehabilitation of neurological diseases.Whole-body vibration and focal muscle vibration appear to play a considerable role in reducing spasticity and improving gait, balance, and motor function in patients affected by stroke.Focal muscle vibration appears to be more useful if applied to non-spastic antagonist muscles with reciprocal inhibitory action on spastic muscles in subjects affected by stroke.Vibration therapy seems not to be able to reduce spasticity in multiple sclerosis and cerebral palsy.
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Affiliation(s)
- Lucrezia Moggio
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Alessandro de Sire
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Nicola Marotta
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Andrea Demeco
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Antonio Ammendolia
- Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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Alashram AR, Annino G, Aldajah S, Raju M, Padua E. Rehabilitation of limb apraxia in patients following stroke: a systematic review. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1658-1668. [PMID: 33851895 DOI: 10.1080/23279095.2021.1900188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Apraxia is widely used to describe one of the more disabling deficits following left strokes. The role of rehabilitation in treating apraxic stroke patients remains unclear. This systematic review was conducted to study the impacts of various rehabilitation interventions on the limb apraxia post-stroke. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched for the experimental studies that investigated the effects of the rehabilitation interventions on apraxia in patients with stroke. The methodological quality was rated using the Physiotherapy Evidence Database scale (PEDro). Six studies met our inclusion criteria in this systematic review. Four were randomized controlled trials, pilot (n = 1), and case study (n = 1). The scores on the PEDro scale ranged from two to eight, with a median of seven. The results showed some evidence for the effects of strategy training and gesture training interventions on the cognitive functions, motor activities, and activities of daily livings outcomes poststroke. The preliminary findings showed that the effects of the strategy training and the gesture training on apraxia in patients with stroke are promising. Further randomized controlled trials with long-term follow-ups are strongly needed.
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Affiliation(s)
- Anas Radi Alashram
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Roma, Italy.,Department of Physiotherapy, Isra University, Amman, Jordan
| | - Giuseppe Annino
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Roma, Italy
| | | | - Manikandan Raju
- Department of Neuroscience, University of Rome La Sapienza, Roma, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, Telematic University San Raffaele Rome Srl, Roma, Italy
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Ayvat F, Özçakar L, Ayvat E, Aksu Yıldırım S, Kılınç M. Effects of low vs. high frequency local vibration on mild-moderate muscle spasticity: Ultrasonographical and functional evaluation in patients with multiple sclerosis. Mult Scler Relat Disord 2021; 51:102930. [PMID: 33836458 DOI: 10.1016/j.msard.2021.102930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/16/2021] [Accepted: 03/26/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Local vibration (LV) is a physiotherapy application that aims to reduce spasticity. The study aimed to compare the effects of 50 Hz vs. 100 Hz LV on mild-moderate spasticity, functional performance and muscle architecture. METHODS Thirty-three patients were randomly divided into three groups: 50 Hz LV group, 100 Hz LV group and the control group. Physical therapy was applied for one hour a day, three days a week, for a total of eight weeks. LV was applied to the right and left medial gastrocnemius muscles for five minutes. Clinical (spasticity, ankle joint position sense, balance, gait) and ultrasonographic (gastrocnemius fascicle length and pennation angle) measurements were performed before and after treatment. RESULTS The study was completed with 27 patients. The decrease in spasticity and the increase in fascicle length were found to be statistically significant in the 50 Hz group (both p<0.05). Ankle joint position sense, single-leg stance time, limits of stability/postural sway range in the medio-lateral direction significantly improved in the vibration treatment groups (all p<0.05). The antero-posterior limits of stability and postural sway showed significant improvement in all groups (all p<0.05). While the 50 Hz group showed significant improvement for all walking parameters; velocity, step length and base of support values improved in the 100 Hz group (all p<0.05). The exercise group showed significant improvement only for single support and stance phase percentages of the gait cycle (both p<0.05). According to between group comparisons, significant difference was found only in medio-lateral limits of stabillity (p<0.05). Medio-lateral limits of stabillity scores were better for the 50 Hz group than the 100 Hz and exercise group. CONCLUSION Our findings show that LV does not have any substantial effect except for medio-lateral limits of stability. CLINICAL TRIAL NUMBER NCT04192786.
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Affiliation(s)
- Fatma Ayvat
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı/Altındag, Ankara, Turkey.
| | - Levent Özçakar
- Hacettepe University Medical School, Department of Physical and Rehabilitation Medicine, Ankara, Turkey.
| | - Ender Ayvat
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı/Altındag, Ankara, Turkey.
| | - Sibel Aksu Yıldırım
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı/Altındag, Ankara, Turkey.
| | - Muhammed Kılınç
- Hacettepe University, Faculty of Physical Therapy and Rehabilitation, 06100 Samanpazarı/Altındag, Ankara, Turkey.
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Alashram AR, Alghwiri AA, Padua E, Annino G. Efficacy of proprioceptive neuromuscular facilitation on spasticity in patients with stroke: a systematic review. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.1892281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Anas R. Alashram
- PhD School in Neuroscience, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Rome, Italy
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
- Department of Physiotherapy, Isra University, Amman, Jordan
| | - Alia A. Alghwiri
- Physical Therapy Department, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
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Alashram AR, Annino G. Bilateral Arm Training vs Unilateral Arm Training for Severely Affected Patients With Stroke: Comments on Exploratory Single-Blinded Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:1236. [PMID: 33711276 DOI: 10.1016/j.apmr.2021.01.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Anas R Alashram
- School of Neuroscience, Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
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Li W, Li C, Liu P, Li Y, Xiang Y, Jia T, Xu Q, Ji L. Development and Preliminary Validation of a Pneumatic Focal Vibration System to the Mitigation of Post-Stroke Spasticity. IEEE Trans Neural Syst Rehabil Eng 2021; 29:380-388. [PMID: 33460383 DOI: 10.1109/tnsre.2021.3052187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Some evidence has demonstrated that focal vibration (FV) plays an important role in the mitigation of spasticity. However, the research on developing the FV system to mitigate the spasticity effectively has been seldom reported. To relieve post-stroke spasticity, a new pneumatic FV system has been proposed in this paper. An image processing approach, in which the edge of vibration actuator was identified by the Canny edge detector, was utilized to quantify this system's parameters: the frequency ranging from 44 Hz to 128 Hz and the corresponding amplitude. Taking one FV protocol with the frequency of 87 Hz and the amplitude 0.28 mm of this system as an example, a clinical experiment was carried out. In the clinical experiment, FV was applied over the muscle belly of the antagonist of spastic muscle for twelve chronic spastic stroke patients. Spasticity was quantified by the muscle compliance and area under the curve for muscle (AUC_muscle). The result has demonstrated that, in the state of flexion of spastic muscle, the AUC_muscle and muscle compliance of the spastic muscle significantly increased immediately after FV compared with before-FV, illustrating the mitigation of the spasticity. This study will not only provide a potential tool to relieve post-stroke spasticity, but also contribute to improving the sensory and motor function of patients with other neurological diseases, e.g. spinal cord injury, multiple sclerosis, Parkinson and dystonia, etc.
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Avvantaggiato C, Casale R, Cinone N, Facciorusso S, Turitto A, Stuppiello L, Picelli A, Ranieri M, Intiso D, Fiore P, Ciritella C, Santamato A. Localized muscle vibration in the treatment of motor impairment and spasticity in post-stroke patients: a systematic review. Eur J Phys Rehabil Med 2020; 57:44-60. [PMID: 33111513 DOI: 10.23736/s1973-9087.20.06390-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION During the last decades, many studies have been carried out to understand the possible positive effects of vibration therapy in post-stroke rehabilitation. In particular, the use of localized muscle vibration (LMV) seems to have promising results. The aim of this systematic review was to describe the use of LMV in post-stroke patients to improve motor recovery, reducing spasticity and disability in both upper and lower limb. EVIDENCE ACQUISITION A search was conducted on PubMed, Scopus, Pedro and REHABDATA electronic database. Only randomized controlled trials have been included, excluding no-localized vibratory treatments and other pathological conditions. Fourteen studies met the inclusion criteria and were included in this review. EVIDENCE SYNTHESIS Collectively, the studies involved 425 stroke patients. Most studies included chronic stroke patients (ten) and treated only the upper limb (eleven). There is evidence that LMV therapy is effective in reducing spasticity and improving motor recovery, especially when associated with conventional physical therapy. CONCLUSIONS LMV may be a feasible and safe tool to be integrated into traditional and conventional neurorehabilitation programs for post-stroke patients to reduce spasticity. Analysis of the available clinical trials do not allow us to indicate vibration therapy as effective in functional motor recovery, despite some studies showed encouraging results. Further studies, with larger size of homogeneous patients and with a shared methodology are needed to produce more reliable data, especially on the lower limb.
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Affiliation(s)
- Christian Avvantaggiato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy.,Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy
| | - Roberto Casale
- OPUS Medica Persons, Care and Research (PC&R), Piacenza, Italy
| | - Nicoletta Cinone
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Salvatore Facciorusso
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Antonio Turitto
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Lucia Stuppiello
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Verona, Italy
| | - Maurizio Ranieri
- Department of Basic Sciences, Neuroscience and Sense Organs, Aldo Moro University, Bari, Italy
| | - Domenico Intiso
- Department of Neuro-Rehabilitation IRCCS, Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Pietro Fiore
- Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Ciritella
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Andrea Santamato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy -
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Characterization of the stimulation output of four devices for focal muscle vibration. Med Eng Phys 2020; 85:97-103. [PMID: 33081969 DOI: 10.1016/j.medengphy.2020.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 11/20/2022]
Abstract
Different devices for mechano-acoustic muscle vibration became available on the market in the last ten years. Although the use of these vibrators is increasing in research and clinical settings, the features of their stimulation output were never described in literature. In this study we aimed to quantify and compare the stimulation output of the four most widespread pneumatic devices for focal muscle vibration available on the market. A piezoelectric pressure sensor was used to measure the pressure profile generated by the four selected devices in the following experimental conditions: i) measurement of the output changes associated with variations of the stimulation amplitude for three stimulation frequencies (100 Hz, 200 Hz, and 300 Hz); ii) measurement of the output changes during a 20-min long stimulation at constant frequency (300 Hz) and amplitude; iii) measurement of the output changes associated with the progressive activation of all stimulation channels at constant frequency (200 Hz) for different amplitudes. The maximum peak-to-peak amplitudes of the pressure waves were in the range 102 mbar - 369 mbar (below the maximum values declared by the different manufacturers). The shape of the pressure waves generated by the four devices was quasi-sinusoidal and asymmetric with respect to the atmospheric pressure. All output features had a remarkable intra- and inter-device variability. Further studies are required to support the technological improvement of the currently available devices and to focus the issues of vibration effectiveness, limitations, proper protocols, modalities of its application and assessment in neuromuscular training and rehabilitation.
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