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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.

Few minutes of focal vibration (FV) on limb muscles can improve motor control in neurological (stroke, Parkinson) patients for unknown underlying neurophysiological mechanisms. Here we hypothesized that in healthy volunteers this FV would increase excitability in the primary sensorimotor cortex (S1-M1) during an isometric contraction of the stimulated muscle. The design included an initial control condition with no FV stimulation (Baseline) as well as three short experimental sessions of FV and a Sham (fake) session in a pseudo-random order. In the Baseline condition and immediately after those sessions, electroencephalographic (EEG) activity was recorded during a mild isometric muscle contraction of the right arm. Alpha and beta motor-related EEG power desynchronization (MRPD) at C4 and C3 electrodes overlying Rolandic regions were used as an index of the cortical excitation in S1-M1. Results showed that, compared to the Baseline (no FV) or Sham stimulation, the first two FV sessions showed a cumulative increase in alpha (but not beta) MRPD at C3 electrode, suggesting a specific effect of vibration on the excitability of contralateral S1-M1 generating EEG "mu" rhythms. FV over limb muscles modulates neurophysiological oscillations enhancing excitability of contralateral S1-M1 in healthy volunteers. The proposed mechanism may explain the clinical effects of vibratory rehabilitation in neurological patients with motor deficits., (Copyright © 2017 IBRO. Published by Elsevier Ltd. All rights reserved.)

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.

Background: Nonpainful tactile and electrical stimulation of the large myelinated fibers reduces spontaneous pain and the amplitude of laser-evoked potentials (LEPs), which represent the most reliable technique to assess the nociceptive pathway function. Focal mechanical vibration stimulates the Aβ afferents selectively; thus, it is conceivable its action on nociceptive pathways., Aim: The aim of this study was to investigate the effect of vibratory stimuli, activating either both muscle and skin receptors or cutaneous afferents only on the LEPs and subjective laser-pain rating., Methods: Ten healthy volunteers were studied. The subjects were evaluated in two different sessions to test muscle and skin receptors or cutaneous afferents only. In each session, LEPs were recorded to stimulation of the dorsal hand skin in radial and ulnar territory bilaterally, while the vibratory stimulus was delivered on the radial territory of the right forearm., Results: The results showed a substantial stability of the potential N1 and N2/P2 after the two protocols, with a declining trend from the initial to the last test of the same session, probably due to habituation. Accordingly, the laser-pain perception did not change during the experimental setting., Conclusions: We conclude that a vibratory stimulus is ineffective in reducing the laser-evoked potentials and laser-pain perception., (© 2016 World Institute of Pain.)

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.

Objective: To examine the clinical effect of repetitive focal muscle vibration (rMV) on the motor function of the upper extremity 1 month after treatment in patients with chronic stroke., Design: We performed a pilot randomized controlled trial using a double-blind, parallel-group study design., Setting: Medical center., Participants: Patients with chronic stroke (N=49)., Interventions: Patients randomly assigned to the study group (SG) received rMV, while patients in the control group (CG) received a placebo vibratory treatment. The patients and the clinical examiner were blind to the intervention., Main Outcome Measures: The primary endpoint was an improvement of more than .37 points on the Functional Ability Scale of the Wolf Motor Function Test (WMFT FAS). The Modified Ashworth Scale and the visual analog scale were the secondary outcome measures. All measures were administered before the treatment (t0) and 1 week (t1) and 1 month (t2) after the treatment., Results: Twenty-eight patients were allocated to the SG and 21 to the CG. The analysis of variance for repeated measurements revealed a significant difference in the expression of the WMFT FAS score over time only in the SG (P=.006). The treatment was successful for 7 (33%) of 21 patients recruited in the SG and for 2 (13%) of 15 patients recruited in the CG. The relative risk was 2.5 (95% confidence interval, .60-10.39), and the number needed to treat was 5. The Wilcoxon test showed a statistically significant difference between t0 and t2 in the SG (P=.02). No adverse event was observed in the 2 groups., Conclusions: Our results suggest that rMV treatment of the upper limb may improve the functional ability of chronic stroke patients, but a larger, multicenter, randomized controlled study is needed., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Muscle vibration modifies corticomotor excitability in healthy subjects and reduces muscle tonus in stroke patients., Objective: This study examined whether repeated muscle vibration (rMV) applied over the flexor carpi radialis (FCR) and biceps brachii (BB) can induce long-lasting changes, using transcranial magnetic stimulation (TMS), in patients with chronic stroke., Methods: Thirty hemiparetic patients who offered at least minimal wrist and elbow isometric voluntary contractions were randomly assigned to either an experimental group, which received rMV in addition to physiotherapy (rMV + PT), or a control group that underwent PT alone. The following parameters of the FCR, BB, and extensor digitorum communis (EDC) were measured through TMS before, and 1 hour, 1 week, and 2 weeks after the end of intervention: resting motor threshold (RMT), map area, map volume, short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF). Muscle tonus and motor function were assessed on the same day as TMS., Results: Pre-post analysis revealed a reduction in RMT and an increase in motor map areas occurred in the vibrated muscles only in the rMV + PT group, with an increase in map volumes of all muscles. Moreover, SICI increased in the flexors and decreased in the extensor. These neurophysiological changes lasted for at least 2 weeks after the end of rMV + PT and paralleled the reduction in spasticity and increase in motor function. A significant correlation was found between the degree of spasticity and the amount of intracortical inhibition., Conclusion: rMV with PT may be used as a nonpharmacological intervention in the neurorehabilitation of mild to moderate hemiparesis.

Unlabelled: Filippi GM, Brunetti O, Botti FM, Panichi R, Roscini M, Camerota F, Cesari M, Pettorossi VE. Improvement of stance control and muscle performance induced by focal muscle vibration in young-elderly women: a randomized controlled trial., Objective: To determine the effect of a particular protocol of mechanical vibration, applied focally and repeatedly (repeated muscle vibration [rMV]) on the quadriceps muscles, on stance and lower-extremity muscle power of young-elderly women., Design: Double-blind randomized controlled trial; 3-month follow-up after intervention., Setting: Human Physiology Laboratories, University of Perugia, Italy., Participants: Sedentary women volunteers (N=60), randomized in 3 groups (mean age +/- SD, 65.3+/-4.2y; range, 60-72)., Intervention: rMV (100Hz, 300-500microm, in three 10-minute sessions a day for 3 consecutive days) was applied to voluntary contracted quadriceps (vibrated and contracted group) and relaxed quadriceps (vibrated and relaxed group). A third group received placebo stimulation (nonvibrated group)., Main Outcome Measures: Area of sway of the center of pressure, vertical jump height, and leg power., Results: Twenty-four hours after the end of the complete series of applications, the area of sway of the center of pressure decreased significantly by approximately 20%, vertical jump increased by approximately 55%, and leg power increased by approximately 35%. These effects were maintained for at least 90 days after treatment., Conclusions: rMV is a short-lasting and noninvasive protocol that can significantly and persistently improve muscle performance in sedentary young-elderly women.

Objective: The effects of a novel repeated muscle vibration intervention (rMV; 100 Hz, 90 min over 3 consecutive days) on corticomotor excitability were studied in healthy subjects., Methods: rMV was applied over the flexor carpi radialis (FCR) during voluntary contraction (experiment 1), during relaxation and during contraction without vibration (experiment 2). Focal transcranial magnetic stimulation (TMS) was applied before rMV and one hour, and one, two and three weeks after the last muscle vibration intervention. At each of these time points, we assessed the motor map area and volume in the FCR, extensor digitorum communis (EDC) and abductor digiti minimi (ADM). Short-interval intracortical inhibition (SICI) and facilitation (ICF) were tested for the flexor/extensor muscles alone., Results: Following rMV under voluntary contraction, we observed a significant reduction in the FCR map volumes and an enhancement in the EDC. SICI was increased in the FCR and reduced in the EDC. These changes persisted for up to two weeks and occurred at the cortical level in the hemisphere contralateral to the side of the intervention., Conclusion: We conclude that rMV, applied during a voluntary contraction, may induce prolonged changes in the excitatory/inhibitory state of the primary motor cortex. These findings may represent an important advance in motor disorder rehabilitation.