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European Journal of Physical and Rehabilitation Medicine 2017 February;53(1):32-40

DOI: 10.23736/S1973-9087.16.04211-8

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Short-term effect of local muscle vibration treatment versus sham therapy on upper limb in chronic post-stroke patients: a randomized controlled trial

Cosimo COSTANTINO, Laura GALUPPO, Davide ROMITI

Unit of Rehabilitation Medicine, Department of Biomedical, Biotechnological and Translational Sciences, University of Parma, Parma, Italy


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BACKGROUND: In recent years, local muscle vibration received considerable attention as a useful method for muscle stimulation in clinical therapy. Some studies described specific vibration training protocol, and few of them were conducted on post-stroke patients. Therefore there is a general uncertainty regarding the vibrations protocol.
AIM: The aim of this study was to evaluate the effects of local muscle high frequency mechano-acoustic vibratory treatment on grip muscle strength, muscle tonus, disability and pain in post-stroke individuals with upper limb spasticity.
DESIGN: Single-blind randomized controlled trial.
SETTING: Outpatient rehabilitation center.
POPULATION: Thirty-two chronic poststroke patients with upper-limb spasticity: 21 males, 11 females, mean age 61.59 years ±15.50, time passed from stroke 37.78±17.72 months.
METHODS: The protocol treatment consisted of the application of local muscle vibration, set to a frequency of 300 Hz, for 30 minutes 3 times per week, for 12 sessions, applied to the skin covering the venter of triceps brachii and extensor carpi radialis longus and brevis muscles during voluntary isometric contraction. All participants were randomized in two groups: group A treated with vibration protocol; group B with sham therapy. All participants were evaluated before and after 4-week treatment with Hand Grip Strength Test, Modified Ashworth Scale, QuickDASH score, FIM scale, Fugl-Meyer Assessment, Jebsen-Taylor Hand Function Test and Verbal Numerical Rating Scale of pain. Outcomes between groups was compared using a repeated-measures ANOVA.
RESULTS: Over 4 weeks, the values recorded in group A when compared to group B demonstrated statistically significant improvement in grip muscle strength, pain and quality of life and decrease of spasticity; P-values were <0.05 in all tested parameters.
CONCLUSIONS: Rehabilitation treatment with local muscle high frequency (300 Hz) vibration for 30 minutes, 3 times a week for 4 weeks, could significantly improve muscle strength and decrease muscle tonus, disability and pain in upper limb of hemiplegic post-stroke patients.
CLINICAL REHABILITATION IMPACT: Local muscle vibration treatment might be an additional and safe tool in the management of chronic poststroke patients, granted its high therapeutic efficiency, limited cost and short and repeatable protocol of use.


KEY WORDS: Vibration - Hand strength - Muscle tonus - Muscle spasticity - Stroke

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