None listed
Conditions
Brief summary
The primary purpose of the present study is to ascertain whether the application of low-amplitude/high-frequency segmental muscle vibration on spastic muscles of the arm of patients with hemiparesis secondary to chronic focal ischemic brain injury, improves kinematic characteristics of reaching movement.
Interventions
Segmental muscle vibration (SMV) is a technique that applies a vibratory stimulus to a specific muscle using a mechanical device. When applied to a muscle–tendon unit, SMV induces the generation of Ia inputs as a consequence of activation of muscle spindle primary endings. The Ia inputs activated by SMV can alter the excitability of the corticospinal pathway by modulation of intracortical inhibiting and facilitating inputs to the primary motor cortex. Indeed, recent transcranial magnetic stimula
Segmental muscle vibration (SMV) is a technique that applies a vibratory stimulus to a specific muscle using a mechanical device. When applied to a muscle–tendon unit, SMV induces the generation of Ia inputs as a consequence of activation of muscle spindle primary endings. The Ia inputs activated by SMV can alter the excitability of the corticospinal pathway by modulation of intracortical inhibiting and facilitating inputs to the primary motor cortex. Indeed, recent transcranial magnetic stimulation (TMS) studies have shown increased excitability in the primary motor cortex representation of the vibrated muscle following the application of low-amplitude SMV to the flexor carpi radialis muscle and intrinsic hand muscles in healthy subjects. Moreover, SMV applied to healthy subjects effectively compensates for repetitive TMS-induced inhibition of the prefrontal cortex. It has been demonstrated that SMV added to general physical therapy may improve gait performance in patients with foot drop secondary to chronic stroke. SMV is chracterized by amplitude of displacement (mm), frequency (Hz) and duration of application. Particularly suited for application in neurological condition are low amplitude (0.01 mm), high frequency (120 Hz) stimuli, applied for 30 minutes/day, 5 days/week over a total of 2 weeks. Patients will also receive exercise therapy consisting in stretching, strengthening, proprioceptive training and reaching training. Exercise will be performed under the guidance of a physical therapist with experience in the field of stroke rehabilitation, 60 minutes/day, 5 days/week over a total of 2 weeks. Exercise therapy will be delivered at the end of each SMV session.
Sponsors
Sapienza University of Rome
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
45 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Right or left hemiplegia of at least 6 months duration, secondary to magnetic resonance imaging–documented chronic ischemic stroke.
Exclusion criteria
Bilateral brain lesions, ischemic involvement of the cerebellum or basal ganglia, aphasia, psychiatric disease, cognitive impairment (Mini-Mental State Exam evaluation <23), and previous history of neurological diseases, diabetes, or rheumatic and orthopedic conditions that may interfere with upper limb movement. Patients are also excluded if they are involved in other clinical trials or if they are under antispasticity therapy.
Outcome results
None listed