Abstract
Background: The reduction of muscle hypertonia and spasticity, as well as an increase in mobility, is an essential prerequisite for the amelioration of physiotherapeutical treatments. Repetitive peripheral magnetic nerve stimulation (rPMS) is a putative adjuvant therapy that improves the mobility of patients, but the underlying mechanism is not entirely clear.Methods: Thirty-eight participants underwent either an rPMS treatment (N = 19) with a 5 Hz stimulation protocol in the posterior tibial nerve or sham stimulation (N = 19). The stimulation took place over 5 min. The study was conducted in a pre-test post-test design with matched groups. Outcome measures were taken at the baseline and after following intervention.Results: The primary outcome was a significant reduction of the reflex activity of the soleus muscle, triggered by a computer-aided tendon-reflex impact. The pre-post differences of the tendon reflex response activity were −23.7% (P < 0.001) for the treatment group. No significant effects showed in the sham stimulation group.Conclusion: Low-frequency magnetic stimulation (5 Hz rPMS) shows a substantial reduction of the tendon reflex amplitude. It seems to be an effective procedure to reduce muscular stiffness, increase mobility, and thus, makes the therapeutic effect of neuro-rehabilitation more effective. For this reason, the 5 Hz rPMS treatment might have the potential to be used as an adjuvant therapy in the rehabilitation of gait and posture control in patients suffering from limited mobility due to spasticity. The effect observed in this study should be investigated conjoined with the presented method in patients with impaired mobility due to spasticity.
Highlights
Reducing muscle hypertonia or spasticity in order to regain independent mobility is an essential goal of a physiotherapeutical treatment in neuro-rehabilitation
The reflex response behavior of the skeletal musculature after the repetitive peripheral magnetic nerve stimulation (rPMS) was measured in terms of the tendon tap triggered compound muscle action potential (CMAPpp) amplitude values
The CMAPpp amplitudes decreased after 5 Hz rPMS stimulation in the treatment group (Figure 2)
Summary
Reducing muscle hypertonia or spasticity in order to regain independent mobility is an essential goal of a physiotherapeutical treatment in neuro-rehabilitation. Based on the knowledge of the mechanisms responsible for muscular hypertonia, one option for patients could be a targeted treatment with repetitive peripheral magnetic nerve stimulation (rPMS), as adjuvant therapy that could improve the mobility of patients or athletes. By employing a pulsed magnetic stimulation of the peripheral nerve a twitch can be triggered in a specific skeletal muscle. This twitch contraction is achieved initially through the triggering of an action potential in the associated motor nerve [7]. Depending on the stimulation frequency, the repetitive stimulation of the nerve can lead to muscle contraction in such a way that the individual twitches merge on higher stimulation frequencies. Repetitive peripheral magnetic nerve stimulation (rPMS) is a putative adjuvant therapy that improves the mobility of patients, but the underlying mechanism is not entirely clear
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