Focal Muscle Vibration Research Articles

Focal muscle vibration and action observation: a combined approach for muscle strengthening.

Muscle strength is essential for autonomy in daily activities and performance in sports activities. Yet, conventional strength training is challenging during recovery from pathological conditions. This study investigates a novel combined intervention employing Focal Muscle Vibration (FMV) and Action Observation (AO) to enhance muscle strength. Twenty-seven healthy volunteers (18 females and 9 males, aged 22 to 42 years) were enrolled for an intervention-control study comparing 2 groups: the intervention group received AO treatment with FMV on the right leg, and the control group underwent only FMV on the right leg. This design allowed the comparison of four conditions: FMV+AO (intervention group, right leg), AO alone (intervention group, left leg), FMV alone (control group, right leg), and no-treatment NT (control group, left leg). The treatment, conducted five times a week (Mon-Fri) for two weeks, involved a 20-minute session of FMV on the right quadriceps, coupled, for the intervention group, with the observation of a gym training video. The assessments of Maximum Voluntary Contraction (MVC), and fatigue coefficient (FC) expressed at knee extension bilaterally were measured at the beginning (T0), after the first week (T1), at the end of treatment (T2), and one-week post-intervention for the follow-up (T3). The FMV+AO group demonstrated a significant improvement in MVC over time, reaching statistical significance at T2 and maintaining the gain at T3. In contrast, all the other conditions demonstrated milder MVC increases without statistical significance. FC did not differ significantly in any condition. The combination of FMV and AO optimized muscle strengthening, offering insights for targeted treatments in various settings.

Effects of focal muscle vibration on cervical pain in Parkinson's disease patients: a pilot study.

Musculoskeletal pain is a common symptom of Parkinson's disease (PD) that is not adequately treated with current dopaminergic drugs. This pilot study sought to investigate the effect of focal muscle vibration (fMV) on a group of Parkinson's disease patients suffering from chronic cervical pain. In addition to conventional physiotherapy, twenty-two patients with idiopathic Parkinson's disease (Hoehn and Yahr stages II-III) received three weeks of bilateral focal musclevibration to the trapezius muscles. The Visual Analogue Scale (VAS), the Short-form McGill, and the Present PainIntensity scales were used to assess pain at baseline (T0), after three weeks of treatment (T1), one week after the last treatment session (T2), and three weeks after T2 (T3). Pain intensity decreased significantly from baseline to T1 across all pain scales (p < 0.0001). Furthermore, the beneficial effect of fMV on cervical pain lasted up to one month after treatment. Our findings show that fMV, in combination with conventional physiotherapy, is effective at reducing pain intensity in PD patients, with results visible even after a month of follow-up.

Modification of heart rate variability induced by focal muscle vibration in patients with severe acquired brain injury

ABSTRACT Background/Purpose Heart rate variability (HRV) is a biomarker of autonomic nervous system (ANS) reaction in persons with severe acquired brain injury (sABI) who undergo a rehabilitation treatment, such as focal muscle vibration (FMV). This study aims to evaluate if and how FMV can modulate HRV and to compare potential differences in FMV modulation in HRV between patients with sABI and healthy controls. Methods Ten patients with sABI and seven healthy controls have been recruited. Each individual underwent the same stimulation protocol (four consecutive trains of vibration of 5 minutes each with a 1-minute pause). HRV was analyzed through the ratio of frequency domain heart-rate variability (LF/HF). Results In the control group, after performing FMV, a significant LF/HF difference was observed in the in the second vibration session compared to the POST phase. Patients with SABI treated on the affected side showed a statistically significant LF/HF difference in the PRE compared to the first vibration session. Conclusion These preliminary results suggest that FMV may modify the cardiac ANS activity in patients with sABI.

Impact of Focal Muscle Vibration on Flaccid Upper Limb Motor Paralysis following Acute Brain Disease: A Case Study

Focal muscle vibration (FMV) is increasingly being recognized as a rehabilitative therapy for enhancing motor function in central nervous system (CNS) diseases, particularly in patients with fine motor control deficits stemming from CNS damage. Brain lesions from these diseases disrupt the motor networks, necessitating novel rehabilitation strategies. By applying vibrations to muscles, FMV stimulates sensory fibers to induce cortical activity and kinesthetic illusions. While initial studies have highlighted FMV’s role in reducing spasticity, recent evidence points to its potential in treating motor paralysis. However, prior research has been limited by the lack of acute‐phase studies and a focus on patients with minimal muscle contraction capability. This report aimed to explore FMV’s efficacy on upper limb motor function in patients with flaccid motor paralysis immediately after acute CNS diseases. We report the case of a septuagenarian male with a brain abscess in the right parietal lobe, leading to flaccid motor paralysis. Rehabilitation included 28 sessions of occupational and physical therapy that incorporated FMV. Significant improvements were observed in upper extremity function, with moderate to very large effect sizes, while lower limb function showed lesser improvement without adverse effects. This case suggests the utility of FMV in enhancing upper‐limb motor function after acute CNS injuries, potentially serving as a supplementary therapy for spontaneous recovery. This report contributes to emerging evidence on FMV’s benefits in acute flaccid motor paralysis, expanding the documented therapeutic scope.

Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study.

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. 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. 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. 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.

The effects of focal muscle vibration on motor impairments in people with multiple sclerosis: A systematic review

BACKGROUND: Motor impairments are common consequences in people with multiple sclerosis (PwMS). These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the central nervous system. No systematic review has been published investigating the effects of FMV on motor impairments in people with MS. OBJECTIVES: This review was conducted to investigate the effects of FMV in motor rehabilitation in PwMS. METHODS: PubMed, SCOPUS, REHABDATA, PEDro, CINAHL, EMBASE, MEDLINE, and Web of science were searched from their inception until May 2023. Studies were included if they were experimental studies, used FMV in PwMS, and evaluated motor impairments. Studies were excluded if they used other forms of vibration application (e.g., whole-body vibration) or used pharmacological treatments as a primary intervention. We evaluate the risk of bias using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Five studies met our eligibility criteria. Three studies were randomized controlled trials, a clinical controlled trial (n = 1), and a pilot study (n = 1). A total of 123 participants were included in this review (Mean age = 47), 42.28% of whom were men. The PEDro scale scores ranged from three to eight. The findings revealed beneficial and non-beneficial effects of FMV on motor function in PwMS. CONCLUSIONS: The FMV application is safe and well-tolerated in PwMS. The evidence for the impacts of FMV on motor impairments in PwMS was limited. Additional studies with long-term follow-ups are encouraged.

Focal Muscle Vibration (fMV) for Post-Stroke Motor Recovery: Multisite Neuroplasticity Induction, Timing of Intervention, Clinical Approaches, and Prospects from a Narrative Review

Despite newly available therapies for acute stroke and innovative prevention strategies, stroke remains the third leading cause of disability-adjusted life-years (DALYs) lost worldwide, mostly because more than half of stroke survivors aged 65 and over exhibit an incomplete functional recovery of the paretic limb. Given that a repeated sensory input is one of the most effective modulators of cortical motor and somatosensory structures, focal muscle vibration (fMV) is gaining growing interest as a safe, well-tolerated, and non-invasive brain stimulation technique to promote motor recovery after stroke with a long-lasting and clinically relevant improvement in strength, step symmetry, gait, and kinematics parameters. In this narrative review, we first summarize the structural (neural plasticity) and functional changes (network relearning) triggered by the stroke lesion and carried out at a brain and spinal cord level in an attempt to recover from the loss of function. Then, we will focus on the fMV’s plasticity-based mechanisms reporting evidence of a possible concurrently acting multisite plasticity induced by fMV. Finally, to understand what the most effective fMV rehabilitation protocol could be, we will report the most recent evidence regarding the different clinical approaches and timing of the fMV treatment, the related open issues, and prospects.

Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review.

Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.

Inhibitory Effects of Prolonged Focal Muscle Vibration on Maximal Grip Strength and Muscle Activity of Wrist and Extrinsic Finger Flexor Muscles

ObjectiveThe 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. MethodsA 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. ResultsCompared 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. ConclusionFive-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.

Investigating the Effects of a Focal Muscle Vibration Protocol on Sensorimotor Integration in Healthy Subjects.

Background: The ability to perceive two tactile stimuli as asynchronous can be measured using the somatosensory temporal discrimination threshold (STDT). In healthy humans, the execution of a voluntary movement determines an increase in STDT values, while the integration of STDT and movement execution is abnormal in patients with basal ganglia disorders. Sensorimotor integration can be modulated using focal muscle vibration (fMV), a neurophysiological approach that selectively activates proprioceptive afferents from the vibrated muscle. Method: In this study, we investigated whether fMV was able to modulate STDT or STDT-movement integration in healthy subjects by measuring them before, during and after fMV applied over the first dorsalis interosseous, abductor pollicis brevis and flexor radialis carpi muscles. Results: The results showed that fMV modulated STDT-movement integration only when applied over the first dorsalis interosseous, namely, the muscle performing the motor task involved in STDT-movement integration. These changes occurred during and up to 10 min after fMV. Differently, fMV did not influence STDT at rest. We suggest that that fMV interferes with the STDT-movement task processing, possibly disrupting the physiological processing of sensory information. Conclusions: This study showed that FMV is able to modulate STDT-movement integration when applied over the muscle involved in the motor task. This result provides further information on the mechanisms underlying fMV, and has potential future implications in basal ganglia disorders characterized by altered sensorimotor integration.

The Role of Technological Rehabilitation in Patients with Intensive Care Unit Weakness: A Randomized Controlled Pilot Study

Intensive-Care-Unit-Acquired Weakness (ICU-AW) is the most common neuromuscular impairment in critically ill patients and can have a significant impact on long-term disability. Early rehabilitation has been suggested to facilitate the natural recovery process. This is a pilot, randomized, single-blind study that aimed to evaluate the effectiveness of intensive combined technological rehabilitation treatment including focal muscle vibration and non-immersive virtual reality for patients with severe acquired brain injury (sABI) and ICU-AW. Twenty-four patients were randomized into the conventional group, which performed only conventional rehabilitation, and the experimental group, which also performed technological treatment. At baseline and after 3 weeks of treatment, assessments of motor function, autonomy, disability and quality of life were conducted. At the end of the intervention, both groups showed significant improvements. However, patients in the experimental group achieved greater improvements in disability (p = 0.001) and quality of life (p = 0.001). The results show that intensive structured rehabilitation is effective in improving the motor function, disability and quality of life of patients with severe acquired brain injury and acquired weakness. The combination of non-immersive virtual reality training and focal muscle vibration can result in a significant improvement in overall disability and quality of life compared with conventional treatment alone.

Plastic changes induced by muscle focal vibration: A possible mechanism for long-term motor improvements.

Repetitive focal vibrations can induce positive and persistent after-effects. There is still no satisfactory interpretation of the underlying mechanisms. A rationale, which can provide consistency among different results, is highly desirable to guide both the use of the application and future research. To date, interpretive models are formulated to justify the results, depending on the specific protocol adopted. Indeed, protocol parameters, such as stimulus intensity and frequency, intervention time and administration period, are variable among different studies. However, in this article, we have identified features of the protocols that may allow us to suggest a possible common mechanism underlying the effectiveness of focal vibration under different physiologic and pathologic conditions. Since repetitive focal muscle vibration induces powerful and prolonged activation of muscle proprioceptors, we hypothesize that this intense activation generates adaptive synaptic changes along sensory and motor circuits. This may lead to long-term synaptic potentiation in the central network, inducing an enhancement of the learning capability. The plastic event could increase proprioceptive discriminative ability and accuracy of the spatial reference frame and, consequently, improve motor planning and execution for different motor functions and in the presence of different motor dysfunctions. The proposed mechanism may explain the surprising and sometimes particularly rapid improvements in motor execution in healthy and diseased individuals, regardless of specific physical training. This hypothetic mechanism may require experimental evidence and could lead to extend and adapt the application of the "learning without training" paradigms to other functional and recovery needs.

A review of current rehabilitation practices and their benefits in patients with multiple sclerosis.

Multiple sclerosis (MS) is a chronic, debilitating disease characterised by demyelination of the nerves of the central nervous system that results in patients progressively losing the ability to perform daily tasks. As there is no cure for this disease, rehabilitation therapy is an important aspect of care; assisting patients to regain or retain function and improve their physical, mental and social wellbeing. At present there is no current consistent model of care for MS, likely due to the variable symptom presentation. Various forms of rehabilitation therapy are available, and these include physical rehabilitation methods, such as balance and gait therapy, speech and respiration rehabilitation, and occupational therapy. Contrary to previous understanding, exercise-based therapies have shown various benefits for patients with MS, and in addition to improving MS-related physical symptoms, have been shown to reduce the risk of developing cardiovascular disease and can improve cognitive function. Cognition rehabilitation therapy specifically focuses on behavioural tasks and is divided into two main forms: compensatory rehabilitation, which offers cognitive functioning benefits, and restorative rehabilitation, which offers memory benefits. Excitation therapies include cranial stimulation and other stimulation rehabilitation methods such as focal muscle vibration therapy and these non-invasive techniques may improve patient's physical ability. Additionally, more novel rehabilitation methods include robot-assisted gait therapy and telerehabilitation, both of which are expected to play progressively more prominent roles in the future of rehabilitation therapy. The structure of the care team has been found to impact patient outcomes, and both in- and out-patient care settings have been found to be beneficial, dependant on the patient's circumstances, with certain patients better suited to a particular setting. While a single point of care is recommended for patients, a multidisciplinary care team and regular reassessment is recommended to manage changing symptoms and ensure continuity of care. The importance of the critical components of rehabilitation have been identified, and these are of vital importance in achieving beneficial outcomes. These components include the patients' participation in the treatment, goal setting with a multidisciplinary care team, a guiding-light purpose for the patient, which focusses on recognizing their personal potential and obtaining improvements through a tailored plan. The final critical component of rehabilitation is the results measurement, which highlights the need for a quantifiable reduction in impairment and improvement in activity and participation. Overall, a lack of standardisation in outcome measurements makes comparison challenging. This is particularly important when comparing standard methods of care with more novel rehabilitation techniques. However, within the broad area of rehabilitation therapies, it is clear that patients with MS can benefit from rehabilitation practices; physically, mentally and socially.

Vibration motor stimulation device in smart leggings that promotes motor performance in older people.

Globally, accelerated aging is taking place alongside increased life expectancy of the population. This poses a challenge to maintaining autonomy and independence as people age but preventing falls and disabilities. Currently, there are few specific technologies on the market that are focused on the rehabilitation and promotion of autonomy in older adults. This study presents the development of a prototype (Myoviber®) of a low-cost, wearable everyday garment, designed to stimulate the lower limbs by the application of focal muscle vibration and incorporating technical textile qualities. The presented approach is proactive and preventive, maintaining functionality for the elderly while integrating electronic technology into an everyday garment. For this, a comprehensive study was carried out that included the design of the leggings through anthropometric analyses, the development of vibration devices at a stable frequency located in the knee extensor muscle and a smart belt with wireless connection, and the optimization of the battery autonomy. The development of the prototype was carried out through the construction of a vibratory device, which was validated with biomechanical evaluations. The results show an increase in the functional capacity of the lower limbs, in relation to motor tasks such as postural balance and gait in older people.

Effects of Focal Muscle Vibration on Gait and Balance in Parkinson Patients: Preliminary Results

Background: Postural instability has a major impact on the mobility and daily life activities of Parkinson’s disease (PD) patients as it often leads to reduced mobility, insecure stance and falls. The aim of this study was to evaluate the effect of focal vibration on the static and dynamic balance of a group of Parkinson’s disease patients. Methods: Twenty-three idiopathic PD patients (14 M; 9 F), Hoehn and Yahr (HeY) stage II–III, underwent three weeks of focal muscle vibration applied to the quadriceps, soles of the feet and trapezius muscles bilaterally in addition to conventional physiotherapy. The static and dynamic balance was assessed at baseline (T0), after 3 weeks of treatment (T1) and after 1 month from the last treatment (T2) with the Tinetti scale and stabilometry evaluations. Results: There was a statistically significant improvement in the mean Tinetti score at T1, and in the Romberg area (CE/OE) of oscillation and oscillation velocity on the x-axis with the eyes closed at T2. Conclusions: Focal muscle vibration in conjunction with physiotherapy is a useful tool in the rehabilitation of gait and balance disorders of patients with Parkinson’s disease HeY stage II–III.

Effect of upper limb focal muscle vibration on cortical activity: A systematic review with a focus on primary motor cortex

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.

Focal Muscle Vibration Reduces Spasticity and Improves Functional Level in Incomplete Spinal Cord Injury: A Case Report

Abstract Background Spasticity is a common impairment following spinal cord injury (SCI) that negatively affects the activity of daily livings (ADLs). Focal muscle vibration (FMV) has beneficial effects in reducing spasticity post-stroke. Objectives This case report aimed to investigate the effects of 8-week FMV on spasticity and ADLs in a single patient with an incomplete spinal cord injury. Case description The patient was a 26-year-old man with 6-month post-SCI. Twenty-four sessions of FMV were provided for 15 minutes per session. Outcome measures included the Modified Ashworth Scale (MAS) and the Barthel Index (BI). Findings The FMV treatment resulted in spasticity reduction of biceps muscle (reduction from 2 to 1+point median), quadriceps (reduction from 2 to 1 point median), and dorsiflexors (reduction from 3 to 1+point median) as measured by the Modified Ashworth Scale. The activity of daily livings assessed by the Barthel Index (improved from 67 to 79 points median) postintervention and at follow-up. Conclusions This case report demonstrates that FMV reduces spasticity and improves the activity of daily livings in patients with incomplete spinal cord injury. Further research is needed in a larger patient population to verify our findings.

Development and deployment of cyclical focal muscle vibration system to improve walking performance in multiple sclerosis

Vibration, a potent mechanical stimulus for activating muscle spindle primary afferents, may improve gait performance in persons with multiple sclerosis (MS), but has yet to be developed and deployed for multiple leg muscles with application during walking training. This study explored the development of a cyclic focal muscle vibration (FMV) system, and the deployment feasibility to correct MS walking swing phase deficits in order to determine whether this intervention warrants comprehensive study. The system was deployed during twelve, two-hour sessions of walking with cyclic FMV over six weeks. Participants served as their own control. Blood pressure, heart rate, walking speed, kinematics (peak hip, knee and ankle angles during swing), toe clearance, and step length were measured before and after deployment with blood pressure and heart rate monitored during deployment. During system deployment, there were no untoward sensations and physiological changes in blood pressure and heart rate, and volitional improvements were found in walking speed, improved swing phase kinematics, toe clearance and step length. This FMV training system was developed and deployed to improve joint flexion during walking in those with MS, and it demonstrated feasibility and benefits. Further study will determine the most effective vibration frequency and dose, carryover effects, and those most likely to benefit from this intervention.

When Two Is Better Than One: A Pilot Study on Transcranial Magnetic Stimulation Plus Muscle Vibration in Treating Chronic Pelvic Pain in Women.

Chronic pelvic pain syndrome (CPPS) affects about 4–16% of adult women, and about one-third of them require medical assistance due to severe symptoms. Repetitive transcranial magnetic stimulation (rTMS) over the supplementary motor area (SMA) has been shown to manage pain in refractory CPPS. Focal muscle vibration (FMV) has also been reported to relieve pelvic pain. The objective of this study was to assess the feasibility and effect of rTMS coupled with FMV to reduce pain in seven adult women with refractory CPPS. This pilot, open-labeled, prospective trial examined treatment by 5 Hz rTMS over SMA and 150 Hz FMV over the perineum, suprapubic, and sacrococcygeal areas, with one daily session for five consecutive days for three weeks. We assessed tolerance and subjective pain changes (as per visual analog scale, VAS) until one month post-treatment, with a primary endpoint at day 7. No patients experienced serious adverse effects or a significant increase in pain. Six out of seven patients experienced a VAS improvement of at least 10% at T7; three of these individuals experienced a VAS improvement of more than 30%. Overall, we found a significant VAS reduction of 15 points (95% CI 8.4–21.6) at T7 (t = 6.3, p = 0.001; ES = 2.3 (1.1–3.9)). Three of the women who demonstrated a significant VAS reduction at T7 retained such VAS improvement at T30. VAS decreased by six points (95% CI 1.3–10.7) at T30 (t = 3.1, p = 0.02; ES = 1.5 (0.2–2.6)). This coupled approach seems promising for pain management in adult women with refractory CPPS and paves the way for future randomized controlled trials.

Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: Asystematic review.

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. This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders. 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 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. 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.