Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, Rome, Italy.
Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
Neurol Sci. 2020 Jan;41(1):11-24. doi: 10.1007/s10072-019-04047-3. Epub 2019 Aug 30.
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.
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.
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.
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.
已经设计了几种局部肌肉振动(fMV)和全身振动(WBV)方案,以促进中风患者的大脑重组过程。然而,fMV 和 WBV 是否应被视为促进中风后恢复的有用工具,目前仍很大程度上不清楚。
我们在这里全面回顾了 fMV 和 WBV 在促进中风患者大脑重组过程中的应用。首先讨论了 fMV 和 WBV 的假定生理基础,然后检查了中风患者最近的随机对照试验(RCT)中的先前观察结果,我们批判性地讨论了当前可用数据的可能优势和局限性。
我们提供了对 fMV 研究的首次系统评估,这些研究表明慢性中风患者的上下肢功能有所改善。我们还证实并扩展了先前关于当前 WBV 方案在慢性中风患者中应用的合理性有限的考虑。
基于现有信息,我们提出了新的建议,以优化刺激参数和策略,招募更有可能从未来的 fMV 或 WBV 应用中受益的特定中风人群,以实现更快和更多的中风后功能恢复。