Saito Hirotaka, Kobayashi Haruka, Oba Kodai, Hamaya Yosuke
Department of Rehabilitation Medicine St. Marianna University School of Medicine Hospital, Kawasaki, Japan.
Department of Rehabilitation Medicine Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan.
Case Rep Neurol Med. 2024 Jun 25;2024:2469074. doi: 10.1155/2024/2469074. eCollection 2024.
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.
局部肌肉振动（FMV）越来越被视为一种康复治疗方法，用于增强中枢神经系统（CNS）疾病患者的运动功能，特别是那些因中枢神经系统损伤而存在精细运动控制缺陷的患者。这些疾病导致的脑损伤会破坏运动网络，因此需要新的康复策略。通过对肌肉施加振动，FMV刺激感觉纤维以诱导皮层活动和动觉错觉。虽然最初的研究强调了FMV在减轻痉挛方面的作用，但最近的证据表明其在治疗运动性麻痹方面具有潜力。然而，先前的研究受到急性期研究缺乏以及专注于肌肉收缩能力极小的患者的限制。本报告旨在探讨FMV对急性中枢神经系统疾病后弛缓性运动麻痹患者上肢运动功能的疗效。我们报告了一名患有右顶叶脑脓肿的老年男性病例，该病例导致弛缓性运动麻痹。康复治疗包括28次结合了FMV的职业治疗和物理治疗。上肢功能有显著改善，效应大小为中度至非常大，而下肢功能改善较小且无不良反应。该病例表明FMV在急性中枢神经系统损伤后增强上肢运动功能方面的效用，可能作为自发恢复的辅助治疗方法。本报告为FMV在急性弛缓性运动麻痹中的益处提供了新的证据，扩大了已记录的治疗范围。
