Effects of Focal Muscle Vibration Versus Whole Upper Limb Vibration in Post-Stroke Patients

NCT ID: NCT07340034

Last Updated: 2026-01-14

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 54 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-20
• Study Completion Date: 2026-05-20

Brief Summary

This study contributes to the growing body of knowledge on rehabilitation strategies for post-stroke patients, specifically focusing on the efficacy of vibration therapy modalities. By comparing focal muscle vibration therapy and whole upper limb vibration therapy, the research aims to provide empirical evidence that can inform clinical practices and enhance rehabilitation outcomes. The findings are expected to clarify which modality is more effective in reducing spasticity and improving motor control, thereby guiding clinicians in selecting appropriate interventions tailored to individual patient needs, increasing chances of benefits, time management and useful for academic purpose. Furthermore, the study addresses a critical gap in the literature, facilitating further research and discussion on the mechanisms underlying vibration therapy's effects.

Ultimately, this research aims to reduce spasticity and improve community outcomes by enhancing the quality of life for stroke survivors, enabling them to regain independence and participate more fully in daily activities by regaining the motor control functions. By contributing to both theoretical and practical frameworks, the study seeks to advance the field of neurorehabilitation and support informed decision-making among healthcare professionals.

Detailed Description

Motor impairment post-stroke, which usually affects the movement of the face, arm, and leg on one side of the body, impacts approximately 80% of individuals who have experienced a stroke. Upper limb motor impairments (involving the arm, hand, and/or fingers) are often long-lasting and debilitating; only about half of stroke survivors with an initially paralyzed upper limb recover some useful function within six months.

Recently, mechanical vibrations have been utilized as a form of somatosensory stimulation to enhance motor function and to address muscle spasticity in the upper limbs following a stroke. When applying vibration stimuli during exercise or physical rehabilitation, these can be broadly classified into two categories: (a) vibrations that are directly applied to a specific muscle or tendon, and (b) indirect vibrations that are not limited to a specific muscle, delivered either through the feet while standing on a platform or through the hands using a handheld device. The direct application of vibrations to a muscle or tendon is often referred to as focal muscle vibration (FMV) or segmental vibration (SV), and it may also be called repetitive muscle vibration (rMV). In contrast, indirect vibrations delivered through the hands are typically known as upper limb vibration (ULV), while those aimed at the lower limbs are referred to as whole-body vibration (WBV).

Vibration therapy (VT) is a form of physical therapy that employs mechanical vibration waves to stimulate the human neuromuscular system for therapeutic benefits. It demonstrates promising potential for use in the rehabilitation of dysfunctions part of bosy resulting from a stroke.

Focal muscle vibration (FMV) OR segmental muscle vibration is a relatively new approach used to enhance motor function and reduce spasticity in the hemiplegic upper limb of stroke patients. In FMV, a vibratory stimulus is delivered to a specific muscle tendon via a mechanical device, which activates the muscle spindle primary endings and generates Ia inputs. Vibration applied to a muscle can elevate the motor-evoked potential recorded from that muscle at rest, indicating an increase in corticospinal excitability during the vibration. Additionally, studies have shown that the duration of the cortical silent period in a forearm flexor muscle can increase when the antagonist forearm extensors are vibrated, providing strong evidence that pure sensory stimulation can influence motor cortical excitability.

Conditions

Stroke; Post Stroke Upper Limb Spasticity

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

Focal muscle vibration through focal muscle vibrator along with conventional neurorehabilitation

Group A will receive the Focal muscle vibration in the major group of muscle such as Elbow flexors and wrist flexors along with the conventional neurorehabilitation.

Group Type: EXPERIMENTAL

Focal muscle vibration through focal muscle vibrator along with conventional neurorehabilitation

Intervention Type: OTHER

Group A will receive the 30 minutes treatment protocol. Warm-up exercises for first 15 minutes with ROM and stretching exercises of upper extremity 15 minutes application of FMV All participants were instructed to sit back in a high, fixed chair without armrests, keeping their feet flat on the floor. The dominant shoulder was positioned slightly away from the trunk i.e. in slight abduction and the elbow was held at a 90° angle as part of the designated vibration position. After setting up, the researcher guided the participants to remain seated in the same position as it might affect the results and treatment. The participants then received the vibration in frequency of 30 Hz in both vertical and horizontal directions.

Based on our review of prior clinical studies aimed at improving muscle spasticity we implemented vibration protocols with exposure times ranging from 30 to 60 seconds and rest intervals between 15 and 60 seconds. The analysis focused on seven muscle groups

Upper limb vibration through whole body vibrator along with conventional neurorehabilitation

Group B will receive the upper limb vibration which will include all muscles of effected limb along with the conventional neurorehabilitation.

Group Type: ACTIVE_COMPARATOR

Upper limb vibration through whole body vibrator along with conventional neurorehabilitation

Intervention Type: OTHER

Group B will receive the 30 minutes treatment protocol. Warm-up exercises for first 15 minutes with ROM and stretching exercises of upper extremity.

Patients in the treatment group received upper limb vibration using the Power Plate vibration platform (Performance Health Systems, Power Plate Pro5, North America 2009). The patient was seated on a stool placed next to the whole-body vibration device; the elbow was positioned at 70-80 degrees flexion and wrist was positioned at dorsiflexion and upper limb vibration was applied through Whole body vibrator to the affected limb for two minutes. The WBV consisted of two sessions of 60 seconds of stimulation interrupted by a one-minute break between each session to prevent muscle fatigue. The amplitude of the vibration was 2 mm, and the frequency was 35-40 Hz. An experienced physical therapist supervised the WBV administration. The upper limb vibration treatment was performed 5 times a week for 8 weeks.

Interventions

Focal muscle vibration through focal muscle vibrator along with conventional neurorehabilitation

Group A will receive the 30 minutes treatment protocol. Warm-up exercises for first 15 minutes with ROM and stretching exercises of upper extremity 15 minutes application of FMV All participants were instructed to sit back in a high, fixed chair without armrests, keeping their feet flat on the floor. The dominant shoulder was positioned slightly away from the trunk i.e. in slight abduction and the elbow was held at a 90° angle as part of the designated vibration position. After setting up, the researcher guided the participants to remain seated in the same position as it might affect the results and treatment. The participants then received the vibration in frequency of 30 Hz in both vertical and horizontal directions.

Based on our review of prior clinical studies aimed at improving muscle spasticity we implemented vibration protocols with exposure times ranging from 30 to 60 seconds and rest intervals between 15 and 60 seconds. The analysis focused on seven muscle groups

Intervention Type: OTHER

Upper limb vibration through whole body vibrator along with conventional neurorehabilitation

Group B will receive the 30 minutes treatment protocol. Warm-up exercises for first 15 minutes with ROM and stretching exercises of upper extremity.

Patients in the treatment group received upper limb vibration using the Power Plate vibration platform (Performance Health Systems, Power Plate Pro5, North America 2009). The patient was seated on a stool placed next to the whole-body vibration device; the elbow was positioned at 70-80 degrees flexion and wrist was positioned at dorsiflexion and upper limb vibration was applied through Whole body vibrator to the affected limb for two minutes. The WBV consisted of two sessions of 60 seconds of stimulation interrupted by a one-minute break between each session to prevent muscle fatigue. The amplitude of the vibration was 2 mm, and the frequency was 35-40 Hz. An experienced physical therapist supervised the WBV administration. The upper limb vibration treatment was performed 5 times a week for 8 weeks.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

INCLUSION CRITERIA Clinical diagnosis of first-ever ischemic stroke Age from 45 to 60 years Both male and female participants Onset of stroke 3 month to 6 months previously Modified Ashworth Scale (MAS) score for the upper limb muscles on the hemiparetic side between 1+ and 3 Able to follow verbal commands and sign informed consent forms EXCLUSION CRITERIA Cardiovascular disease or uncontrolled diabetes Upper limb muscle contracture on the affected side Peripheral neuropathy Uncontrolled hypertension Malignant tumors Uncontrolled seizures Dementia

• Minimum Eligible Age: 45 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Lahore University of Biological and Applied Sciences

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Ramsha Tariq, DPT

Role: CONTACT

ramshatariq.rt@gmail.com

+923030034444

Yamna Mazhar Yamna, MS NMPT

Role: CONTACT

yamna.mazhar@ubas.edu.pk

+923327965489

References

Lu YH, Chen HJ, Liao CD, Chen PJ, Wang XM, Yu CH, Chen PY, Lin CH. Upper extremity function and disability recovery with vibration therapy after stroke: a systematic review and meta-analysis of RCTs. J Neuroeng Rehabil. 2024 Dec 21;21(1):221. doi: 10.1186/s12984-024-01515-6.

Reference Type: BACKGROUND

PMID: 39707380 (View on PubMed)

Karnath HO. Pusher syndrome--a frequent but little-known disturbance of body orientation perception. J Neurol. 2007 Apr;254(4):415-24. doi: 10.1007/s00415-006-0341-6. Epub 2007 Mar 25.

Reference Type: BACKGROUND

PMID: 17385082 (View on PubMed)

Other Identifiers

UBAS/ERB/FoRS/25/036

Identifier Type: -

Identifier Source: org_study_id