Spastic hypertonia is common after stroke. Whole-body vibration (WBV) is known to have modulatory effects of muscle reflex activity and blood flow in other populations and thus have potential applications in the management of spastic hypertonia post-stroke. This study aims to investigate the acute effect of WBV on leg muscle H-reflex, stiffness, and blood perfusion in people with chronic stroke.
Spastic hypertonia is common after stroke. Whole-body vibration (WBV) is known to have modulatory effects of muscle reflex activity and blood flow in other populations and thus have potential applications in management of spastic hypertonia post-stroke. However, the potential effects of WBV on leg muscle stiffness in stroke rehabilitation remains unknown. Scientific evidence is warranted to fill the knowledge gap. Purpose This study aims to investigate the acute effect of WBV on leg muscle H-reflex, stiffness and blood perfusion in people with chronic stroke. Methods Individuals with chronic stroke will be recruited from community self-help groups and existing patient database. Relevant information (e.g. demographic information, medical history) will be obtained from medical records and subject interviews. Each subject will have to fulfill the following inclusion criteria: (1) diagnosis of chronic stroke, (2) community-dwelling, (3) able to follow simple verbal instructions. Exclusion criteria are: (1) other diagnoses of neurological conditions, (2) significant musculoskeletal conditions (e.g. amputations), (3) metal implants in the lower extremity or spine, (4) recent fracture in the lower extremity, (5) diagnosis of osteoporosis, (6) vestibular disorders, (7) peripheral vascular disease, and (11) other serious illnesses or contraindications to exercise. This is a single-blinded randomized within-patient cross-over study. Each participant was evaluated for the soleus H-reflex, stiffness and blood perfusion of the medial gastrocnemius (MG) using ultrasound on both sides before and after either a 5-minute WBV intervention (30 Hertz, 1.5mm, knee flexed 60 degrees) or a no-WBV condition (5 minutes). The measurements were performed at baseline and every 1-min post-intervention up to 5 minutes. The outcomes generated included the soleus H/M ratio, shear modulus and vascular index (VI) of the MG muscle.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
36
standing on the vibration platform, with no vibration signals delivered.
standing on the vibration platform, with WBV at 30Hz, 1.5mm.
standing on the vibration platform, with no vibration signals delivered.
The Hong Kong Polytechnic University
Hung Hom, Kowloon, Hong Kong
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: Immediately before the intervention
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 1st minute after the intervention
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 2nd minute after the intervention
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 3rd minute after the intervention
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 4th minute after the intervention
H-reflex of paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 5th minute after the intervention
Muscle stiffness of paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: Immediately before the intervention
Muscle stiffness of paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 1st minute after the intervention
Muscle stiffness of paretic medial gastrocnemius
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standing on the vibration platform, with WBV at 30Hz, 1.5mm.
Measured by Supersonic elastography with ankle in neutral position
Time frame: 2nd minute after the intervention
Muscle stiffness of paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 3rd minute after the intervention
Muscle stiffness of paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 4th minute after the intervention
Muscle stiffness of paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 5th minute after the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: Immediately before the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 1st minute after the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 2nd minute after the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 3rd minute after the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 4th minute after the intervention
H-reflex of non-paretic soleus muscle
To measure the efficacy of synaptic transmission
Time frame: 5th minute after the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: Immediately before the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 1st minute after the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 2nd minute after the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 3th minute after the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 4th minute after the intervention
Muscle stiffness of non-paretic medial gastrocnemius
Measured by Supersonic elastography with ankle in neutral position
Time frame: 5th minute after the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: Immediately before the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 1 minute after the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 2nd minute after the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 3rd minute after the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 4th minute after the intervention
Intramuscular blood perfusion of paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 5th minute after the intervention
Intramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: Immediately before the intervention
Intramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 1th minute after the intervention
Intramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 2nd minute after the intervention
Intramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 3rd minute after the intervention
MoviIntramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 4th minute after the intervention
Intramuscular blood perfusion of non-paretic medial gastrocnemius muscle
Measured by power Doppler ultrasound
Time frame: 5th minute after the intervention