Freezing of gait in Parkinson's disease: Evidence of sensory rather than attentional mechanisms through muscle vibration.

Background Cast immobilization induces mechanical hypersensitivity, which disturbs rehabilitation. Although vibration therapy can reduce various types of pain, whether vibration reduces immobilization-induced hypersensitivity remains unclear.

Objective The purpose of this study was to investigate the preventive and therapeutic effects of vibration therapy on immobilization-induced hypersensitivity.

Design The experimental design of the study involved conducting behavioral, histological, and immunohistochemical studies in model rats.

Methods Thirty-five Wistar rats (8 weeks old, all male) were used. The right ankle joints of 30 rats were immobilized by plaster cast for 8 weeks, and 5 rats were used as controls. The immobilized rats were divided randomly into the following 3 groups: (1) immobilization-only group (Im, n=10); (2) vibration therapy group 1, for which vibration therapy was initiated immediately after the onset of immobilization (Im+Vib1, n=10); and (3) vibration therapy group 2, for which vibration therapy was initiated 4 weeks after the onset of immobilization (Im+Vib2, n=10). Vibration was applied to the hind paw. The mechanical hypersensitivity and epidermal thickness of the hind paw skin were measured. To investigate central sensitization, calcitonin gene-related peptide (CGRP) expression in the spinal cord and dorsal root ganglion (DRG) was analyzed.

Results Immobilization-induced hypersensitivity was inhibited in the Im+Vib1 group but not in the Im+Vib2 group. Central sensitization, which was indicated by increases in CGRP expression in the spinal cord and the size of the area of CGRP-positive neurons in the DRG, was inhibited in only the Im+Vib1 group. Epidermal thickness was not affected by vibration stimulation.

Limitations A limitation of this study is that the results were limited to an animal model and cannot be generalized to humans.

Conclusions The data suggest that initiation of vibration therapy in the early phase of immobilization may inhibit the development of immobilization-induced hypersensitivity.

Effects of Vibration Therapy on Immobilization-Induced Hypersensitivity in Rats

Perceptual and goal-directed behaviors may be improved by repetitive sensory stimulations without practice-based training. Focal muscle vibration (f-MV) modulating the spatiotemporal properties of proprioceptive inflow is well-suited to investigate the effectiveness of sensory stimulation in influencing motor outcomes. Thus, in this study, we verified whether optimized f-MV stimulation patterns might affect motor control of upper limb movements. To answer this question, we vibrated the slightly tonically contracted anterior deltoid (AD), posterior deltoid (PD), and pectoralis major muscles in different combinations in forty healthy subjects at a frequency of 100 Hz for 10 min in single or repetitive administrations. We evaluated the vibration effect immediately after f-MV application on upper limb targeted movements tasks, and one week later. We assessed target accuracy, movement mean and peak speed, and normalized Jerk using a 3D optoelectronic motion capture system. Besides, we evaluated AD and PD activity during the tasks using wireless electromyography. We found that f-MV may induce increases (p < 0.05) in movement accuracy, mean speed and smoothness, and changes (p < 0.05) in the electromyographic activity. The main effects of f-MV occurred overtime after repetitive vibration of the AD and PD muscles. Thus, in healthy subjects, optimized f-MV stimulation patterns might over time affect the motor control of the upper limb movement. This finding implies that f-MV may improve the individual’s ability to produce expected motor outcomes and suggests that it may be used to boost motor skills and learning during training and to support functional recovery in rehabilitation.

/pdf/sensory-inflow-manipulation-induces-learning-like-phenomena-3bshu7pz3w.pdf

Sensory inflow manipulation induces learning-like phenomena in motor behavior

Background Pharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease. Methods We first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices. Results Our review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark. Conclusion Invasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

/pdf/therapeutic-devices-for-motor-symptoms-in-parkinsons-disease-2i563ecs.pdf

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Muscle vibration is a technique that applies a low-amplitude/high-frequency vibratory stimulus to a specific muscle using a mechanical device. The aim of this study was to evaluate, using robot-based outcomes, the effects of focal muscle vibration, at different frequencies, on the motor performance of the upper limb in healthy subjects. Forty-eight volunteer healthy subjects (age: 31 ± 8 years) were enrolled. Subjects were assigned to three different groups: the first group, in which subjects underwent muscle vibration treatment with a frequency of 100 Hz; the second group of subjects underwent the same treatment protocol, but using a frequency of vibration of 200 Hz; finally, the control group did not undergo any treatment. The robot-based evaluation session consisted of visually guided reaching task, performed in the sagittal plane. Our results showed that the vibration treatment improved upper limb motor performance of healthy subjects from the baseline (T0) to 10 days after the end of the treatment (T2), but only the group treated with a frequency of 200 Hz reached statistical significance. Specifically, in this group we found an increase of the number of repetitions (T0: 51.4 ± 22.7; T2: 66.3 ± 11.8), and the smoothness of the movement, as showed by a decrease of the Normalized Jerk (T0: 10.5 ± 2.8; T2: 7.7 ± 0.5). The results of our study support the use of focal muscle vibration protocols in healthy subjects, to improve motor performance.

Muscle focal vibration in healthy subjects: evaluation of the effects on upper limb motor performance measured using a robotic device

[Purpose] The purpose of this study was to investigate the effect of muscle vibration in the lower extremities in patients with Parkinson’s disease (PD) during walking. [Subjects] Nine patients with PD participated in this study and were tested with and without vibration (vibration at 60 Hz). [Methods] Eight oscillators of vibration were attached to the muscle bellies (tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris) on both sides of the lower extremities with adhesive tape in this study. Spatiotemporal gait parameters were measured using a motion analysis system. [Results] Stride length and walking speed with vibration were significantly increased compared with those without vibration in PD patients. [Conclusion] These results suggest that the application of vibration to lower extremity muscles in patients with PD may improve the parkinsonian gait pattern.

Effect of muscle vibration on spatiotemporal gait parameters in patients with Parkinson's disease

Polydactyly, the addition of one or more extra digits, occurs in various vertebrates as well as in humans with prevalence ranging from 5 to 19 per 10,000 live births. This common malformation has a genetic cause and was one of the earliest genetic mutations studied in chicken 3) . Furthermore, polydactyly relates to the phenotype found in many domestic chicken breeds including Dorking, Silkie, and Sultan. Autosomal inheritance is shown in polydactyly of chicken with incomplete penetrance 4) . One proposal is that it is

https://ir.ymlib.yonsei.ac.kr/bitstream/22282913/157089/1/T201505343.pdf

A model system for polydactyly; The Korean Ogye

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Effect of muscle vibration on spatiotemporal gait parameters in patients with Parkinson's disease

A model system for polydactyly; The Korean Ogye