Vibration in Neurorehabilitation: a narrative review
Main Article Content
Abstract
Abstract
Over the last decade, have been extensively investigated vibrations applied to the physical and rehabilitation medicine, including the neurorehabilitation, a field where giant steps have been taken in understanding both pathophysiology of the diseases and the influence of vibrational energy on the nervous system.
The purpose of this review is to understand the point at which knowledge is on this topic, what kind of vibration and what modes of applications are used in the rehabilitation of subjects suffering from pathologies affecting the nervous system.
Studies of the last 36 months available on Ovid MEDLINE, PEDro, PubMed Central have been consulted.
The review has shown a positive impact, particularly for focused vibration, in the treatment of neurological disorders.
Keywords:
Neurorehabilitation, vibration, multiple sclerosis, parkinson, spinal cord injury, stroke
Article Details
How to Cite
SAGGINI, Raoul; BELLOMO, Rosa Grazia; COSENZA, Lucia.
Vibration in Neurorehabilitation: a narrative review.
Medical Research Archives, [S.l.], v. 5, n. 11, nov. 2017.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/1563>. Date accessed: 18 apr. 2024.
doi: https://doi.org/10.18103/mra.v5i11.1563.
Keywords
Neurorehabilitation, vibration, multiple sclerosis , parkinson , spinal cord injury, stroke
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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3. Saggini R, Ancona E. The applied mechanical vibration as whole-body
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4. Cauna N, Mannan G. The structure of human digital Pacinian corpusclesand its functional significance. J Anat (London). 1958; 92: 1-20.
5. Stillman BC. Vibratory Motor Stimulation.A Preliminary Report. The Australian journal of physiotherapy. XVI. 1970.
6. Milner-Brown HS, Stein RB, Lee RG. Synchronization of human motor units: possible roles of exercise and supraspinal reflexes. Electroencephalogr Clin Neurophysiol. 1975;38(3):245-54.
7. Kerschan-Schindl K, Grampp S, Henk C, Resch H, Preisinger E, FialkaMoser V, Imhof H. Whole-body vibration exercise leads to alterations in muscle blood volume. Clin Physiol. 2001; 3: 377–382.
8. Kantele S, Karinkanta S2, Sievänen H. Effects of long-term whole-body vibration training on mobility in patients with multiple sclerosis: A meta-analysis of randomized controlled trials. J Neurol Sci. 2015;358(1-2):31-7. doi: 10.1016/j.jns.2015.09.357
9. Uszynski MK, Purtill H, Donnelly A, Coote S. Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study. Clin Rehabil. 2016 Jul;30(7):657-68. doi: 10.1177/0269215515595522.
10. Yang F, Finlayson M, Bethoux F, Su X, Dillon L, Maldonado HM. Effects of controlled whole-body vibration training in improving fall risk factors among individuals with multiple sclerosis: A pilot study. Disabil Rehabil. 2016; 15:1-8. DOI: 10.1080/09638288.2016.1262466.
11. Camerota F, Celletti C, Di Sipio E, De Fino C, Simbolotti C, Germanotta M, Mirabella M, Padua L, Nociti V. Focal muscle vibration, an effective rehabilitative approach in severe gait impairment due to multiple sclerosis. J Neurol Sci. 2017;15; 372:33-39. doi: 10.1016/j.jns.2016.11.025
12. Spina E, Carotenuto A, Aceto MG, Cerillo I, Silvestre F, Arace F, Paone P, Orefice G, Iodice R. The effects of mechanical focal vibration on walking impairment in multiple sclerosis patients: A randomized, double-blinded vs placebo study. Restor Neurol Neurosci. 2016; 21;34(5):869-76. doi: 10.3233/RNN-160665.
13. Alfonsi E, Paone P, Tassorelli C, De Icco R, Moglia A, Alvisi E, Sandrini G. Acute effects of highfrequency microfocal vibratory stimulation on the H reflex of the soleus muscle. A double-blind study in healthy subjects. Functional Neurology. 2016; 30(4), 269-274.
14. De Nunzio AM, Grasso M, Nardone A, Godi M, Schieppati M. Alternate rhythmic vibratory
stimulation of trunk muscles affects walking cadence and velocity in Parkinson’s disease. Clin
Neurophysiol 2010; 121(2): 240-7.
15. Camerota F, Celletti C, Suppa A, Galli M, Cimolin V, Filippi GM, De Pandis MF. Focal Muscle Vibration Improves Gait in Parkinson's Disease: A Pilot Randomized, Controlled Trial. Movement Disorders Clinical Practice. 2016; 3(6), 559-566. DOI:10.1002/mdc3.12323
16. Vaugoyeau M, Azulay JP. Role of sensory information in the control of postural orientation in Parkinson’s disease. J Neurol Sci. 2010; 289:66-8. doi: 10.1016/j. jns.2009.08.019
17. Sharififar S, Coronado RA, Romero S, Azari H, Thigpen M. The Effects of Whole Body Vibration on Mobility and Balance in Parkinson Disease: a Systematic Review. Iranian Journal of Medical Sciences. 2014;39(4):318-326.
18. Kaut O, Brenig D, Marek M, Allert N, Wüllner U. Postural Stability in Parkinson’s Disease Patients Is Improved after Stochastic Resonance Therapy. Parkinson’s Disease, vol. 2016, Article ID 7948721, 7 pages, 2016. doi:10.1155/2016/7948721.
19. Payoux P, Brefel-Courbon C, Ory-Magne F, Regragui W, Thalamas C, Balduyck S, Durif F, Azulay JP, Tison F, Blin O, Esquerre JP, Rascol O. Motor activation in multiple system atrophy and Parkinson disease: a PET study. Neurology. 2010;75(13):1174-80.
20. Schneider C, Kaut O, Fließbach K, Wüllner U. Stochastic whole body vibration induced basal ganglia activation. In: Proceedings of the Congress of the German Society of Neurology. Hamburg. Germany. September 2012.
21. Courtine G, De Nunzio AM, Schmid M, Beretta MV, Schieppati M. Stance- and locomotion-dependent processing of vibration-induced proprioceptive inflow from multiple muscles in humans. J Neurophysiol. 2007; 97: 772–779.
22. Volpe D, Giantin MG, Fasano A. A Wearable Proprioceptive Stabilizer (Equistasi®) for Rehabilitation of Postural Instability in Parkinson’s Disease: A Phase II Randomized Double-Blind, Double-Dummy, Controlled Study. PLoS ONE. 2014;9(11): e112065. doi:10.1371/journal.pone.0112065
23. Minematsu A, Nishii Y, Imagita H, Takeshita D, Sakata S. Whole-body vibration can attenuate the deterioration of bone mass and trabecular bone microstructure in rats with spinal cord injury. Spinal Cord. 2016; 54(8):597-603. doi: 10.1038/sc.2015.220.
24. Bramlett HM, Dietrich WD, Marcillo A, et al. Effects of low intensity vibration on bone and muscle in rats with spinal cord injury. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2014;25(9):2209-2219. doi:10.1007/s00198-014-2748-8.
25. Butezloff MM, Zamarioli A, Maranho DA, Shimano AC. Effect of Electrical Stimulation and Vibration Therapy on Skeletal Muscle Trophism in Rats with Complete Spinal Cord Injury. Am J Phys Med Rehabil. 2015; 94(11):950-7. doi: 10.1097/PHM.0000000000000278.
26. Wuermser LA, Beck LA, Lamb JL, Atkinson EJ, Amin S. The effect of low-magnitude whole body vibration on bone density and microstructure in men and women with chronic motor complete paraplegia. The Journal of Spinal Cord Medicine. 2015;38(2):178-186. doi:10.1179/2045772313Y.0000000191
27. Dudley-Javoroski S, Petrie MA, McHenry CL, Amelon RE, Saha PK, Shields RK. Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb. Osteoporos Int. 2016; 27(3):1149-1160. doi: 10.1007/s00198-015-3326-4
28. Alizadeh-Meghrazi M, Masani K, Zariffa J, Sayenko DG, Popovic MR and Craven BC. Effect of whole-body vibration on lower-limb EMG activity in subjects with and without spinal cord injury. J Spinal Cord Med 2014; 37(5): 525–536.
29. Bosveld R, Field-Fote EC. Single-dose effects of whole body vibration on quadriceps strength in individuals with motor-incomplete spinal cord injury. J Spinal Cord Med 2015; 38(6): 784–791.
30. Ji Q, He H, Zhang C, Lu C, Zheng Y, Luo XT, He C. Effects of whole-body vibration on neuromuscular performance in individuals with spinal cord injury: A systematic review. Clin Rehabil. 2016; 29.
31. Da Silva U, Villagra HA, Oliva LL, Marconi NF. EMG activity of upper limb on spinal cord injury individuals during whole-body vibration. Physiol Int. 2016;103(3):361-367. doi: 10.1556/2060.103.2016.3.10
32. Menéndez H, Ferrero C, Martín-Hernández J, Figueroa A, Marín PJ, Herrero AJ. Chronic effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury. Spinal Cord. 2016;54(12):1169-1175. doi: 10.1038/sc.2016.60
33. Gomes-Osman J, Field-Fote EC. Cortical vs. afferent stimulation as an adjunct to functional task practice training: a randomized, comparative pilot study in people with cervical spinal cord injury. Clin Rehabil. 2015; 29(8):771-82. DOI: 10.1177/0269215514556087
34. Backus D, Cordo P, Gillott A, Kandilakis C, Mori M, Raslan AM. Assisted movement with proprioceptive stimulation reduces impairment and restores function in incomplete spinal cord injury. Arch. Phys. Med. Rehabil. 2014; 95, 1447–1453.
35. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M, Venketasubramanian N, Barker-Collo S, Lawes CM, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245-254.
36. Morris RG. D.O. Hebb: The Organization of Behavior, Wiley: New York; 1949. Brain Res Bull. 1999; 50(5-6):437.
37. Liao LR, Lam FM, Pang MY, Jones AY, Ng GY. Leg muscle activity during whole-body vibration in individuals with chronic stroke. Med Sci Sports Exerc. 2014;46(3):537-45. doi: 10.1249/MSS.0b013e3182a6a006.
38. Silva AT, Dias MP, Calixto R Jr, Carone AL, Martinez BB, Silva AM, Honorato DC. Acute effects of whole-body vibration on the motor function of patients with stroke. American Journal of Physical Medicine & Rehabilitation 2014;93(4):310-319.
39. Yang X, Wang P, Liu C, He C, Reinhardt JD. The effect of whole body vibration on balance, gait performance and mobility in people with stroke: a systematic review and meta-analysis. Clin Rehabil. 2015;29(7):627-38. doi: 10.1177/0269215514552829
40. Paoloni M, Tavernese E, Fini M, Sale P, Franceschini M, Santilli V, Mangone M. Segmental muscle vibration modifies muscle activation during reaching in chronic stroke: A pilot study. NeuroRehabilitation. 2014; 405–414. DOI:10.3233/NRE-141131
41. Tavernese E, Paoloni M, Mangone M, Mandic V, Sale P, Franceschini M, Santilli, V. Segmental muscle vibration improves reaching movement in patients with chronic stroke. A randomized controlled trial. NeuroRehabilitation. 2013; 32(3), 591-599. doi: 10.3233/NRE-130881
42. Etoh S, Noma T, Takiyoshi Y, Arima M, Ohama R, Yokoyama K, Hokazono A, Amano Y, Shimodozono M, Kawahira K. Effects of repetitive facilitative exercise with neuromuscular electrical stimulation, vibratory stimulation and repetitive transcranial magnetic stimulation of the hemiplegic hand in chronic stroke patients. Int J Neurosci. 2016;126(11):1007-12. DOI: 10.3109/00207454.2015.1094473
43. Celletti C, Sinibaldi E, Pierelli F, Monari G, Camerota F Focal Muscle Vibration and Progressive Modular Rebalancing with neurokinetic facilitations in post- stroke recovery of upper limb. Clin Ter. 2017;168(1): e33-e36. doi: 10.7417/CT.2017.1979
44. Saggini R, Scarcello L, Di Stefano A, Carmignano SM, Barassi G, Visciano C, Antonacci R, Scorrano V, Bellomo RG. Integrated rehabilitation treatment of focal spasticity after botulinum toxin type-A injection. Journal of Clinical Trials. 2015, 5:6.
45. Casale R, Damiani C, Maestri R, Fundarò C, Chimento P, Foti C. Localized 100 Hz vibration improves function and reduces upper limb spasticity: a double-blind controlled study. Eur J Phys Rehabil Med. 2014;50(5):495-504.
2. Saggini R, Carmignano SM, Palermo T, Bellomo RG. Mechanical Vibration in Rehabilitation: State of the Art. J Nov Physiother. 2016; 6:314. doi:10.4172/2165-7025.1000314.
3. Saggini R, Ancona E. The applied mechanical vibration as whole-body
and focal vibration. In: The mechanical vibration: therapeutic effects and applications. Pp. 25-88. BenthamScience. 2016. DOI: 10.2174/97816810850811170101
4. Cauna N, Mannan G. The structure of human digital Pacinian corpusclesand its functional significance. J Anat (London). 1958; 92: 1-20.
5. Stillman BC. Vibratory Motor Stimulation.A Preliminary Report. The Australian journal of physiotherapy. XVI. 1970.
6. Milner-Brown HS, Stein RB, Lee RG. Synchronization of human motor units: possible roles of exercise and supraspinal reflexes. Electroencephalogr Clin Neurophysiol. 1975;38(3):245-54.
7. Kerschan-Schindl K, Grampp S, Henk C, Resch H, Preisinger E, FialkaMoser V, Imhof H. Whole-body vibration exercise leads to alterations in muscle blood volume. Clin Physiol. 2001; 3: 377–382.
8. Kantele S, Karinkanta S2, Sievänen H. Effects of long-term whole-body vibration training on mobility in patients with multiple sclerosis: A meta-analysis of randomized controlled trials. J Neurol Sci. 2015;358(1-2):31-7. doi: 10.1016/j.jns.2015.09.357
9. Uszynski MK, Purtill H, Donnelly A, Coote S. Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study. Clin Rehabil. 2016 Jul;30(7):657-68. doi: 10.1177/0269215515595522.
10. Yang F, Finlayson M, Bethoux F, Su X, Dillon L, Maldonado HM. Effects of controlled whole-body vibration training in improving fall risk factors among individuals with multiple sclerosis: A pilot study. Disabil Rehabil. 2016; 15:1-8. DOI: 10.1080/09638288.2016.1262466.
11. Camerota F, Celletti C, Di Sipio E, De Fino C, Simbolotti C, Germanotta M, Mirabella M, Padua L, Nociti V. Focal muscle vibration, an effective rehabilitative approach in severe gait impairment due to multiple sclerosis. J Neurol Sci. 2017;15; 372:33-39. doi: 10.1016/j.jns.2016.11.025
12. Spina E, Carotenuto A, Aceto MG, Cerillo I, Silvestre F, Arace F, Paone P, Orefice G, Iodice R. The effects of mechanical focal vibration on walking impairment in multiple sclerosis patients: A randomized, double-blinded vs placebo study. Restor Neurol Neurosci. 2016; 21;34(5):869-76. doi: 10.3233/RNN-160665.
13. Alfonsi E, Paone P, Tassorelli C, De Icco R, Moglia A, Alvisi E, Sandrini G. Acute effects of highfrequency microfocal vibratory stimulation on the H reflex of the soleus muscle. A double-blind study in healthy subjects. Functional Neurology. 2016; 30(4), 269-274.
14. De Nunzio AM, Grasso M, Nardone A, Godi M, Schieppati M. Alternate rhythmic vibratory
stimulation of trunk muscles affects walking cadence and velocity in Parkinson’s disease. Clin
Neurophysiol 2010; 121(2): 240-7.
15. Camerota F, Celletti C, Suppa A, Galli M, Cimolin V, Filippi GM, De Pandis MF. Focal Muscle Vibration Improves Gait in Parkinson's Disease: A Pilot Randomized, Controlled Trial. Movement Disorders Clinical Practice. 2016; 3(6), 559-566. DOI:10.1002/mdc3.12323
16. Vaugoyeau M, Azulay JP. Role of sensory information in the control of postural orientation in Parkinson’s disease. J Neurol Sci. 2010; 289:66-8. doi: 10.1016/j. jns.2009.08.019
17. Sharififar S, Coronado RA, Romero S, Azari H, Thigpen M. The Effects of Whole Body Vibration on Mobility and Balance in Parkinson Disease: a Systematic Review. Iranian Journal of Medical Sciences. 2014;39(4):318-326.
18. Kaut O, Brenig D, Marek M, Allert N, Wüllner U. Postural Stability in Parkinson’s Disease Patients Is Improved after Stochastic Resonance Therapy. Parkinson’s Disease, vol. 2016, Article ID 7948721, 7 pages, 2016. doi:10.1155/2016/7948721.
19. Payoux P, Brefel-Courbon C, Ory-Magne F, Regragui W, Thalamas C, Balduyck S, Durif F, Azulay JP, Tison F, Blin O, Esquerre JP, Rascol O. Motor activation in multiple system atrophy and Parkinson disease: a PET study. Neurology. 2010;75(13):1174-80.
20. Schneider C, Kaut O, Fließbach K, Wüllner U. Stochastic whole body vibration induced basal ganglia activation. In: Proceedings of the Congress of the German Society of Neurology. Hamburg. Germany. September 2012.
21. Courtine G, De Nunzio AM, Schmid M, Beretta MV, Schieppati M. Stance- and locomotion-dependent processing of vibration-induced proprioceptive inflow from multiple muscles in humans. J Neurophysiol. 2007; 97: 772–779.
22. Volpe D, Giantin MG, Fasano A. A Wearable Proprioceptive Stabilizer (Equistasi®) for Rehabilitation of Postural Instability in Parkinson’s Disease: A Phase II Randomized Double-Blind, Double-Dummy, Controlled Study. PLoS ONE. 2014;9(11): e112065. doi:10.1371/journal.pone.0112065
23. Minematsu A, Nishii Y, Imagita H, Takeshita D, Sakata S. Whole-body vibration can attenuate the deterioration of bone mass and trabecular bone microstructure in rats with spinal cord injury. Spinal Cord. 2016; 54(8):597-603. doi: 10.1038/sc.2015.220.
24. Bramlett HM, Dietrich WD, Marcillo A, et al. Effects of low intensity vibration on bone and muscle in rats with spinal cord injury. Osteoporosis international: a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA. 2014;25(9):2209-2219. doi:10.1007/s00198-014-2748-8.
25. Butezloff MM, Zamarioli A, Maranho DA, Shimano AC. Effect of Electrical Stimulation and Vibration Therapy on Skeletal Muscle Trophism in Rats with Complete Spinal Cord Injury. Am J Phys Med Rehabil. 2015; 94(11):950-7. doi: 10.1097/PHM.0000000000000278.
26. Wuermser LA, Beck LA, Lamb JL, Atkinson EJ, Amin S. The effect of low-magnitude whole body vibration on bone density and microstructure in men and women with chronic motor complete paraplegia. The Journal of Spinal Cord Medicine. 2015;38(2):178-186. doi:10.1179/2045772313Y.0000000191
27. Dudley-Javoroski S, Petrie MA, McHenry CL, Amelon RE, Saha PK, Shields RK. Bone architecture adaptations after spinal cord injury: impact of long-term vibration of a constrained lower limb. Osteoporos Int. 2016; 27(3):1149-1160. doi: 10.1007/s00198-015-3326-4
28. Alizadeh-Meghrazi M, Masani K, Zariffa J, Sayenko DG, Popovic MR and Craven BC. Effect of whole-body vibration on lower-limb EMG activity in subjects with and without spinal cord injury. J Spinal Cord Med 2014; 37(5): 525–536.
29. Bosveld R, Field-Fote EC. Single-dose effects of whole body vibration on quadriceps strength in individuals with motor-incomplete spinal cord injury. J Spinal Cord Med 2015; 38(6): 784–791.
30. Ji Q, He H, Zhang C, Lu C, Zheng Y, Luo XT, He C. Effects of whole-body vibration on neuromuscular performance in individuals with spinal cord injury: A systematic review. Clin Rehabil. 2016; 29.
31. Da Silva U, Villagra HA, Oliva LL, Marconi NF. EMG activity of upper limb on spinal cord injury individuals during whole-body vibration. Physiol Int. 2016;103(3):361-367. doi: 10.1556/2060.103.2016.3.10
32. Menéndez H, Ferrero C, Martín-Hernández J, Figueroa A, Marín PJ, Herrero AJ. Chronic effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury. Spinal Cord. 2016;54(12):1169-1175. doi: 10.1038/sc.2016.60
33. Gomes-Osman J, Field-Fote EC. Cortical vs. afferent stimulation as an adjunct to functional task practice training: a randomized, comparative pilot study in people with cervical spinal cord injury. Clin Rehabil. 2015; 29(8):771-82. DOI: 10.1177/0269215514556087
34. Backus D, Cordo P, Gillott A, Kandilakis C, Mori M, Raslan AM. Assisted movement with proprioceptive stimulation reduces impairment and restores function in incomplete spinal cord injury. Arch. Phys. Med. Rehabil. 2014; 95, 1447–1453.
35. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, Moran AE, Sacco RL, Anderson L, Truelsen T, O'Donnell M, Venketasubramanian N, Barker-Collo S, Lawes CM, Wang W, Shinohara Y, Witt E, Ezzati M, Naghavi M, Murray C. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383(9913):245-254.
36. Morris RG. D.O. Hebb: The Organization of Behavior, Wiley: New York; 1949. Brain Res Bull. 1999; 50(5-6):437.
37. Liao LR, Lam FM, Pang MY, Jones AY, Ng GY. Leg muscle activity during whole-body vibration in individuals with chronic stroke. Med Sci Sports Exerc. 2014;46(3):537-45. doi: 10.1249/MSS.0b013e3182a6a006.
38. Silva AT, Dias MP, Calixto R Jr, Carone AL, Martinez BB, Silva AM, Honorato DC. Acute effects of whole-body vibration on the motor function of patients with stroke. American Journal of Physical Medicine & Rehabilitation 2014;93(4):310-319.
39. Yang X, Wang P, Liu C, He C, Reinhardt JD. The effect of whole body vibration on balance, gait performance and mobility in people with stroke: a systematic review and meta-analysis. Clin Rehabil. 2015;29(7):627-38. doi: 10.1177/0269215514552829
40. Paoloni M, Tavernese E, Fini M, Sale P, Franceschini M, Santilli V, Mangone M. Segmental muscle vibration modifies muscle activation during reaching in chronic stroke: A pilot study. NeuroRehabilitation. 2014; 405–414. DOI:10.3233/NRE-141131
41. Tavernese E, Paoloni M, Mangone M, Mandic V, Sale P, Franceschini M, Santilli, V. Segmental muscle vibration improves reaching movement in patients with chronic stroke. A randomized controlled trial. NeuroRehabilitation. 2013; 32(3), 591-599. doi: 10.3233/NRE-130881
42. Etoh S, Noma T, Takiyoshi Y, Arima M, Ohama R, Yokoyama K, Hokazono A, Amano Y, Shimodozono M, Kawahira K. Effects of repetitive facilitative exercise with neuromuscular electrical stimulation, vibratory stimulation and repetitive transcranial magnetic stimulation of the hemiplegic hand in chronic stroke patients. Int J Neurosci. 2016;126(11):1007-12. DOI: 10.3109/00207454.2015.1094473
43. Celletti C, Sinibaldi E, Pierelli F, Monari G, Camerota F Focal Muscle Vibration and Progressive Modular Rebalancing with neurokinetic facilitations in post- stroke recovery of upper limb. Clin Ter. 2017;168(1): e33-e36. doi: 10.7417/CT.2017.1979
44. Saggini R, Scarcello L, Di Stefano A, Carmignano SM, Barassi G, Visciano C, Antonacci R, Scorrano V, Bellomo RG. Integrated rehabilitation treatment of focal spasticity after botulinum toxin type-A injection. Journal of Clinical Trials. 2015, 5:6.
45. Casale R, Damiani C, Maestri R, Fundarò C, Chimento P, Foti C. Localized 100 Hz vibration improves function and reduces upper limb spasticity: a double-blind controlled study. Eur J Phys Rehabil Med. 2014;50(5):495-504.