Speed up the timing of the results on the motor recovery of the neurological patient

The motor recovery of the so-called “neurological patient” represents a difficult challenge for any therapist. In fact, any positive results come after long periods of functional rehabilitation and in most cases you have to be content with minimal improvements that take place over months of methodical and repetitive work.

If a patient suffering from pain or with a bad ankle sprain or just recovering from surgery comes to our center, we would have several therapy options available, some more effective and faster, others that require more time, but in any case we would have many possibilities for action. The same could certainly not be said for those cases in which the patient’s “restitutio ad integrum” largely depends on the ability of the central nervous system (CNS) to interact with the peripheral nervous system (PNS).

Atrophy, motor deficit, loss of strength and balance, are all disorders associated with impaired communication between the CNS and PNS.

In addition to any pharmacological treatments (which we are not dealing with here), controlled exercise, proprioceptive movement, functional exercises, biofeedback are some examples of therapeutic actions that can be undertaken to follow the so-called “neurological patient”.

The purpose of each of these stimuli is not so much to improve the mechanics of the tissues or to accelerate their regeneration, but to stimulate the ability of the tissues to exchange information with the brain. It is through these forms of neuronal re-education and “training” that we proceed towards clinical improvement. All of this takes a lot of time and dedication.

Is there a way to accelerate the motor recovery process of the neurological patient?

We know that the motor units, their synapses and the mechanoreceptors connected to them play a fundamental role in the information exchange that takes place between the CNS and the SNP. Already at the beginning of the last century they were studying how to stimulate these organs for therapeutic purposes. In 1975 Lucier et al. with a study published in the Journal of Physiology described how the vibratory stimulus was able to maximize neuronal activity provided that the reference mechanoreceptor was subjected to a vibratory stimulus with specific frequencies.

What is the role of the focal vibration stimulus?

Over the years, dozens of studies have followed on the therapeutic role of focal vibration. For example Saggini et al. in 2006 they described its positive effects on muscle fatigue. In 2009 Filippi et al. highlight the effects of this type of physical therapy on position control and muscle strength. Between 2012 and 2020 other publications by international authors (Spina et al., Rotovich et al, Lee et al, Toscano et al., Rabini et al.; etc.) have described how focal vibration is an effective therapeutic tool for counteract the motor deficit that occurs in many patients suffering from different pathologies.

Under which conditions could focal vibration be a useful ally?

• Painful Myofascial Syndrome.
• Geriatric sarcopenia.
• Flat foot syndrome.
• Jumper’s knee syndrome.
• Recovery of muscle strength in pathological states that impact the locomotor system such as stroke, multiple sclerosis, paralysis, incomplete spinal cord injuries, post-surgical course, osteoarthritis of the knee.
• Recovery of proprioceptive balance, postural balance, motor control in pathological states that impact the locomotor system such as stroke, multiple sclerosis, paralysis, incomplete spinal cord injuries, post-surgical course, Charcot Marie Tooth disease, Parkinson’s disease, osteoarthritis of the knee.
• Post-stroke rehabilitation course; Muscle spasticity; Osteoporosis and bone mineral density.
• Geriatric motor dysfunctions with particular application for the prevention of falls in the elderly.
• Male sexual dysfunction.
• Urinary incontinence.
• Post-tumor rehabilitation course only in cases with clinical evidence of complete eradication of tumor cells.
• Post-stroke rehabilitation course.

What are the characteristics that an instrument must have to guarantee an effective vibratory stimulus from a therapeutic point of view?

Based on the analysis of the literature mentioned above, it is possible to define its fundamental features:

• Given the different sensitivity to different frequencies of mechanical receptors of different types, the instrument must allow to control the vibratory frequency and to modulate it on a scale ranging from a few tens to 300 Hz.

• Given the depth and distribution of some mechanical receptors inside the human body, the instrument must guarantee a sufficient vibratory force (at least 6 Newton / cm2 or 0.6 bar) on all applicable frequencies to be able to reach the deep layers of tissue. The more mass is treated the more strength will be needed.

• Given the innate adaptive capacity of the mechano-receptors which over time reduces the effect of vibration on the excitability of the receptor itself, the instrument must guarantee the possibility of creating intermittent or variable vibratory signals over the time of application in order to counteract this adaptive phenomenon. and maximize the stimulus for the duration of the therapy.

• Given the extension and distribution of the body parts useful to be treated with the focal vibration, the instrument must ensure the possibility of distributing the vibratory stimulus on different applicators to be positioned on different areas of the body.

• Since different muscle groups are sensitive to different vibrational frequencies, the instrument should have the ability to apply varying vibrational frequencies to each applicator.

• Since the long-term therapeutic effects improve when the vibratory stimulus is combined with voluntary movement, it is useful for the tool to allow the applicators to be fixed to the body while it is free to move.

• Requiring some applications to exert high levels of pressure on the body (eg trigger point) and also reaching very specific parts of the body (eg Subscapularis; piriformis etc …) it is useful that the instrument allows the use of applicators of various sizes both manually and in automatic applications

• Given the need to repeat the treatment several times a week, it is useful for the instrument to be as quiet as possible.

• Given the very wide applicability of focal vibration in the performance and geriatric fields, it is useful for the instrument to have such dimensions and weight as to make it transportable in the field or at the patient’s home.

Although there are different types of focal vibration instruments, to date, there is only one instrument capable of responding to all the characteristics listed above. Find out which one… click on the button below.