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Six weeks of whole-body vibration improves fine motor accuracy, functional mobility and quality of life in people with multiple sclerosis

ABSTRACT: People with multiple sclerosis (MS) suffer from sensorimotor deficits with the distal extremities being more severely affected than proximal ones. Whole-body vibration (WBV) training is known to enhance voluntary activation and coordination in healthy people. However, evidence about beneficial effects of WBV in MS patients is scarce. The current study aimed to investigate if six weeks of WBV enhances motor function in the ankle joint, coordination and quality of life in patients suffering from severe MS. In a longitudinal design, changes in motor function and quality of life were assessed before and after a 6-week control period without a training (CON) and a 6-week WBV training (2-3x/week) in 15 patients (53 ±10 years) with advanced MS (EDSS 3–6.5). Before CON (t0), after CON (t1) and after WBV(t2), outcome measures included (1) active range of motion (aROM) and (2) motor accuracy at the ankle joint, (3) functional mobility (Timed “Up & Go” test with preferred and non-preferred turns) and (4) physical and psychological impact of MS (MSIS-29 questionnaire). For (1) and (2), the stronger (SL) and the weaker leg (WL) were compared. After WBV, aROM (1) did not change (SL p = 0.26, WL p = 0.10), but was diminished after CON (SL -10% p = 0.06, WL -14% p = 0.03) with significant group differences (Δgroup WL p = 0.02). Motor accuracy in SL (2) was improved during dorsal flexion after WBV (p = 0.01, Δgroup p = 0.04) and deteriorated during plantar flexion after CON (p = 0.01, Δgroup p = 0.04). Additionally, participants (3) improved their functional mobility at the preferred turn (p = 0.04) and (4) ranked their quality of life higher solely after WBV (p = 0.05), without any differences between groups. However, values correlated significantly between angular precision and aROM as well as functional mobility. No further changes occurred. The results point towards an interception of degenerating mono-articular mobility and improvement of accuracy in the ankle joint. The motor effects after WBV are in line with enhanced perception of quality of life after six weeks which is why WBV could be a stimulus to enable greater overall autonomy in MS patients.

SUBMITTER: Krause A

PROVIDER: S-EPMC9273076 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Core stability training (CST) has increased in popularity among athletes and the general fitness population despite limited evidence CST programmes alone lead to improved athletic performance. In female athletes, neuromuscular training combining balance training and trunk and hip/pelvis dominant CST is suggested to reduce injury risk, and specifically peak vertical ground reaction forces (vGRF) in a drop jump landing task. However, the isolated effect of trunk dominant core stability training on vGRF during landing in female athletes had not been evaluated. Therefore, the objective of this study was to evaluate landing kinetics during a drop jump test following a CST intervention in female capoeira athletes. After giving their informed written consent, sixteen female capoeira athletes (mean ± SD age, stature, and body mass of 27.3 ± 3.7 years, 165.0 ± 4.0 cm, and 59.7 ± 6.3 kg, respectively) volunteered to participate in the training program which consisted of static and dynamic CST sessions, three times per week for six weeks. The repeated measures T-test revealed participants significantly reduced relative vGRF from pre- to post-intervention for the first (3.40 ± 0.78 vs. 2.85 ± 0.52 N·NBW-1, respectively [p<0.05, effect size = 0.60]), and second landing phase (5.09 ± 1.17 vs. 3.02 ± 0.41 N·NBW-1, respectively [p<0.001, effect size = 0.87]). The average loading rate was reduced from pre- to post-intervention during the second landing phase (30.96 ± 18.84 vs. 12.06 ± 9.83 N·NBW·s-1, respectively [p<0.01, effect size = 0.68]). The peak loading rate was reduced from pre- to post-intervention during the first (220.26 ± 111.51 vs. 120.27 ± 64.57 N·NBW·s-1 respectively [p<0.01, effect size = 0.64]), and second (99.52 ± 54.98 vs. 44.71 ± 30.34 N·NBW·s-1 respectively [p<0.01, effect size = 0.70]) landing phase. Body weight, average loading rate during the first landing phase, and jump height were not significantly different between week 0 and week 6 (p=0.528, p=0.261, and p=0.877, respectively). This study provides evidence that trunk dominant core stability training improves landing kinetics without improving jump height, and may reduce lower extremity injury risk in female athletes.

Project description:Priming is a learning process that refers to behavioral changes caused by previous exposure to a similar stimulus. Motor imagery (MI), which involves the mental rehearsal of action representations in working memory without engaging in actual execution, could be a strategy for priming the motor system. This study investigates whether MI primes action execution in Multiple Sclerosis (MS). Here, 17 people with MS (PwMS) and 19 healthy subjects (HS), all right-handed and good imaginers, performed as accurately and quickly as possible, with a pencil, actual or mental pointing movements between targets of small (1.0 × 1.0 cm) or large (1.5 × 1.5 cm) size. In actual trials, they completed five pointing cycles between the left and right targets, whereas in mental trials, the first 4 cycles were imagined while the fifth was actually executed. The fifth cycle was introduced to assess the MI priming effect on actual execution. All conditions, presented randomly, were performed with both dominant (i.e., right) and non-dominant arms. Analysis of the duration of the first 4 cycles in both actual and mental trials confirmed previous findings, showing isochrony in HS with both arms and significantly faster mental than actual movements (anisochrony) in PwMS (p < 0.01) [time (s); HS right: actual: 4.23 ± 0.15, mental: 4.36 ± 0.16; left: actual: 4.32 ± 0.15, mental: 4.43 ± 0.18; PwMS right: actual: 5.85 ± 0.16, mental: 5.99 ± 0.21; left: actual: 6.68 ± 0.20, mental: 5.94 ± 0.23]; anisochrony in PwMS was present when the task was performed with the non-dominant arm. Of note, temporal analysis of the fifth actual cycle showed no differences between actual and mental trials for HS with both arms, whereas in PwMS the fifth actual cycle was significantly faster after the four actual cycles for the non-dominant arm (p < 0.05) [time (s); HS right: actual: 1.03 ± 0.04, mental: 1.03 ± 0.03; left: actual: 1.08 ± 0.04, mental: 1.05 ± 0.03; PwMS right: actual: 1.48 ± 0.04, mental: 1.48 ± 0.06; left: actual: 1.66 ± 0.05, mental: 1.48 ± 0.06]. These results seem to suggest that a few mental repetitions of an action might be sufficient to exert a priming effect on the actual execution of the same action in PwMS. This would indicate further investigation of the potential use of MI as a new motor-cognitive tool for MS neurorehabilitation.

Project description:BackgroundVibration therapy is one of the rehabilitation programs that may be effective in treating both motor and non-motor symptoms in Multiple Sclerosis patients. We conducted a comprehensive systematic review and meta-analysis to assess the effects of vibration therapy on motor and non-motor symptoms (functional mobility, balance, walking endurance, gait speed, fatigue, and quality of life) of this population.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Physiotherapy Evidence Database, Scopus, Google Search Engine, and the China National Knowledge Infrastructure (CNKI). Two reviewers independently assessed the study quality.ResultsFourteen studies with 393 participants were finally included in the meta-analysis. The pooled results showed that vibration therapy had a significant advantage over the control intervention in improving balance function [mean difference (MD) = 2.04, 95% confidence interval (CI): 0.24-3.84, P = 0.03], and walking endurance (SMD = 0.34, 95% CI: 0.07-0.61, P = 0.01). Meanwhile, the degree of disability subgroup analysis revealed that the Expanded Disability Status Scale (EDSS) score (3.5-6) significantly improved functional mobility (MD: -1.18, 95% CI: -2.09 to 0.28, P = 0.01) and balance function (MD: 3.04, 95% CI: 0.49-5.59, P = 0.02) compared with the control group, and the EDSS (0-3.5) were more beneficial in walking endurance. The duration subgroup analysis indicated a significant difference in the effect of the duration (<4 weeks) on enhancing walking endurance (SMD: 0.46, 95% CI: 0.04-0.87, P = 0.03). However, no significant improvement was found in functional mobility, gait speed, fatigue, and quality of life.ConclusionVibration therapy may improve balance function and walking endurance, and the degree of disability and duration of intervention may affect outcomes. The evidence for the effects of vibration therapy on functional mobility, gait speed, fatigue, and quality of life remains unclear. More trials with rigorous study designs and a larger sample size are necessary to provide this evidence.Systematic review registrationPROSPERO, https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022326852.

Project description:Aging is a progressive process leading to functional decline in many domains. Recent studies have shown that physical exercise (PE) has a positive influence on the progression of age-related functional decline, including motor and brain functions. Whole body vibration (WBV) is a form of passive stimulation by mechanical vibration platforms, which offers an alternative for PE interventions, especially for aged individuals. WBV has been demonstrated to mimic the beneficial effects of PE on the musculoskeletal system, as well on the central nervous system. However, preclinical data with aged rodents are very limited. Hence, the purpose of this experiment was to investigate the effects of a 5-week WBV intervention with an aged animal model on memory functions, anxiety-related behavior, and motor performance. The 18-month old male (N = 14) and female (N = 14) Wistar rats were divided into two groups, namely, vibration and pseudo-vibration. Animals underwent a 5-week WBV intervention protocol with low intensity (frequency of 30 Hz and amplitude of 50-200 μm) stimulation. After 5 weeks, the following cognitive and motor tests were administered: open-field, novel and spatial object recognition, grip-hanging, and balance-beam. WBV-treated rats showed a decrease in their anxiety level in the open field test compared with those in the pseudo-treated controls. In addition, WBV-treated male animals showed significantly increased rearing in the open-field test compared to their pseudo controls. Spatial memory was significantly improved by WBV treatment, whereas WBV had no effect on object memory. Regarding motor performance, both grip strength and motor coordination were improved by WBV treatment. Our results indicate that WBV seems to have comparable beneficial effects on age-related emotional, cognitive, and motor decline as what has been reported for active PE. No striking differences were found between the sexes. As such, these findings further support the idea that WBV could be considered as a useful alternative for PE in case active PE cannot be performed due to physical or mental issues.

Project description:Cannabidiol (CBD) presents antiparkinsonian properties and neuromodulatory effects, possibly due to the pleiotropic activity caused at multiple molecular targets. Recently, the GPR55 receptor has emerged as a molecular target of CBD. Interestingly, GPR55 mRNA is expressed in the external globus pallidus (GPe) and striatum, hence, it has been suggested that its activity is linked to motor dysfunction in Parkinson's disease (PD). The present study aimed to evaluate the effect of the intrapallidal injection of both CBD and a selective GPR55 antagonist (CID16020046) on motor asymmetry, fine motor skills, and GAD-67 expression in hemiparkinsonian rats. The hemiparkinsonian animal model applied involved the induction of a lesion in male Wistar rats via the infusion of the neurotoxin 6-hydroxydopamine (6-OHDA) into the medial forebrain bundle via stereotaxic surgery. After a period of twenty days, a second surgical procedure was performed to implant a guide cannula into the GPe. Seven days later, lysophosphatidylinositol (LPI), CBD, or CID16020046 were injected once a day for three consecutive days (from the 28th to the 30th day post-lesion). Amphetamine-induced turning behavior was evaluated on the 14th and 30th days post-injury. The staircase test and fine motor skills were evaluated as follows: the rats were subject to a ten-day training period prior to the 6-OHDA injury; from the 15th to the 19th days post-lesion, the motor skills alterations were evaluated under basal conditions; and, from the 28th to the 30th day post-lesion, the pharmacological effects of the drugs administered were evaluated. The results obtained show that the administration of LPI or CBD generated lower levels of motor asymmetry in the turning behavior of hemiparkinsonian rats. It was also found that the injection of CBD or CID16020046, but not LPI, in the hemiparkinsonian rats generated significantly superior performance in the staircase test, in terms of the use of the forelimb contralateral to the 6-OHDA-induced lesion, when evaluated from the 28th to the 30th day post-lesion. Similar results were also observed for superior fine motor skills performance for pronation, grasp, and supination. Finally, the immunoreactivity levels were found to decrease for the GAD-67 enzyme in the striatum and the ipsilateral GPe of the rats injected with CBD and CID16020046, in contrast with those lesioned with 6-OHDA. The results obtained suggest that the inhibitory effects of CBD and CID16020046 on GPR55 in the GPe could be related to GABAergic overactivation in hemiparkinsonism, thus opening new perspectives to explain, at a cellular level, the reversal of the motor impairment observed in PD models.

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Six weeks of whole-body vibration improves fine motor accuracy, functional mobility and quality of life in people with multiple sclerosis

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