Punctual mechanical oscillation in modulation of muscular tonus in children with spasticity





Cerebral Pals, Mechanomyography, Modified Ashworth Scale, Muscle belly, Muscle tendon.


Spasticity is a motor condition present in 75 to 88% of children with Cerebral Palsy (CP). One form of treatment is called punctual mechanical oscillation (PO). The current study aimed to study different protocols for the application of PO and the magnitude of their effects. In total, 7children with medical diagnosis of CP and ICD (International Classification of Diseases) were included. The first intervention protocol (Int1) consisted of the application of PO to the spastic muscle tendon and the second intervention protocol (Int2) to the muscle belly ofthe spastic antagonist muscle. For evaluation, the Modified Ashworth Scale (MAS) was used, while simultaneously capturing the mechanomyography (MMG) signals. Data were collected pre-intervention and 1 (Post1), 15 (Post15), 30 (Post30), 45 (Post45), and60 (Post60) minutes after the interventions. The MAS values (median ± interquartile range) post intervention were statistically lower when compared to the pre values in the 2 protocols studied; in Int1between Pre (2 ± 0) andPost15 (0 ± 1.75), Post30 (0 ± 1), Post45 (1 ± 1),and Post60 (1 ± 1), and in Int2only between Pre (2 ± 1) and Post1 (0 ± 1).The values found in the MMG in both its temporal and spectral domains did not follow a pattern (p>0.05). The comparison between the protocols did not demonstrate statistical differences in any characteristics (MAS, MMGMF, and MMGRMS). However, PO was shown to be a therapeutic resource that modulated spasticity for up to 60 minutes after its application, and PO could contribute as a tool to aid the treatment of spasticity.


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BALBINOT, A. Caracterização dos níveis de vibração em motoristas de ônibus: um enfoque no conforto e na saúde. 2001. Available from: https://www.lume.ufrgs.br/handle/10183/248

BATISTA, M.A., et al. Efeitos do treinamento com plataformas vibratórias. Revista Brasileira de Ciência e Movimento. 2007, 15(3), 103-114. http://dx.doi.org/10.31501/rbcm.v15i3

BRASIL. Ministério da Saúde. Protocolo clínico e diretrizes terapêuticas espasticidade. 2009. Available from: http://portalarquivos.saude.gov.br/images/pdf/2017/julho/03/PCDT-Espasticidade_29_05_2017.pdf.

BURKE, D., ANDREWS, C.J. and LANCE, J.W. Tonic vibration reflex in spasticity, Parkinson's disease, and normal subjects. Journal of Neurology, Neurosurgery & Psychiatry. 1972, 35(4), 477-486. http://dx.doi.org/10.1136/jnnp.35.4.477

CALIANDRO, P., et al. Focal muscle vibration in the treatment of upper limb spasticity: a pilot randomized controlled trial in patients with chronic stroke. Archives of physical medicine and rehabilitation. 2012, 93(9), 1656-1661. https://doi.org/10.1016/j.apmr.2012.04.002

CAMEROTA, F., et al. Focal muscle vibration, an effective rehabilitative approach in severe gait impairment due to multiple sclerosis. Journal of the neurological sciences. 2017, 372, 33-39. https://doi.org/10.1016/j.jns.2016.11.025

COHEN, J. Statistical power analysis for the behavioral sciences. Abingdon: Routledge. 1988, pp. 567.

COHEN, J. Statistical power analysis for the behavioral sciences. Academic press Routledge: Nova York. Revised Edition. 2013.

CONRAD, M.O., SCHEIDT, R.A. and SCHMIT, B.D. Effects of wrist tendon vibration on arm tracking in people poststroke. Journal of neurophysiology. 2011, 106(3), 1480-1488. https://doi.org/10.1152/jn.00404.2010

DE MORAES SILVA, J., LIMA, M.O. and DE PAULA JÚNIOR, A.R. Efeito agudo da estimulação vibratória em hemiparéticos espásticos pós-acidente vascular encefálico. Research on Biomedical Engineering. 2011, 27(4), 224-230. http://dx.doi.org/10.4322/rbeb.2011.018

DIAS, C.P., et al. Paralisia cerebral em Pediatria. Pediatria moderna. 2015. 51(6), 224-229.

ELIASSON, A.C., et al. The Manual Ability Classification System (MACS) for children with cerebral palsy: scale development and evidence of validity and reliability. Developmental medicine & child neurology. 2006, 48(7), 549-554. https://doi.org/10.1017/S0012162206001162

FAHEY, M.C., et al. The genetic basis of cerebral palsy. Developmental Medicine & Child Neurology. 2017, 59(5), 462-469. https://doi.org/10.1111/dmcn.13363

FALLON, J.B. and MACEFIELD, V.G. Vibration sensitivity of human muscle spindles and Golgi tendon organs. Muscle & nerve. 2007, 36(1), 21-29. https://doi.org/10.1002/mus.20796

GILLIES, J., LANCE, J., NEILSON, P. and TASSINARI, C. Presynaptic inhibition of the monosynaptic reflex by vibration. The Journal of physiology. 1969, 205(2), 329-339. https://doi.org/10.1113/jphysiol.1969.sp008968

HAGBARTH, K.-E. and EKLUND, G. The effects of muscle vibration in spasticity, rigidity, and cerebellar disorders. Journal of neurology, neurosurgery, and psychiatry. 1968, 31(3), 207. http://dx.doi.org/10.1136/jnnp.31.3.207

HAGBARTH, K. and EKLUND, G. Tonic vibration reflexes (TVR) in spasticity. Brain research. 1966, 2(2), 201. https://doi.org/10.1016/0014-4886(66)90088-4

KATUSIC, A., ALIMOVIC, S. and MEJASKI-BOSNJAK, V. The effect of vibration therapy on spasticity and motor function in children with cerebral palsy: a randomized controlled trial. NeuroRehabilitation. 2013, 32(1), 1-8. https://doi.org/10.3233/NRE-130817

KRUEGER-BECK, E., NOGUEIRA-NETO, G.N. and NOHAMA, P. Estímulo vibracional na espasticidade–uma perspectiva de tratamento. Revista Neurociências. 2010, 18(4), 523–530. https://doi.org/10.4181/RNC.2010.ip02.7p

LI, W., LI, C., XU, Q. and JI, L. Effects of Focal Vibration over Upper Limb Muscles on the Activation of Sensorimotor Cortex Network: An EEG Study. Journal of Healthcare Engineering. 2019, 2019, 2040-2295. https://doi.org/10.1155/2019/9167028

MACLENNAN, A.H., THOMPSON, S.C. and GECZ, J. Cerebral palsy: causes, pathways, and the role of genetic variants. American Journal of Obstetrics & Gynecology. 2015, 213(6), 779-788. https://doi.org/10.1016/j.ajog.2015.05.034

NOMA, T., et al. Anti-spastic effects of the direct application of vibratory stimuli to the spastic muscles of hemiplegic limbs in post-stroke patients: a proof-of-principle study. Journal of rehabilitation medicine. 2012, 44(4), 325-330. https://doi.org/10.2340/16501977-0946

O’SHEA, T.M. Diagnosis, treatment, and prevention of cerebral palsy in near-term/term infants. Clinical obstetrics and gynecology. 2008, 51(4), 816. https://doi.org/10.1097/GRF.0b013e3181870ba7

ORTOLAN, R.L., et al. Tratamento de terapia vibratória em pacientes com espasticidade. Fisioterapia em Movimento. 2017, 18(1), 67-74.

PALISANO, R., et al. GMFCS - E&R: Gross Motor Function Classification System - Expanded & Revised. 2007. Available from: https://canchild.ca/en/resources/42-gross-motor-function-classification-system-expanded-revised-gmfcs-e-r

REDDIHOUGH, D.S. and COLLINS, K.J. The epidemiology and causes of cerebral palsy. Australian Journal of physiotherapy. 2003, 49(1), 7-12. https://doi.org/10.1016/S0004-9514(14)60183-5

ROSENBAUM, P., et al. A report: the definition and classification of cerebral palsy. Developmental medicine and child neurology. Supplement. 2007, 109(109), 8-14.

SANTOS, E.d.L.d. Correlação entre o sinal mecanomiográfico e a escala modificada de Ashworth durante avaliação clínica da espasticidade. Universidade Tecnológica Federal do Paraná: Curitiba, 2016.

YUN, S., et al. Effect of segmental muscle vibration on spasticity in children with cerebral palsy: a randomized cross-over experiment. Physiotherapy. 2015, 101(1), 700-701. https://doi.org/10.1016/j.physio.2015.03.3550

ZANINI, G., CEMIN, N.F. and PERALLES, S.N. Cerebral palsy: causes and prevalences. Fisioterapia em Movimento. 2009, 22(3), 375-381.




How to Cite

POL, S. de ., NEVES, E.B., LAZZARETTI, A.E.., SMAILI, S.M.. and KRUEGER, E.., 2021. Punctual mechanical oscillation in modulation of muscular tonus in children with spasticity. Bioscience Journal [online], vol. 37, pp. e37069. [Accessed14 April 2024]. DOI 10.14393/BJ-v37n0a2021-53574. Available from: https://seer.ufu.br/index.php/biosciencejournal/article/view/53574.



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