Alternate rhythmic vibratory stimulation of trunk muscles affects walking cadence and velocity in Parkinson's disease.
OBJECTIVE
During the administration of timed bilateral alternate vibration to homonymous leg or trunk muscles during quiet upright stance, Parkinsonian (PD) patients undergo cyclic antero-posterior and medio-lateral transfers of the centre of foot pressure. This event might be potentially exploited for improving gait in these patients. Here, we tested this hypothesis by applying alternate muscle vibration during walking in PD.


METHODS
Fifteen patients and 15 healthy subjects walked on an instrumented walkway under four conditions: no vibration (no-Vib), and vibration of tibialis anterior (TA-Vib), soleus (Sol-Vib) and erector spinae (ES-Vib) muscles of both sides. Trains of vibration (internal frequency 100 Hz) were delivered to right and left side at alternating frequency of 10% above preferred step cadence.


RESULTS
During vibration, stride length, cadence and velocity increased in both patients and healthy subjects, significantly so for ES-Vib. Stance and swing time tended to decrease. Width of support base increased with Sol-Vib or TA-Vib, but was unaffected by ES-Vib.


CONCLUSIONS
Alternate ES vibration enhances gait velocity in PD. The stronger effect of ES over leg muscle vibration might depend on the relevance of the proprioceptive inflow from the trunk muscles and on the absence of adverse effects on the support base width.


CONCLUSIONS
Trunk control is defective in PD. The effect of timed vibratory stimulation on gait suggests the potential use of trunk proprioceptive stimulation for tuning the central pattern generators for locomotion in PD.
De Nunzio
Alessandro M
AM
Department of Experimental Medicine, Centro Studi Attività Motorie, Fondazione Salvatore Maugeri (IRCCS), Istituto Scientifico di Pavia, University of Pavia, Italy.
Grasso
Margherita
M
Nardone
Antonio
A
Godi
Marco
M
Schieppati
Marco
M
D000368:Aged; D005260:Female; D005684:Gait / Q000502:physiology; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D010300:Parkinson Disease / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010507:Periodicity; D026741:Physical Therapy Modalities; D011187:Posture / Q000502:physiology; D011434:Proprioception / Q000502:physiology; D013997:Time Factors; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*