Vibration stimulation to the lower limbs improves freezing of gait and modifies cortical electrical activities in Parkinson's disease

Muscle vibration, a form of proprioceptive stimulation, is a promising therapeutic method for alleviating freezing of gait in Parkinson's disease. This study aimed to investigate whether vibration stimulation enhances freezing of gait in Parkinson's Disease by modifying sensory-motor integration and cortical excitability. Sixty patients with Parkinson's Disease patients with freezing of gait were enrolled to participate in 10-m Timed Up and Go test with/without lower limbs vibration stimulation during single, cognitive-load, and motor-load task walking. Spatiotemporal gait data were collected from 36 patients during timed up and go tests with unilateral vibration to the less affected or more affected side and bilateral stimulation. Additionally, 22 and 28 patients with and without freezing of gait, respectively, underwent neuroelectrophysiological evaluations with/without vibration stimulation. Spatiotemporal gait and neuroelectrophysiological relative changes in patients with freezing of gait were compared between "ON" and "OFF" vibration. Our results showed both unilateral and bilateral vibration stimulation improved gait and reduced freezing of gait, with more pronounced effects on the less affected side. Patients with freezing of gait revealed decreased latency afferent inhibition and short interval intracortical inhibition in comparison to patients without freezing of gait and healthy controls. Bilateral vibration stimulation improved latency afferent inhibition and short interval intracortical inhibition, which could be attributed to improvements in gait. Overall, our findings suggested that vibration stimulation improved gait and freezing of gait in Parkinson's disease, potentially by enhancing sensory-motor integration and modifying cortical excitability.