Tibialis anterior focal vibration therapy: a pilot randomized trial during the subacute phase poststroke

BACKGROUND: Proprioceptive Vibratory Stimulation (PVS) provides targeted proprioceptive input that may enhance sensorimotor control and reduce spasticity in individuals with stroke. However, few studies have investigated lower limb PVS and its potential clinical effects during the subacute phase. METHODS: We conducted a pilot randomized controlled trial (NCT04737018) comparing tibialis anterior PVS (100-Hz, 1 mm, 20 sessions) with sham stimulation in subacute individuals with hemiplegia. The Fugl-Meyer Assessment for the lower extremity (FMA-LE), Medical Research Council (MRC) muscle strength testing, the modified Modified Ashworth Scale (mMAS), and the Postural Assessment Scale for Stroke (PASS) were assessed at baseline (day 0), during the intervention (day 15, day 30), and after the intervention (day 60). RESULTS: Sixteen subacute individuals with hemiplegia were recruited. PVS resulted in a significant increase in tibialis anterior MRC score (p= 0.027), which was maintained at follow-up (p= 0.026). In addition, soleus and gastrocnemius spasticity mMAS scores in the PVS group did not worsen at the end of the intervention. No significant between-group differences were observed for FMA-LE or PASS scores. CONCLUSIONS: A selective improvement in strength of the targeted muscle, together with a concurrent antispastic effect in antagonist muscles, suggests that tibialis anterior PVS may represent a promising rehabilitation approach warranting further investigation in post-stroke populations.