The Effect of Whole Body Vibration (WBV) on Spasticity in Poststroke Hemiplegia
The Effect of Whole Body Vibration (WBV) on Spasticity in Poststroke Hemiplegia
The primary purpose of this study is to show whether WBV application has antispastic effect.
 The secondary aim is to demonstrate whether WBV has neuromodulatory activity on increased
 stretch reflex and motor neuron activity, which is the basis of the pathophysiology of
 spasticity.Hypotheses of this study:Whole body vibration in poststroke hemiplegia reduces
 ankle plantar flexion spasticity.

 1. WBV ; reduces plantar flexor spasticity after stroke

 2. WBV decreases poststroke spasticity, by decreasing increased stretch reflex and motor
 neuron activity.
Patients with a stroke of at least 1 month before and with a history of ankle plantar flexion
 spasticity will be included in the study. Conventional rehabilitation program will be applied
 to all patients (n=48).The intervention group (n=24) will be applied for 4 weeks, 2 days a
 week, a total of 8 sessions with the WBV powerplate pro5 device.(Vibration frequency: 30
 Hertz(Hz), amplitude: 2.2 mm and duration 1x10 seconds (starting period) + 3x30 seconds).The
 Sham control group (n=24) will have 8 sessions WBV in total, the same time,.with the same
 frequency but 99.5% weakened amplitude.The surface Electromyography (EMG) and degree of
 spasticity of soleus muscle will be evaluated at the beginning and end of the all sessions.
 Soleus T-reflex and soleus H-reflex will be recorded with surface EMG.To obtain the H-reflex
 response, the posterior tibial nerve in the popliteal region will be stimulated by using a
 stimulator (FE155 Stimulator HC ADInstrument, Oxford UK) with 1 ms-pulse current. The records
 will be taken with the Ag / AgCl electrodes (Kendall ®Coviden, self-adhesive electrodes)
 placed on skin according to the SENIAM protocol. To obtain T reflex response, an electronic
 reflex hammer (Elcon 100-150 Germany) will be used.The degree of spasticity will be measured
 as a soleus muscle tone torque on a fixed angular velocity moving platform.The data will be
 recorded with the PowerLab data acquisition device
Inclusion Criteria:

 1. Ischemic / hemorrhagic poststroke hemiplegia

 2. Stroke time ≥1 months,

 3. Ankle plantar flexor spasticity MAS ≥1,

 4. Brunnstrom stage ≥3 for lower extremity,

 5. Patients who were standing for more than one minute and had a static balance

 Exclusion Criteria:

 1. Cardiac disorder (rhythm / conduction disorder, cardiac pacemaker, ischemic heart
 disease)

 2. The presence of lower extremity fracture,

 3. Findings or suspicion of active deep vein thrombosis,

 4. A history of deep vein thrombosis and pulmonary embolism,

 5. Orthostatic hypotension

 6. Resistant hypertension,

 7. Peripheral nerve lesions such as polyneuropathy, radiculopathy

 8. Active inflammatory, rheumatologic or infectious disease,

 9. Having joint contracture,

 10. Having a history of panic attacks,

 11. Patients with dizziness and balance problems,

 12. Patients with not intact skin surface to connect electrodes

 13. Patients with communication problems: aphasia, major depression

 14. Epilepsy

 15. Patients who received botulinum A toxin in the last 6 months