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Optimizing focal vibration therapy for balance and gait: A systematic review.

OBJECTIVE: This systematic review evaluated the efficacy of focal (localized) vibration therapy (FVT) applied to muscles/tendons on balance, gait, and mobility, with a specific focus on defining optimal vibration protocols (frequency, amplitude, dosing) and muscle-targeting strategies to maximize sensorimotor recovery. METHODS: A systematic review was conducted across six databases (CINHAL, Embase, Medline, Web of Science, Scopus, CENTRAL) from January 2000 to May 2025. Studies were included if they involved human participants, applied FVT therapeutically, and reported balance, gait, or mobility outcomes. Data extraction included study characteristics, intervention protocols, and outcomes. Methodological quality was assessed using the PEDro scale. RESULTS: Sixty-two studies (n = 2090 participants) were included. Methodological quality assessment (PEDro scale) indicated 44% of studies met high-quality standards. Biomechanical analysis identified the quadriceps, gastrocnemius/soleus, and plantar muscles as the most effective vibration sites, given their critical roles in gait propulsion and postural stability. The synthesis of protocol data indicated a promising therapeutic window characterized by a vibration frequency of 80-120 Hz (primarily fixed sinusoidal waveforms at a single frequency) and an amplitude of 0.2-0.5 mm (reported only in 12 studies; amplitude was not reported in 23 studies), applied bilaterally for a minimum of 3 sessions per week over 4-12 weeks, which could lead to improved balance and gait performance with benefits sustained for up to 5 months. CONCLUSION: FVT shows potential to improve gait and balance, particularly when targeting lower-extremity muscles with optimized vibration parameters. To advance the field, future research must prioritize the development of standardized protocols and investigate neurophysiological mechanisms to refine FVT as a precision bioengineering solution for mobility deficits.

Humans

Mitochondrial dysfunction in muscle cells induced by snoring vibrations.

Snoring-related vibrations have been proposed as a pathogenic factor contributing to upper airway muscle dysfunction in patients with obstructive sleep apnea (OSA). To investigate whether exposure to snoring vibration is linked to muscle weakness, we used an in vitro vibration model to examine its effects on mitochondrial homeostasis in L6 muscle cells at 8, 12, 24, and 48 h. The findings were then compared with mitochondrial alterations in the upper airway muscles from snorers and patients with OSA. Proteomic analysis of L6 myoblasts revealed extensive remodeling of the mitochondrial proteome at 8 h, affecting pathways involved in oxidative phosphorylation, protein import, ribosome biogenesis, and RNA processing. Respiratory chain remodeling was subunit-specific, with increased abundance of selected components of Complexes I, IV, and V, including NDUFS4, COX5A, and ATP5PD. However, reductions in spliceosome-associated factors, such as SRSF2 and DDX46, along with alterations in mitochondrial ribosomal proteins, indicated impaired RNA processing and protein synthesis. Furthermore, both proteomic and transcriptomic analyses revealed activation of a mechanosensing-mechanotransduction axis, with early upregulation of integrin subunits and mechanosensitive ion channels, followed by transient activation of focal adhesion signaling. Despite transcriptional upregulation of selected Complex IV subunits Cox5a and Cox6a2, this response was accompanied by accumulation of unspliced pre-mRNA, indicating impaired RNA processing efficiency and a decoupling between transcript and protein levels. Real-time Seahorse assay revealed a collapse of mitochondrial respiration and glycolytic reserve at 8 h. Although mitochondrial oxygen consumption recovered after 48 h, the ability to dynamically upregulate glycolysis remained impaired. In patients, muscle capillarization was impaired, COX activity was reduced, and mitochondrial organization was disrupted. Moreover, transcription of Complex IV subunits COX5A and COX6A2 was, as in vibrated L6 cells, upregulated, suggesting a mismatch between transcript levels and protein expression. We conclude that snoring-induced vibrations are an unrecognized stressor that disrupts mitochondrial homeostasis in muscle by impairing RNA processing, protein synthesis, and mechanotransduction-driven mitochondrial remodeling, leading to transcript-protein uncoupling and likely muscle dysfunction.

Humans

[Cortical localizations seen by the dynamic gamma-camera : a new approach in neuropsychology].

We present here the results obtained in the study of normal brain functions, in normal awake man performing normal voluntary tasks, by mean of new approach developed in our laboratory. Its principle lies on the fact that focal changes in cortical blood flow during brain function are due to the coupling between local function aand metabolism, which has been demonstrated in man during hand movement by Olesen (1971) and by Raichle and associates (1976). So far as the changes are focal (uni- or multifocal) they can be assessed by external measurement of focal cerebral blood flow (rCBF) with the 133Xenon clearance technique, provided that the detection apparatus used yields a proper spatial and temporal resolution. A temporal resolution of 45 sec. is made possible by the initial slope calculation of Olesen and coll. (1971), using intracarotid injection of isotope. The spatial resolution has been improved by the design of a special system using 254 scintillation detectors with individual collimation, each 8 mm ø, connected to individual ratemeters (Sveinsdottir et al., 1975). This allows the simultaneous processing of the 254 clearance curves by a small on-line Varian computer. The results are displayed as functional colour pictures of the brain on a T.B. screen, less than 3 min. after isotope injection. The studies have been performed to date in more than 200 patients, usually in connection with carotid angiography. 84 subjects could be classified as "normals+ because of lack of detectable brain lesion and of permanent symptoms, and they constitute the reference material for exploring normal brain functions. In each case one or two "rest" studies have been made for comparison with the test situations. The following observations were made: Resting pattern: with the patients lying in a quiet dark room with minimal sensory input the normal pattern is much the same in both hemispheres and it is characterized by higher flows in the anterior upper parts of the frontal lobes (fig. 1 a). The percent variation in a given area during two different rest studies is about 5 percent (fig. 1 b). Primary sensory inputs. Auditory and visual inputs activate the corresponding parts of temporal and occipital regions (fig. 2 and 3). Simple cutaneous stimulation such as touch or vibrations do not change the rest pattern. Moderate pain gives a global increase of CBF, pre-dominantly in the frontal regions (Ingvar, 1976). Vestibular stimulation with cold or warm water in the ear gives an increase of rCBF in the parietal regions. Simple movements. Movements of mouth, eyes, hand or foot clearly activate the corresponding parts of the central region, with an increase of rCBF up to 50--100% (Sveinsdottir et al., 1975). When the movement is repetitive there is in all cases an additional clearcut increase in the upper premotor region, probably including the supplementary motor area. This last region is activated alone when the subject tries to imagine a movement without actually moving (fig. 5 a, b, c). Sensory discrimination...

Acoustic Stimulation