Whole Body Vibration Improves Brain and Musculoskeletal Health by Modulating the Expression of Tissue-Specific Markers: FNDC5 as a Key Regulator of Vibration Adaptations.

Whole body vibration (WBV) is well known to exert beneficial effects on multiple tissues, improving synaptic transmission, muscle mass, bone quality, and reducing anxiety and depressive behavior. However, the underlying molecular mechanisms are not yet fully understood, and organs and tissues may respond differently to the vibratory stimulus depending on multiple factors. Therefore, we investigated the WBV effects on the brain and musculoskeletal tissue of 4-month-old young mice, evaluating synaptic plasticity by electrophysiological recordings and tissue organization by histology and histomorphometric analysis. Specifically, WBV protocols were characterized by the same vibration frequency (45 Hz), but different in vibration exposure time (five series of 3 min for the B protocol and three series of 2 min and 30 s for the C protocol) and recovery time between two vibration sessions (1 min for the B protocol and 2 min and 30 s for the C protocol). In addition, immunohistochemistry was conducted to evaluate the expression of fibronectin type III domain-containing protein 5 (FNDC5), as well as that of tissue-specific markers, such as brain-derived neurotrophic factor (BDNF) in brain, myostatin in muscle and collagen I (COL-1) in bone. Our results suggest that the WBV effects depend closely on the type of protocol used and support the hypothesis that different organs or tissues have different susceptibility to vibration. Further studies will be needed to deepen our knowledge of physiological adaptations to vibration and develop customized WBV protocols to improve and preserve cognitive and motor functions.

A Pilot Study on the e-Kayak System: A Wireless DAQ Suited for Performance Analysis in Flatwater Sprint Kayaks.

Nowadays, in modern elite sport, the identification of the best training strategies which are useful in obtaining improvements during competitions requires an accurate measure of the physiologic and biomechanical parameters that affect performance. The goal of this pilot study was to investigate the capabilities of the e-Kayak system, a multichannel digital acquisition system specifically tailored for flatwater sprint kayaking application. e-Kayak allows the synchronous measure of all the parameters involved in kayak propulsion, both dynamic (including forces acting on the paddle and footrest) and kinematic (including stroke frequency, displacement, velocity, acceleration, roll, yaw, and pitch of the boat). After a detailed description of the system, we investigate its capability in supporting coaches to evaluate the performance of elite athletes' trough-specific measurements. This approach allows for a better understanding of the paddler's motion and the relevant effects on kayak behavior. The system allows the coach to carry out a wide study of kayak propulsion highlighting, and, at the same time, the occurrences of specific technical flaws in the paddling technique. In order to evaluate the correctness of the measurement results acquired in this pilot study, these results were compared with others which are available in the literature and which were obtained from subjects with similar characteristics.

Effectiveness of Warm-Up Routine on the Ankle Injuries Prevention in Young Female Basketball Players: A Randomized Controlled Trial.

Background and Objectives: Ankle joint is the most common site of injury for basketball athletes. An effective warm-up (WU) is a period of preparatory exercise to improve training performance and reduce sports injuries. Continuous examination of effective WU routines in basketball players is a necessity. The aim of this study was to investigate the effects of general and combined warm up on ankle injury range of motion (ROM) and balance in young female basketball players. Materials and Methods: A sample of 28 young female basketball players were randomly allocated to either global warm up control group (GWU) (n = 11) or combined warm up experimental group (CWU) (n = 17). All participants performed 7-min of run. The CWU group performed a single leg stance barefoot with eyes closed, plank forearm position and triceps sural stretching. Participants in GWU performed walking ball handling and core stability using a Swiss ball. Both WU routines were conducted 3 times per week for 10 weeks. Outcome measurements were the Stabilometric platform and dorsiflexion lunge test. Results: Twenty-eight young female basketball players completed the study. Participants in the experimental group improved significantly in the range of motion (ROM) in right and left ankle and the center of pressure displacement (CoP). The control group did not show any changes in ankle dorsiflexion and a significant reduction in all body balance parameters. Conclusions: An 8-min combined warm-up routine for 10 weeks improves the ankle dorsiflexion ROM and CoP displacement that plays a key role in ankle injuries prevention in basketball players. Further studies are strongly needed to verify our findings.

Hyperbaric oxygen therapy for cognitive impairments in patients with traumatic brain injury: A systematic review.

Cognitive deficits are the most common impairments after traumatic brain injury (TBI). It can be linked with poor physical function. Hyperbaric oxygen therapy (HBOT) increases blood flow and oxygen supply to the brain. This review aimed to summarize and evaluate the available literature on the influences of HBOT on cognitive deficits in patients with TBI. PubMed, SCOPUS, PEDro, REHABDATA, MIDLINE, CHINAL, EMBASE, and Web of Science were searched from inception until June 2021. The methodological quality was measured using the physiotherapy evidence database (PEDro) scale. Ten studies met the eligibility criteria. Six studies were randomized controlled trials, and four were pilot studies. The scores on the PEDro scale ranged from two to nine, with a median score of seven. The included studies showed heterogeneity results for the beneficial effects of HBOT on improving cognitive functions in patients with TBI. The evidence for the beneficial effects of HBOT on cognitive functions post-TBI was limited. Further randomized controlled trials with large sample sizes are strongly needed to understand the effects of HBOT on cognitive functions in patients with TBI.

Transcutaneous spinal cord stimulation effects on spasticity in patients with spinal cord injury: A systematic review.

CONTEXT: Spasticity is one of the most prevalent impairments following spinal cord injury (SCI). It can lead to a decrease in the patient's functional level. Transcutaneous spinal cord stimulation (tSCS) has demonstrated motor function improvements following SCI. No systematic reviews were published examining the influences of tSCS on spasticity post-SCI. OBJECTIVES: This review aimed to investigate the effects of tSCS on spasticity in patients with SCI. METHODS: PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched until June 2021. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. RESULTS: Six studies met the inclusion criteria. Five studies were pilot studies, and one was a case series. The scores on the PEDro scale ranged from two to four, with a median score of four. The results showed heterogenous evidence for the effects of tSCS on spasticity reduction post-SCI. CONCLUSIONS: TSCS appears safe and well-tolerated intervention in patients with SCI. The evidence for the effectiveness of tSCS on spasticity in chronic SCI patients is limited. Further randomized controlled studies are strongly needed to study the effects of tSCS on patients with SCI.

Proprioceptive Focal Stimulation (Equistasi®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review.

Gait and postural deficits are the most common impairments in patients with Parkinson's Disease (PD). These impairments often reduce patients' quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.

Prevention of Secondary Injury after Anterior Cruciate Ligament Reconstruction: Relationship between Pelvic-Drop and Dynamic Knee Valgus.

(1) Background: Optimal neuromuscular, Lumbo-Pelvic-Hip Complex, and lower extremity control are associated with decreased risk factors for secondary anterior cruciate ligament (ACL) injury. This study aimed to analyze any asymmetries and malalignments in the Lumbo-Pelvic-Hip Complex and the lower limbs at 6 months after ACL reconstruction (ACLR). (2) Methods: We conducted an exploratory retrospective observational single-center study in patients during the outpatient postoperative rehabilitation program at ICOT (Latina, Italy). From January 2014 to June 2020, 181 patients were recruited, but only 100 patients (86 male 28 ± 0.6 years, 178 ± 0.5 height; 14 female 24 ± 2.0 years, 178 ± 3.0 height) were eligible for the inclusion criteria and studied 6 months after ACL reconstruction surgery. (3) Statistical analysis: Student's t-tests and Pearson's product-moment correlation coefficient were used to determine significant differences between affected and non-affected limbs and variables' association. (4) Results: The study shows a decrease in neuromuscular control of the Lumbo-Pelvic-Hip Complex and dynamic adaptive valgus of the knee at 6 months after ACLR (mean difference between pathological and healthy limb of dynamic adaptive valgus was -10.11 ± 8.19° 95% CI -14.84 to -9.34; mean value was 16.3 ± 6.8° 95% CI 14.04 to 18.55 for healthy limb and 4.2 ± 3.1° 95% CI 3.15 to 5.21 for pathological limb, p < 0.0001). The results also showed a relationship between dynamic adaptive valgus and contralateral pelvic drop (r = 0.78, 95% CI 0.62 to 0.88, magnitude of correlation very large). (5) Conclusions: The analysis showed an associative correlation between decreased postural control of the pelvic girdle and dynamic adaptive valgus of the knee in 38% of patients; this study highlights the usefulness of the Single-Leg Squat Test (SLST) as a clinical/functional assessment to evaluate the rehabilitation process and as a preventive tool to reduce the risk of second ACL injuries during the return to sport.

Golden ratio and self-similarity in swimming: breast-stroke and the back-stroke.

Introduction: Dynamics-on-graph concepts and generalized finite-length Fibonacci sequences have been used to characterize, from a temporal point of view, both human walking & running at a comfortable speed and front-crawl & butterfly swimming strokes at a middle/long distance pace. Such sequences, in which the golden ratio plays a crucial role to describe self-similar patterns, have been found to be subtly experimentally exhibited by healthy (but not pathological) walking subjects and elite swimmers, in terms of durations of gait/stroke-subphases with a clear physical meaning. Corresponding quantitative indices have been able to unveil the resulting hidden time-harmonic and self-similar structures. Results: In this study, we meaningfully extend such latest findings to the remaining two swimming strokes, namely, the breast-stroke and the back-stroke: breast-stroke, just like butterfly swimming, is highly technical and involves the complex coordination of the arm and leg actions, while back-stroke is definitely similar to front-crawl swimming. An experimental validation with reference to international-level swimmers is included.

Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review.

BACKGROUND: Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders. OBJECTIVES: This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders. METHODS: PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders. CONCLUSIONS: The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.

Analgesic Effect of Extracorporeal Shock-Wave Therapy in Individuals with Lateral Epicondylitis: A Randomized Controlled Trial.

This study was conducted to investigate the effect of extracorporeal shock-wave therapy (ESWT) on pain, grip strength, and upper-extremity function in lateral epicondylitis. A sample of 40 patients with LE (21 males) was randomly allocated to either the ESWT experimental (n = 20) or the conventional-physiotherapy control group (n = 20). All patients received five sessions during the treatment program. The outcome measures used were the Visual Analog Scale (VAS), the Taiwan version of the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and a dynamometer (maximal grip strength). Forty participants completed the study. Participants in both groups improved significantly after treatment in terms of VAS (pain reduced), maximal grip strength, and DASH scores. However, the pain was reduced and upper-extremity function and maximal grip strength were more significantly improved after ESWT in the experimental group. ESWT has a superior effect in reducing pain and improving upper-extremity function and grip strength in people with lateral epicondylitis. It seems that five sessions of ESWT are optimal to produce a significant difference. Further studies are strongly needed to verify our findings.

Paddle propulsive force and power balance: a new approach to performance assessment in flatwater kayaking.

This study aims to determine the propulsive force (Fp) and its timing of application during the paddle stroke confirming the dynamic balance between propulsive and drag powers (Pp = Pd) in kayaking performance. Ten male sub-elite paddlers participated in the study. The athletes carried out three trials of 50 m at three different velocity ranges: 2.70 - 3.00 m/ s; 3.01 - 3.50 m/s and 3.51 - 4.00 m/ s. A constant velocity during each trial was maintained and the section between 15 and 40 m of the total pool length was considered for further analysis. Data were collected using the E-kayak system provided of an instrumented paddle and 2D video analysis. It was observed that the propulsive force increases in intensity (up to 90% of the peak force) as the velocity increases. The dynamic balance between Pd and Pp was confirmed with a Bland and Altman plot (estimated bias: 0.2; LoA: 12.8 and 13.3 W). The related comparisons between the power parameters showed no significant difference (p > 0.050) in each of the considered velocity. By applying the dynamic balance theory between Pp = Pd on the data obtained from the interaction among GPS, force on the paddle and 2D video analysis, it is possible to acquire essential information (Fp, Pp) to monitor the flatwater kayaking performance.

Whole Body Vibration: A Valid Alternative Strategy to Exercise?

Several studies agree that mechanical vibration can induce physiological changes at different levels, improving neuromuscular function through postural control strategies, muscle tuning mechanisms and tonic vibration reflexes. Whole-body vibration has also been reported to increase bone mineral density and muscle mass and strength, as well as to relieve pain and modulate proprioceptive function in patients with osteoarthritis or lower back pain. Furthermore, vibratory training was found to be an effective strategy for improving the physical performance of healthy athletes in terms of muscle strength, agility, flexibility, and vertical jump height. Notably, several benefits have also been observed at the brain level, proving to be an important factor in protecting and/or preventing the development of age-related cognitive disorders. Although research in this field is still debated, certain molecular mechanisms responsible for the response to whole-body vibration also appear to be involved in physiological adaptations to exercise, suggesting the possibility of using it as an alternative or reinforcing strategy to canonical training. Understanding these mechanisms is crucial for the development of whole body vibration protocols appropriately designed based on individual needs to optimize these effects. Therefore, we performed a narrative review of the literature, consulting the bibliographic databases MEDLINE and Google Scholar, to i) summarize the most recent scientific evidence on the effects of whole-body vibration and the molecular mechanisms proposed so far to provide a useful state of the art and ii) assess the potential of whole-body vibration as a form of passive training in place of or in association with exercise.

Acute Effects of Kinesio Taping on Functional Performance in Healthy Soccer Players: A Randomized, Controlled Crossover Trial.

This study aimed to investigate the acute effects of the Kinesio tape (KT) application on functional performance in healthy athletes. In this randomized, controlled crossover trial, a total of sixteen healthy soccer players (male = 14; age = 23.28 ± 3.13 years old) were assigned randomly into either KT over quadriceps, KT over hamstring, KT over quadriceps plus hamstring, or no intervention control condition. Four conditions were applied in a crossover design through three consecutive test sessions for each condition with a washout period of 2 days between the trials. Afterwards, all participants performed a 5-min warm-up routine and four sets of 30-s static stretching exercises for the hamstring and gluteal muscles for three consecutive treatment sessions. The running, jump, and flexibility tests were used to assess the functional performance of healthy athletes. A total of sixteen participants completed the study. No significant differences in the jump, flexibility, and running tests among the conditions were reported (p > 0.05). These findings suggest that KT application has no acute effects in improving functional performance in healthy athletes. However, further studies with larger sample sizes are needed to verify our results.

Acute effects of whole-body vibrations on the fatigue induced by multiple repeated sprint ability test in soccer players.

BACKGROUND: We tested the hypothesis that whole-body vibration (WBV) positively affects the fatigue process ensuing from repeated bouts of maximal efforts, as induced by repeated sprints' ability (RSA). Eleven male soccer players performed three sets of six repeated shuttle sprints (40 meters). METHODS: Eleven male soccer players (age 23.6±4.5 years) were cross-randomized to perform WBW before RSA and during the recovery between sets (WBV-with) or to warm-up and passive recovery between sets (WBV-without). The effects of WBV were quantified by sprint time (ST) and blood lactate concentration (LA), collected up to 15 min after completion of tests. RESULTS: ST during RSA showed a better maintenance of performance in the WBV-with compared to WBV-without condition in all three sets, reaching a statistical significance between-groups during the 2nd and 3rd set (P<0.05). No significant differences in ST over the sets were detected in WBV-with, whereas a significant decrease was observed in the WBV-without condition (P<0.001). LA recovered significantly faster from the 9th to 15th minute of recovery in WBV-with as compared to WBV-without (P<0.05). CONCLUSIONS: These findings would indicate that WBV performed during recovery between RSA sets can delay the onset of muscle fatigue resulting in a better maintenance of sprint performance.

Specificity of weightlifting bench exercises in kayaking sprint performance: A perspective for neuromuscular training.

Several studies showed significant differences between bench lift exercises without investigating which is more related, in biomechanical and neuromuscular terms, to improve the sprint flatwater kayak performance. This study aims to compare the power-load and velocity-load neuromuscular parameters performed in prone bench pull (PBP), and bench press (BP) exercises to identify which of them meet the gesture specificity in sprint flatwater kayak performance. Ten elite kayakers participated in this study. Power-load, velocity-load relationships, the maximum dynamic strength, and the kayak sprint performance test were assessed. The power-load and velocity-load relationships showed significant differences between the PBP and BP for each considered load. The kayakers showed a significant correlation between maximum power performed on the PBP and the maximum velocity reached in the kayak sprint (r = 0.80, p < 0.01) and the stroke frequency (r = 0.61, p < 0.05). Conversely, the maximum power performed on the BP did not correlate with the kinematic parameters analyzed. In addition, the maximum dynamic strength in the PBP and BP did not correlate with the maximum velocity and stroke frequency. Furthermore, no significant difference was observed in both the bench exercises for the maximum dynamic strength (p > 0.05). The results of this study suggest that the maximal muscular power expressed in PBP exercise only seems to be more specific in kayak velocity performance compared with maximal dynamic strength and with all dynamic parameters recorded in the BP. This will allow coaches and trainers to use specific bench exercises for specific neuromuscular kayakers' adaptations during the whole competitive season.

COVID-19 as a Potential Cause of Muscle Injuries in Professional Italian Serie A Soccer Players: A Retrospective Observational Study.

The COVID-19 pandemic has shocked the entire planet. The soccer world has also suffered major upheavals, and many professional soccer players have been infected with the virus. The aim of this study was to evaluate the incidence of injuries in Italian Serie A professional soccer players before and during the COVID-19 pandemic. Methods: We evaluated the incidence of muscle injuries between four competitive seasons of the Italian Serie A (2016-2017, 2017-2018, and 2018-2019 pre-COVID-19 vs. 2020/2021 post-COVID-19) in professional soccer players. Results: Significant differences were found in muscular injuries between the post-COVID-19 season and the previous seasons (p < 0.001). The median split of the players' positivity duration was of 15 days. The players' long positivity (PLP) group showed a significant number of muscular injuries compared to the players' short positivity (PSP) group (p < 0.0014, ES = 0.81, Large). The total teams' days of positivity were significantly related to the total team number of muscular injuries (r = 0.86; CI 95% 0.66 to 0.94; p < 0.0001). In conclusion, this data showed that the competitive season post-COVID-19 lockdown has a higher incidence of muscle injuries in Italian Serie A soccer players compared to the pre-pandemic competitive season.

Kinematic Analysis of Water Polo Player in the Vertical Thrust Performance to Determine the Force-Velocity and Power-Velocity Relationships in Water: A Preliminary Study.

BACKGROUND: To date, studies on muscle force and power-velocity (F-v and P-v) relationships performed in water are absent. AIM: The goal of this study is to derive the F-v and P-v regression models of water polo players in water vertical thrust performance at increasing load. METHODS: After use of a control object for direct linear transformation, displacement over the water and elapsed time was measured, by using a high-speed 2D-videoanalysis system, on 14 players involved in the study. RESULTS: Intra-operator and player's performance interclass correlation coefficient (ICC) reliability showed an excellent level of reproducibility for all kinematic and dynamic measurements considered in this study with a coefficient of variation (CV) of less than 4.5%. Results of this study have shown that an exponential force-velocity relationship seems to explain better the propulsive force exerted in the water in lifting increasing loads compared to the linear one, while the power and velocity have been shown to follow a second-order polynomial regression model. CONCLUSION: Given the accuracy of the video analysis, the high reliability and the specificity of the results, it is pointed out that video analysis can be a valid method to determine force-velocity and power-velocity curves in a specific environment to evaluate the neuromuscular profile of each water polo player.

Effectiveness of focal muscle vibration on hemiplegic upper extremity spasticity in individuals with stroke: A systematic review.

BACKGROUND: The upper extremity spasticity following stroke limits individuals' activities of daily living. Focal muscle vibration (FMV) is a device producing vibration signals affecting the central nervous system. OBJECTIVE: This systematic review was conducted to investigate the effects of FMV on individuals with stroke, and to identify the effective training protocol in reducing upper extremities spasticity post-stroke. METHODS: We searched in SCOPUS, PEDro, PUBMED, REHABDATA, and Web of Science for randomized clinical trials (RCTs) and pseudo-RCTs published in English. The outcome measure included is the Modified Ashworth Scale (MAS). The methodological quality of the included trials was evaluated using the Cochrane Collaboration's instrument. Effect sizes were calculated. RESULTS: Eight articles published from 2012 to 2019 were included in this systematic review. A total of 268 post-stroke patients, 28.73% of which were females, were included in all studies. The methodological quality for included studies ranged from moderate to high. FMV showed some evidence in reducing hemiplegic upper extremity spasticity in patients with stroke. CONCLUSIONS: The FMV may be an efficient intervention in reducing upper extremity spasticity in the stroke population. The efficient treatment protocol and dosage remain unclear. Additional randomized controlled trials are strongly needed to study the effects of FMV on spasticity in individuals with stroke.

Cognitive rehabilitation post traumatic brain injury: A systematic review for emerging use of virtual reality technology.

BACKGROUND: Traumatic brain injury (TBI) can causes numerous cognitive impairments usually in the aspects of problem-solving, executive function, memory, and attention. Several studies has suggested that rehabilitation treatment interventions can be effective in treating cognitive symptoms of brain injury. Virtual reality (VR) technology potential as a useful tool for the assessment and rehabilitation of cognitive processes. OBJECTIVES: The aims of present systematic review are to examine effects of VR training intervention on cognitive function, and to identify effective VR treatment protocol in patients with TBI. METHODS: PubMed, Scopus, PEDro, REHABDATA, EMBASE, web of science, and MEDLINE were searched for studies investigated effect of VR on cognitive functions post TBI. The methodological quality were evaluated using PEDro scale. The results of selected studies were summarized. RESULTS: Nine studies were included in present study. Four were randomized clinical trials, case studies (n = 3), prospective study (n = 1), and pilot study (n = 1). The scores on the PEDro ranged from 0 to 7 with a mean score of 3. The results showed improvement in various cognitive function aspects such as; memory, executive function, and attention in patients with TBI after VR training. CONCLUSION: Using different VR tools with following treatment protocol; 10-12 sessions, 20-40 min in duration with 2-4 sessions per week may improves cognitive function in patients with TBI. There was weak evidence for effects of VR training on attention post TBI.

Effect of segmental muscle vibration on upper extremity functional ability poststroke: A randomized controlled trial.

BACKGROUND: Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke. METHODS: A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n = 18) or SPT and SMV (SPT-SMV) experimental group (n = 19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment. RESULTS: Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV). CONCLUSION: The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke.