Journal of NeuroEngineering and Rehabilitation · Published 2026-07-30 · DOI 10.1186/s12984-026-02066-8
Moeez Ashfaque, Kiran Khushnood, Ganesh R. Naik, Imran K. Niazi, Imran Amjad, Amit N. Pujari
Abstract Background Muscle spasticity, impaired coordination and fatigue are common in cerebral palsy (CP) children. This study investigated frequency-specific effects of focal muscle vibration (FMV) on neuromuscular activation, fatigue, and agonist–antagonist coordination. We hypothesized that 8 weeks of FMV would improve lower limb muscle activation, reduce fatigue, and optimize co-contraction compared to control, with differential effects between 80 and 100 Hz stimulation. Methods In a double-blind randomized controlled trial, 65 spastic diplegic CP children (GMFCS II–IV) were allocated to Control, 80 Hz, or 100 Hz FMV groups. Primary outcomes were EMG-derived muscle activation (RMS) and fatigue (median frequency; and fatigue index). Secondary outcomes included co-contraction index (CCI) between tibialis anterior (TA) and soleus (Sol). Assessments were conducted at baseline, 4, 8, and 12 weeks. Linear mixed-effects models evaluated Group, Time, and Group × Time effects, with Bonferroni-corrected post-hoc comparisons. Results Significant group differences were observed primarily in the TA. In non-dominant leg, the 100 Hz group showed higher RMS compared to Control at 4 weeks (p = 0.027) and 8 weeks (p = 0.027) and compared to 80 Hz at 4 weeks (p = 0.045) and 8 weeks (p = 0.008). In dominant leg, 100 Hz also demonstrated higher RMS than Control at 8 weeks (p = 0.003). Fatigue analysis revealed significant time effects in soleus muscle (p ≤ 0.009), with 100 Hz group demonstrating more sustained MDF values in the dominant limb, suggesting improved fatigue resistance, whereas 80 Hz group showed greater fatigue-related declines. FI analysis further revealed significant Group × Time interactions in non-dominant Sol (p = 0.008), with 80 Hz differing from Control (p = 0.019) and 100 Hz (p = 0.008) at 8 weeks. For co-contraction, a significant group effect was observed in the non-dominant limb (p = 0.034), indicating differences between intervention and control groups, although post-hoc comparisons were not significant. Conclusion FMV induces frequency-specific neuromuscular adaptations in CP children. 100 Hz stimulation appears more effective for enhancing short-term muscle activation and fatigue resistance, while 80 Hz may promote longer-term coordination changes. Trial registration Trial prospectively registered with United States clinical trial registry (clinicaltrials.gov), trial ID: NCT05751135.
Abstract from DOAJ. Public domain (CC0 1.0).
Read the article at the publisher →
Ashfaque, M., Khushnood, K., Naik, G., et al. (2026). Eight weeks of focal muscle vibration shows improvements in muscle co-ordination and co-contraction in cerebral palsy children: a randomized control trial. Journal of NeuroEngineering and Rehabilitation. https://doi.org/10.1186/s12984-026-02066-8