La spasticité et la douleur neuropathique sont deux symptômes apparaissant fréquemment après une lésion médullaire. La spasticité est définie comme une augmentation du tonus musculaire qui provoque des contractures, tandis que la douleur neuropathique se caractérise par des sensations douloureuses survenant suite à une lésion du système nerveux.Ces deux symptômes résultent en partie d’une désinhibition des réseaux neuronaux sous-lésionnels lié à une diminution de l’expression du cotransporteur potassium-chlorure type 2 (KCC2). Pour être efficace,l’inhibition nécessite l’action de cette protéine qui extrait les ions chlorure des neurones.L’objectif de la présente thèse est donc d’identifier des médicaments capables d’activer KCC2 afin de restaurer l’inhibition dans le but de traiter la spasticité et la douleur neuropathique.Dans un premier temps, nos résultats ont montré que l’activation de récepteurs sérotoninergiques 5-HT2A avec le TCB-2 rétablit l’expression de KCC2 dans la corne dorsale après une lésion médullaire ou névrectomie. Or le TCB-2 réduit seulement la douleur neuropathique après la lésion spinale.Par la suite, nous avons identifié la prochlorperazine comme une molécule augmentant l’activité de KCC2. Si la prochlorperazine est efficace contre la spasticité, elle a néanmoins un effet plus modeste envers l’allodynie mécanique suite à une lésion médullaire.Enfin, nous avons démontré que la diminution de KCC2,ainsi que l’hyperexcitabilité des motoneurones suite à la lésion, dépendent de l’activation des calpaïnes.Cette thèse valide KCC2 comme une cible thérapeutique dans le traitement de la spasticité et la douleur neuropathique suite à une lésion médullaire. / Spasticity and neuropathic pain are two symptoms that arise frequently after a spinal cord injury. Spasticity is defined as an increase of the muscle tone contributing to cramps, whereas neuropathic pain consists of painful responses caused by a damaged nervous system. Both symptoms arise, in part, due to a loss of inhibition in the sublesional neural networks, linked to a downregulation of the expression of potassium-chloride cotransporter type 2 (KCC2). For inhibition to be efficient, the action of this protein, which extrudes chloride ions from neurons, is needed.The objective of this thesis is, therefore, to identify drugs capable of activating KCC2 to recover inhibition with the objective of treating spasticity and neuropathic pain.First, our results have proven that the activation of serotonin receptors 5-HT2A with TCB-2 restores KCC2 expression in the dorsal horn after a spinal cord or peripheral nerve injury. However, TCB-2 reduces neuropathic pain after a spinal cord injury exclusively.In the next stage of the work, we have identified prochlorperazine as an enhancer of KCC2 activity. Prochlorperazine is efficient against spasticity, although it only showed a modest reduction of mechanical hyperalgesia in animals with a spinal cord injury.Lastly, we have proven that KCC2 downregulation and motoneuron hyperexcitability after a spinal cord injury depend on the overactivation of calpains.This thesis validates KCC2 as a druggable target to treat spasticity and neuropathic pain after spinal cord injury.

Spasticity is highly prevalent in neurological conditions involving upper motor neuron lesions (UMNL). Lower limb spasticity is known to impair gait and limit participation in physical activity. Multimodal interventions including botulinum toxin A, orthoses, and physiotherapy have shown longer lasting improvements compared to unimodal interventions. Studies to date, however, have not examined the long term efficacy of this multimodal intervention nor have they examined the impact across a breadth of domains necessary to comprehensively and fully understand its impact. The aim of this study was to investigate the efficacy of a multimodal intervention to treat lower limb spasticity in adults using a longitudinal mixed-methods approach, including a comprehensive set of outcome measures spanning the domains of the International Classification of Functioning, Disability and Health (ICF) model. Seven-teen participants with chronic UMNL were included in the analysis as per inclusion criteria and showed improvements at 6 and 12 months, compared to baseline, within all domains of the ICF model. / Graduate / 0571 / 0382 / 0384 / jazkim@uvic.ca

Spasticity is highly prevalent in neurological conditions involving upper motor neuron lesions (UMNL). Lower limb spasticity is known to impair gait and limit participation in physical activity. Multimodal interventions including botulinum toxin A, orthoses, and physiotherapy have shown longer lasting improvements compared to unimodal interventions. Studies to date, however, have not examined the long term efficacy of this multimodal intervention nor have they examined the impact across a breadth of domains necessary to comprehensively and fully understand its impact. The aim of this study was to investigate the efficacy of a multimodal intervention to treat lower limb spasticity in adults using a longitudinal mixed-methods approach, including a comprehensive set of outcome measures spanning the domains of the International Classification of Functioning, Disability and Health (ICF) model. Seven-teen participants with chronic UMNL were included in the analysis as per inclusion criteria and showed improvements at 6 and 12 months, compared to baseline, within all domains of the ICF model. / Graduate / 2015-04-24 / 0571 / 0382 / 0384 / jazkim@uvic.ca

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 5 uppsatser.

Made available in DSpace on 2016-12-06T17:07:28Z (GMT). No. of bitstreams: 1 Elaine.pdf: 2067040 bytes, checksum: d5560a36175f4da115aaff3b8b700e40 (MD5) Previous issue date: 2010-03-26 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / The posture and movement disorders typical of spastic cerebral palsy are often associated with several factors related to injury in the central nervous system, including muscle spasticity. The use of botulinum toxin type A in the lower limbs to reduce the muscle tone in children with spastic cerebral palsy, associated with different therapeutic approaches, including physiotherapy, is intended to assist in the normalization of gait through the improvement in proprioception, selective motor control and strength. Few studies discuss the effects of the botulinum toxin in the functional and biomechanical aspects of the gait cycle. This study aimed to investigate the effects of botulinum toxin type A on gait in children with spastic cerebral palsy. Participated 22 subjects with spastic cerebral palsy, divided into experimental group with 10 children (11±2 years) that received botulinum toxin type A in the lower limbs and the control group with 12 children (10±2 years) who have not received the toxin. The variables analyzed were resistance degree to passive movements of lower limbs (Ashworth Spasticity Modified Scale), gross motor function on dimensions D and E (GMFM), functional abilities in self-care, mobility and social function areas (PEDI), coactivation index of the rectus femoris and semitendinosus muscles, angular and spatiotemporal kinematic variables of the hip and knee in the sagittal plane. All procedures for data collection were performed twice in both groups with a range of 30 to 45 days between the 1st and 2nd assessment (for the experimental group before and between 30-45 days after botulinum toxin type A). The Analysis of Variance and the nonparametric Kruskal-Wallis test were used for data analysis and in case of significant effects they were carried out multiple comparisons. The Spearman correlation coefficient was used to examine the relationship between the variables and time of physical therapy during the study period. The level of significance was p<0,05. Regarding the effect of botulinum toxin type A in the variables analyzed, there were not observed statistically significant differences in any of the variables between the 1st and 2nd evaluation. It was found as longer the duration of physical therapy performed by the child, greater the stride length normalized by the height and lower the level of muscle coactivation and the level of gross motor function in the dimensions D and E of the GMFM. It can be concluded that the application of botulinum toxin type A does not show effect on gait in children with spastic cerebral palsy classified in stages I and II of the GMFCS. / As desordens da postura e do movimento características à paralisia cerebral espástica são freqüentemente associadas a diversos fatores ligados à lesão no sistema nervoso central, entre eles a espasticidade muscular. A utilização da toxina botulínica tipo A nos membros inferiores para redução do tônus muscular em crianças com paralisia cerebral espástica, associada a diferentes abordagens terapêuticas, inclusive a fisioterapia, tem a finalidade de auxiliar na regularização da marcha por meio da melhora na propriocepção, controle motor seletivo e a força. Poucos estudos discutem sobre os efeitos da toxina botulínica nos aspectos funcionais e biomecânicos durante o ciclo de marcha. Este estudo objetivou investigar os efeitos da toxina botulínica tipo A na marcha de crianças com paralisia cerebral espástica. Participaram 22 sujeitos de ambos os sexos com paralisia cerebral espástica divididos em grupo experimental com 10 crianças (11±2 anos) que receberam toxina botulínica tipo A nos membros inferiores e grupo controle com 12 crianças (10±2 anos) que não receberam a toxina. As variáveis analisadas foram grau de resistência para movimentos passivos dos membros inferiores (Escala de Espasticidade Ashworth Modificada), função motora ampla nas dimensões D e E (GMFM), habilidades funcionais nas áreas de auto-cuidado, mobilidade e função social (PEDI), índice de coativação dos músculos reto femoral e semitendíneo e variáveis cinemáticas angulares e espaço-temporais do quadril e joelho no plano sagital. Todos os procedimentos de coleta de dados foram realizados duas vezes em ambos os grupos, com intervalo de 30 a 45 dias entre a 1ª e 2ª avaliação (para o grupo experimental, antes e entre 30-45 dias após a aplicação da toxina botulínica tipo A). Os dados foram analisados por meio da Análise de Variância Univariada e o teste não paramétrico de Kruskal-Wallis e em caso de efeitos significativos procederam-se comparações múltiplas. O coeficiente de correlação de Spearmann foi usado para examinar a relação entre as variáveis e o tempo de atendimento fisioterapêutico no período do estudo. O nível de significância foi p<0,05. Com relação ao efeito da toxina botulínica tipo A nas variáveis analisadas, não foram observadas diferenças estatisticamente significativas em nenhuma das variáveis entre a 1ª e a 2ª avaliação. Constatou-se que quanto maior o tempo de atendimento fisioterapêutico realizado pela criança, maior comprimento da passada normalizado pela estatura e menor o índice de coativação muscular e o nível de função motora ampla nas dimensões D e E do GMFM. Pode ser concluído que a aplicação de toxina botulínica tipo A não demonstra efeito na marcha de crianças com paralisia cerebral espástica classificadas nos níveis I e II do GMFCS.

Submitted by Liliane Ferreira (ljuvencia30@gmail.com) on 2018-09-04T13:15:30Z No. of bitstreams: 2 Dissertação - Michelle Jayme Borges - 2018.pdf: 2628386 bytes, checksum: c8c34ff80b97c3389e1af61f6839baff (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-09-05T11:04:12Z (GMT) No. of bitstreams: 2 Dissertação - Michelle Jayme Borges - 2018.pdf: 2628386 bytes, checksum: c8c34ff80b97c3389e1af61f6839baff (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-09-05T11:04:12Z (GMT). No. of bitstreams: 2 Dissertação - Michelle Jayme Borges - 2018.pdf: 2628386 bytes, checksum: c8c34ff80b97c3389e1af61f6839baff (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-08-20 / Stroke continues to be a major concern today. It is a disease closely related to the decline of functional capacity and quality of life, and the clinical picture is varied, presenting as one of the sequelae, hemiparesis or spastic hemiplegia. Botulinum toxin type A acts by blocking neuromuscular transmission via inhibition of acetylcholine release and is a well-established treatment for post-stroke spasticity. In the literature there are no unified results for the use of Botulinum Toxin Type A with formulations such as BOTOX / DYSPORT / XEOMIN, which justifies the gathering of results of studies already produced, with a view to the construction of updated knowledge, due to the heterogeneity of the studies to the applicability of the toxin. Through a systematic review of the literature followed by meta-analysis, we aimed to present evidence from clinical trials on the effects of Botulinum Toxin Type A (BOTOX / DYSPORT / XEOMIN) on upper and lower limb spasticity and its influence on the functionality in patients sequelae of stroke. This is a documentary research, in three stages: titles, abstracts and full text, for which electronic databases were searched in the English, Spanish and Portuguese languages, using the Ashworth Modified Scale and Disability Assessment Scale ( DAS), restricting data from the last 10 years. Eligible articles fulfilled inclusion and exclusion criteria. Thus, 18 studies were included, with a total of 2573 patients (Subjected to toxin: n = 2112; Not submitted to toxin, n = 460). The quality of the studies was assessed using the Newcastle-Ottawa Scale. The existence of publication bias by the funnel plot was analyzed. The data of interest were extracted and directed to a table for the calculation of the frequency ratio and odds ratio of the results. For the execution of the meta-analysis, the software STATA IC / 64 version 16.1 was used. The overall estimate of the frequency of the effect of botulinum toxin type A on spasticity was 93% (95% CI 0.90 to 0.95, p = 0.00) and functionality resulted in 64% (95% CI, : 0.40 to 0.89, p = 0.00) for the dressing domain; with 69% (95% CI: 0.42 to 0.96, p = 0.00) for hygiene; 69% (95% CI 0.46 to 0.92, p = 0.00) for upper limb position and 79% higher (95% CI 0.68 to 0.90, p = 0, The results showed a high heterogenicity between the studies, probable publication bias for the funnel plot (t = 2, 95% CI = 0.4-8, p = 0.05) and the results suggest a positive association between the effect of botulinum toxin type A on spasticity in MMSS and MMII post-stroke, highlighting the Dysport formulation, followed by Botox and finally Xeomin, besides the improvement in functionality with emphasis on the pain domain, after hygiene and positioning of the upper limb. / O Acidente Vascular Cerebral (AVC) continua sendo uma das grandes preocupações da atualidade. É uma doença intimamente relacionada ao declínio da capacidade funcional e qualidade de vida, e o quadro clínico é variado, apresentando como uma das sequelas, hemiparesia ou hemiplegia espástica. A toxina botulínica tipo A, age através do bloqueio da transmissão neuromuscular via inibição da liberação de acetilcolina e é um tratamento bem estabelecido para espasticidade pós-AVC. Na literatura não há resultados unificados, para o uso da Toxina Botulínica Tipo A com formulações, como BOTOX/DYSPORT/XEOMIN, o que justifica a reunião de resultados de estudos já produzidos, com vista à construção de conhecimento atualizado, pela heterogenicidade dos estudos quanto à aplicabilidade da toxina. Através de uma revisão sistemática da literatura seguida de metanálise, objetivou-se apresentar evidências a partir de ensaios clínicos sobre os efeitos da Toxina Botulínica Tipo A (BOTOX/DYSPORT/XEOMIN) na espasticidade de membros superiores e inferiores e sua influência na funcionalidade em pacientes sequelados de AVC. Trata-se de pesquisa documental, em três etapas: títulos, resumos e texto completo, para a qual foi realizada busca em bases de dados eletrônicos, nos idiomas em inglês, espanhol e português, utlizando a Escala Modificada de Ashworth e Disability Assessment Scale (DAS), restringindo dados dos últimos 10 anos. Os artigos elegíveis preeencheram critérios de inclusão e exclusão. Sendo assim, inclui-se 18 estudos, com um total de 2573 pacientes (Submetidos à toxina: n= 2112; Não submetido à toxina, n= 460). A qualidade dos estudos foi avaliada por meio da Escala de Newcastle-Ottawa. Analisou-se a existência de viés de publiação pelo funnel plot. Os dados de interesse foram extraídos e direcionados a uma tabela para o cálculo da razão de frequência e odds ratio dos resultados. Para a execução da meta-análise foi utlizado o software STATA IC/64 versão 16.1. A estimativa global da freqüência do efeito da toxina botulínica tipo A na espasticidade foi de 93% (IC a 95%: 0,90 a 0,95; p= 0,00) e da funcionalidade resultou em 64% (IC a 95%: 0,40 a 0,89; p=0,00) para o domínio vestir; com 69% (IC a 95%: 0,42 a 0,96; p=0,00) para higiene; 69% (IC a 95%: 0,46 a 0,92; p=0,00) para posição do membro superior e a maior 79% (IC a 95%: 0,68 a 0,90; p=0,06) relacionado a dor.As conclusões mostraram alta heterogenicidade entre os estudos, provável viiés de publicação pelo funnel plot (t=2; IC 95%=0,4-8; p=0,05) e os resultados sugerem associação positiva entre o efeito a toxina botulínica tipo A na espasticidade em MMSS e MMII pós- AVC, destacando a formulação Dysport, seguida de Botox e por fim Xeomin, além da melhora na funcionalidade com ênfase no domínio dor, depois higiene e posicionamento do membro superior.

A neurosurgical method of the selective posterior rhizotomy (SPR) is used for a treatment of spasticity. The aim of this study is to evaluate an effect of the SPR on the reduction of the spasticity and on functional abilities of patients with cerebral palsy. Five patients (four males and a female) aged from 12 to 21 years with a spastic quadruplegia were tested by an Ashworth scale, modified Ashworth scale, Peacock scale and Barthel index of ADL. An initial assessment was preformed one day before the SPR. First assessment of changes was conducted one week after the SPR. An repeated follow-up assessment was done three to four years after the SPR procedure. In one week after SPR assessment a reduction of spasticity of lower and upper limb muscles and reduction of clonus were seen. A last three-year assessment detected some return of spasticity on hip adductors, plantar and dorsal flexors muscles. However, the return of the hypertonus did not reach initial values of spasticity. Powered by TCPDF (www.tcpdf.org)

Selective dorsal rhizotomy is a neurosurgical procedure for treating carefully selected patients with cerebral palsy. The aims of this thesis are to assess the influence of this treatment on changes in spasticity, functional abilities, locomotion and activities of daily living of these patients and also to assess the changes in these parameters in patients who were treated using this method at the neurosurgical department in University Hospital Motol in previous years. Six patients with CP diagnosis were tested - five 6 to 21 years old boys and one 35 years old woman. Ashworth and modified Ashworth scales were used to assess spasticity, goniometry was used to measure the range of passive movements. The Barthel index and Global care impairment scale by Dressler tested activities of daily living. Penn Spasm Frequency Score and Peacock's scale of locomotion were also used. The results showed a reduction in spasticity in lower as well as upper extremities, an increased range of passive movement of lower extremities, reduction of clonus the tendon of Achilles and an improvement of speech. Decreased pain and improved ability to perform activities of daily living were noted and hygienic care of a child was made easier thanks to this treatment. Powered by TCPDF (www.tcpdf.org)

Le complexe muscle-tendon est constitué d’une composante élastique série fondamentale à son fonctionnement. Cette composante élastique série est composée d’une fraction active située au sein du sarcomère et d’une fraction passive formée par les tissus tendineux (tendon et aponévrose). Elle a un rôle majeur pour optimiser le mouvement en améliorant le rendement énergétique du muscle et le travail produit.La mise au point d’une nouvelle méthode couplant une technique de détente rapide (Quick release) et un échographe haute fréquence a permis de quantifier les contributions de compliance des structures élastiques séries (tendon, aponévrose et fascicules musculaires) à la compliance globale du complexe muscle-tendon en condition active lors d’un test de détente rapide. Les résultats de la première étude montrent que le tendon a une contribution de compliance majoritaire (environ 72 %) tandis que les fascicules musculaires et l’aponévrose contribuent respectivement à 18 % et 10 %. Le tendon confirme donc son rôle capital dans la compliance de la composante élastique série en condition active. De plus, les contributions constantes du tendon, des fascicules musculaires et de l’aponévrose observées aux différents niveaux de couple pourraient aider à simplifier le mécanisme de régulation de la compliance et à maintenir le rôle majeur du tendon dans l’efficience du mouvement.Cette nouvelle méthode a permis d’étudier les adaptations mécaniques de la composante élastique série à la variation de la demande fonctionnelle, notamment en quantifiant les modifications des contributions relatives de compliance des structures élastiques séries chez des escrimeurs élites dans la deuxième étude puis chez des sujets spastiques dans la troisième étude. Concernant les escrimeurs élite, les résultats montrent que les contributions de compliance des structures élastiques de la jambe dominante du groupe d’escrimeurs sont significativement différentes à celles correspondant à la jambe du groupe contrôle, avec notamment une part plus importante de contribution pour l’aponévrose (21,1 vs 15,9 %) et une part minorée pour les fascicules (9,5 vs 13,8 %) concernant la jambe dominante des escrimeurs. En revanche, la contribution du tendon (environ 70 %) est identique pour les deux jambes. Ces modifications tendent à majorer le rôle des tissus tendineux (tendon et aponévrose) et à minorer le rôle des fascicules musculaires ce qui permettrait une utilisation supérieure des structures élastiques tendineuses pour un meilleur rendement énergétique et une performance accrue. Il est possible que l'aponévrose soit un système complémentaire à l’adaptation du complexe muscle-tendon en cas d'hyperactivité.La troisième étude est devenue une étude de cas en raison de la difficulté à tester les patients spastiques sur le Quick release. Elle s’est portée sur un patient spastique dont l’atteinte motrice était plus faible que les autres et a montré des contributions relatives de compliance du tendon (75,3 %) et de l’aponévrose (15,2 %) supérieures à celle des fascicules (9,5 %) Ce résultat s’expliquerait par une augmentation de la raideur du muscle et une diminution de la raideur des tissus tendineux observées classiquement dans les études menées sur des sujets spastiques. / The muscle-tendon complex contains a serie elastic component which is fundamental to its functioning. This serie elastic component is composed of an active part located within the sarcomere and a passive part located in the tendon and aponeurosis. It has a major role to optimize the movement by improving the muscle energetic efficiency and the produced work.A new method coupling a quick release ergometer and a high frequency ultrasound device was used to quantify the compliance contributions of the series elastic structures (tendon, aponeurosis and muscle fascicles) to the global compliance of the muscle-tendon complex in active conditions. The results of the first study showed that the tendon has a major compliance contribution (about 72%) while the muscle fascicles and aponeurosis contributions are 18% and 10%, respectively. The tendon confirms its key role in the compliance of the serie elastic component in active condition. In addition, the constant contributions of tendon, muscle fascicles and aponeurosis observed at various levels of torque may help simplify the regulation mechanism of compliance and maintain the major role of the tendon in the efficiency of the movement.This new method was also used to study the mechanical adaptations of the serie elastic component to variation of the functional demand. The changes in the relative compliance contributions of series elastic structures were quantified in elite fencers in the second study and in spastic subjects in the third study. Regarding the elite fencers, the results showed that the compliance contributions of the elastic structures in the dominant leg of fencers group were significantly different to those corresponding to the leg of the control group. The aponeurosis compliance contribution was higher for the dominant leg of the fencers groupe (21.1 vs 15.9%) while the muscle fascicles contribution was lower for the fencers group (9.5 vs 13.8%). The tendon contribution (about 70%) was the same for both legs. These changes tend to increase the role of tendon tissue (tendon and aponeurosis) and decrease the role of muscle fascicles which would allow greater use of tendon elastic structures for better energetic efficiency and improved performance. It is possible that aponeurosis is a complementary system to the adaptation of the muscle-tendon complex in the case of hyperactivity.The third study has become a case study because of the difficulty in testing the spastic patients on Quick release. Finally, the study has been done on a spastic patient with minor motor impairment compared to the others patients. The results showed a tendon and aponeurosis compliance contributions (75.3% and 15.2% respectively) higher than the muscle fascicles compliance contribution (9.5%). This result may be explained by an increase in muscle stiffness and a decrease in tendon stiffness, which is classically observed in studies with spastic subjects.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-14T12:59:28Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) tese ficha catalog oficial 2 Rafael Sales Fisioterapia.pdf: 1472962 bytes, checksum: 049ebb80d707feac704886954e751777 (MD5) / Made available in DSpace on 2016-04-14T12:59:28Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) tese ficha catalog oficial 2 Rafael Sales Fisioterapia.pdf: 1472962 bytes, checksum: 049ebb80d707feac704886954e751777 (MD5) Previous issue date: 2015-07-24 / CNPQ / Introdução: A vibração de Corpo inteiro (VCI) tem sido sugerida como uma abordagem promissora na redução do nível de excitabilidade medular e no manejo da espasticidade. No entanto, ainda não é elucidado se o efeito existente de depressão do reflexo H após a vibração teria a persistência necessária para ter um potencial terapêutico e servir como preparação de indivíduos para a fisioterapia. Objetivo: Avaliar os efeitos agudos da VCI no nível de excitabilidade medular e na espasticidade dos músculos plantiflexores em indíviduos espásticos pós Acidente Vascular Encefálico (AVE) crônico. Métodos: Trata-se de um estudo piloto de um ensaio clínico contralado e randomizado, em que vinte e um homens com espasticidade plantiflexora foram distribuídos em dois grupos: vibração (GV, n=11) e controle (GC, n=10). O GV realizou três séries, uma de familiarização com duração de um minuto e depois duas de cinco minutos, de VCI com frequência de 35 Hz e amplitude de 2 mm, em posição ortostática com semiflexão do joelho a 40˚. O GC realizou o mesmo protocolo sem o estímulo vibratório. A espasticidade foi avaliada através da Escala Modificada de Ashworth (EMA) antes e 10 minutos após a intervenção. O nível de excitabilidade medular foi estimado pela razão Hmáx/Mmáx, e valor da razão H2/H1 e tempo para ocorrência do pico da primeira facilitação na curva de recuperação, antes e 10, 20 e 30 minutos após a intervenção. A percepção global de mudança do paciente também foi estimada após a intervenção. Resultados: Não foram encontradas diferenças significativas entre os grupos no nível de excitabilidade medular nos três momentos avaliados após a intervenção, bem como na espasticidade plantiflexora. Também não houve diferença na percepção global de mudança do paciente entre os grupos (RR: 1,21; IC95% 0,65 a 2,26). Conclusão: Os achados não mostram efeito da intervenção sobre o nível de excitabilidade medular e a espasticidade plantiflexora, nos tempos estudados. Portanto, a indicação da VCI como preparação para a fisioterapia nesta população não pôde ser suportada. / Background: Whole body vibration (WBV) has been suggested as a promising approach to reduce the level of spinal cord excitability and to treat spasticity. However, it is not clarified whether the existing depression effect of the H-reflex after the vibration have the persistence necessary to have a therapeutic potential and serve as subjects preparing for physiotherapy. Objective: To evaluate the acute effects of WBV on the level of spinal cord excitability and on plantarflexion spasticity in chronic post stroke individuals. Methods: It’s a pilot randomized controlled trial which twenty-one men with plantarflexion spasticity were allocated in two groups: vibration (VG, n = 11) and control (CG, n = 10). The VG held three series, one for familiarization lasting one minute and then two five minutes of WBV with frequency 35 Hz and amplitude of 2 mm, in the standing position with 40˚ of knee flexion. The CG went through the same protocol without vibration. The plantarflexion spasticity was evaluated by the Modified Ashworth Scale (MAS) before and 10 minutes after the intervention. The level of spinal cord excitability was estimated by the ratio Hmax/Mmax, the value of ratio H2/H1 and the time to occurrence of the first facilitation peak in the recovery curve before and 10, 20 and 30 minutes after the intervention. The patient global impression of change (PGIC) was also estimated after the intervention. Results: No significant differences were found between groups neither on the level of spinal cord excitability in the three moments evaluated after the intervention nor on plantarflexion spasticity. There was also no difference between groups in PGIC (RR: 1,21; CI95% 0,65 a 2,26). Conclusion: Our results show no effect of the intervention on the level of spinal cord excitability and on plantarflexion spasticity during the analyzed period. Therefore, the indication of the WBV in preparation for physiotherapy in this population could not be supported.