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Jiryaei Z, Amini M, Sanjari MA, Hajiaghaei B, Babazadeh R, Jalali M. The effect of vibration-hinged ankle foot orthoses on gait and spasticity in children with cerebral palsy: A randomized clinical trial design. Prosthet Orthot Int 2024; 48:387-399. [PMID: 39140761 DOI: 10.1097/pxr.0000000000000266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/09/2023] [Indexed: 08/15/2024]
Abstract
BACKGROUND Hinged ankle foot orthoses (HAFO) are commonly prescribed for children with cerebral palsy (CP) to improve their ambulatory function. OBJECTIVES The aim of this study was to compare the effect of vibration-HAFO with that of the same orthosis without vibration on gait, function, and spasticity in hemiplegic CP children. STUDY DESIGN Randomized Control Trial Design (a pilot study). METHODS Twenty-three children with hemiplegic CP participated in this study. The control group (n = 12) used HAFO, and the intervention group (n = 11) used vibration-HAFO for four weeks. Pre-post three-dimensional gait analysis was done. Calf muscle spasticity and function were also measured. RESULTS Results showed significant differences between the two groups in the one-minute walking test (p = 0.023) and spasticity (after intervention [p = 0.022], after follow-up [p = 0.020]). Also, significant differences were detected between the two groups in the step width (p = 0.042), maximum hip abduction (p = 0.008), stance maximum dorsiflexion (p = 0.036) and mean pelvic tilt (p = 0.004) in the barefoot condition. Gait cycle time (p = 0.005), maximum hip abduction (p = 0.042), and cadence (p = 0.001) were different between groups in the braced condition. We couldn't find any significant within and between groups differences in knee kinematic parameters. The mean time of using vibration was 16.83 minutes per day. CONCLUSIONS The vibration-hinged AFO is feasible, safe, and acceptable for children with hemiplegic CP to be integrated into practice. Temporospatial and clinical parameters, especially spasticity, were improved. There were slight trends toward improvement in pelvic and knee kinematics. Vibration-HAFO is of benefit to ambulatory CP children with mild and moderate spasticity. It improved the walking capacity of the children.
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Affiliation(s)
- Zahra Jiryaei
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | - Malek Amini
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | - Mohammad Ali Sanjari
- Rehabilitation Research Center, and Department of Basic Rehabilitation Sciences, Faculty of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Behnam Hajiaghaei
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
| | - Roozbeh Babazadeh
- Non-governmental Organization of Internet of Things and Data Sciences, Tehran, Iran
| | - Maryam Jalali
- Rehabilitation Research Center, Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Science, Tehran, Iran
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Pfenninger C, Zeghoudi N, Bertrand MF, Lapole T. Effects of prolonged vibration to the flexor carpi radialis muscle on intracortical excitability. Sci Rep 2024; 14:8475. [PMID: 38605084 PMCID: PMC11009410 DOI: 10.1038/s41598-024-59255-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
Prolonged local vibration (LV) can induce neurophysiological adaptations thought to be related to long-term potentiation or depression. Yet, how changes in intracortical excitability may be involved remains to be further investigated as previous studies reported equivocal results. We therefore investigated the effects of 30 min of LV applied to the right flexor carpi radialis muscle (FCR) on both short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). SICI and ICF were measured through transcranial magnetic stimulation before and immediately after 30 min of FCR LV (vibration condition) or 30 min of rest (control condition). Measurements were performed during a low-intensity contraction (n = 17) or at rest (n = 7). No significant SICI nor ICF modulations were observed, whether measured during isometric contractions or at rest (p = 0.2). Yet, we observed an increase in inter-individual variability for post measurements after LV. In conclusion, while intracortical excitability was not significantly modulated after LV, increased inter-variability observed after LV may suggest the possibility of divergent responses to prolonged LV exposure.
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Affiliation(s)
- Clara Pfenninger
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Narimane Zeghoudi
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Mathilde Fiona Bertrand
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France
| | - Thomas Lapole
- Laboratoire Interuniversitaire de Biologie de la Motricité, Université Jean Monnet Saint-Etienne, Lyon 1, Université Savoie Mont-Blanc, 42023, Saint-Étienne, France.
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Zeng D, Zhao K, Lei W, Yu Y, Li W, Kong Y, Lai J, Ma F, Ye X, Zhang X. Effects of whole-body vibration training on physical function, activities of daily living, and quality of life in patients with stroke: a systematic review and meta-analysis. Front Physiol 2024; 15:1295776. [PMID: 38322612 PMCID: PMC10844406 DOI: 10.3389/fphys.2024.1295776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024] Open
Abstract
Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of whole-body vibration training (WBVT) in patients with stroke, specifically focusing on its effects on physical function, activities of daily living (ADL), and quality of life (QOL). Additionally, potential moderators influencing WBVT outcomes were explored. Methods: We conducted a systematic search of PubMed, Embase, and Cochrane Library from inception to September 2022. Eligible studies were randomized controlled trials employing WBVT in patients with stroke. Two investigators independently extracted the data and calculated the standardized mean difference (SMD) using random-effect models. Results: Twenty-five studies involving 991 patients were included in this meta-analysis. WBVT demonstrated significant reductions in spasticity (SMD = -0.33, 95% CI = -0.61 to -0.06, p = 0.02), improvements in motor function (SMD = 0.39, 95% CI = 0.16 to 0.61, p < 0.01), and enhancements in balance function (SMD = 0.28, 95% CI = 0.09 to 0.47, p < 0.01) in patients with stroke. However, no significant effects were observed for gait (SMD = -0.23, 95% CI = -0.50 to 0.04, p = 0.10), ADL (SMD = -0.01, 95% CI = -0.46 to 0.44, p = 0.97), or QOL (SMD = 0.12, 95% CI = -0.30 to 0.53, p = 0.59). Subgroup analyses revealed that variable frequency vibration and side-alternating vibration exhibited significant efficacy in reducing spasticity and improving motor and balance functions, while fixed frequency vibration and vertical vibration did not yield significant therapeutic benefits in these domains. Conclusion: Our findings indicate that WBVT may serve as a viable adjunct therapy for stroke patients to alleviate spasticity and enhance motor and balance functions. Variable frequency and side-alternating vibration appear to be crucial factors influencing the therapeutic effects of WBVT on these dysfunctions. Nonetheless, WBVT did not show significant effects on gait, ADL, or QOL in stroke patients. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022384319).
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Affiliation(s)
- Duchun Zeng
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Kun Zhao
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Wei Lei
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
- Graduate School, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yanmei Yu
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Weili Li
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Yurou Kong
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Junmei Lai
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Fenghao Ma
- Department of Physiotherapy, Shanghai Sunshine Rehabilitation Center, Tongji University School of Medicine, Shanghai, China
| | - Xiangming Ye
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
| | - Xiaofeng Zhang
- Center for Rehabilitation Medicine, Rehabilitation & Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital), Hangzhou Medical College, Hangzhou, China
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Shen X, Yu Y, Xiao H, Ji L, Wu J. Cortical activity associated with focal muscle vibration applied directly to the affected forearm flexor muscle in post-stroke patients: an fNIRS study. Front Neurosci 2023; 17:1281160. [PMID: 38192508 PMCID: PMC10773788 DOI: 10.3389/fnins.2023.1281160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024] Open
Abstract
Objective The purpose of this study was to utilize functional near-infrared spectroscopy (fNIRS) to identify changes in cortical activity caused by focal muscle vibration (FMV), which was directly administered to the affected forearm flexor muscles of hemiplegic stroke patients. Additionally, the study aimed to investigate the correlation between these changes and the clinical characteristics of the patients, thereby expanding the understanding of potential neurophysiological mechanisms linked to these effects. Methods Twenty-two stroke patients with right hemiplegia who were admitted to our ward for rehabilitation were selected for this study. The fNIRS data were collected from subjects using a block-design paradigm. Subsequently, the collected data were analyzed using the NirSpark software to determine the mean Oxyhemoglobin (Hbo) concentrations for each cortical region of interest (ROI) in the task and rest states for every subject. The stimulation task was FMV (frequency 60 Hz, amplitude 6 mm) directly applied to belly of the flexor carpi radialis muscle (FCR) on the affected side. Hbo was measured in six regions of interest (ROIs) in the cerebral cortex, which included the bilateral prefrontal cortex (PFC), sensorimotor cortex (SMC), and occipital cortex (OC). The clinical characteristics of the patients were assessed concurrently, including Lovett's 6-level muscle strength assessment, clinical muscle tone assessment, the upper extremity function items of the Fugl-Meyer Assessment (FMA-UE), Bruunstrom staging scale (BRS), and Modified Barthel index (MBI). Statistical analyses were conducted to determine the activation in the ROIs and to comprehend its correlation with the clinical characteristics of the patients. Results Statistical analysis revealed that, except for right OC, there were statistically significant differences between the mean Hbo in the task state and rest state for bilateral SMC, PFC, and left OC. A positive correlation was observed between the muscle strength of the affected wrist flexor group and the change values of Hbo (Hbo-CV), as well as the beta values in the left SMC, PFC, and OC. However, no statistical correlation was found between muscle strength and Hbo-CV or beta values in the right SMC, PFC, and OC. The BRS of the affected upper limb exhibited a positive correlation with the Hbo-CV or beta values in the left SMC and PFC. In contrast, no statistical correlation was observed in the right SMC, PFC, and bilateral OC. No significant correlation was found between the muscle tone of the affected wrist flexor group, FMA-UE, MBI, and Hbo-CV or beta values of cortical ROIs. Conclusion FMV-evoked sensory stimulation applied directly to the FCR belly on the paralyzed side activated additional brain cortices, including bilateral PFC and ipsilesional OC, along with bilateral SMC in stroke patients. However, the clinical characteristics of the patients were only correlated with the intensity of ipsilesional SMC and PFC activation. The results of this study provide neurophysiological theoretical support for the expanded clinical application of FMV.
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Affiliation(s)
- Xianshan Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Yang Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Han Xiao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Leilei Ji
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
| | - Jianxian Wu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Rehabilitation and Sports Medicine, The Second Clinical College of Anhui Medical University, Hefei, China
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Li W, Li C, Liu A, Lin PJ, Mo L, Zhao H, Xu Q, Meng X, Ji L. Lesion-specific cortical activation following sensory stimulation in patients with subacute stroke. J Neuroeng Rehabil 2023; 20:155. [PMID: 37957755 PMCID: PMC10644526 DOI: 10.1186/s12984-023-01276-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Sensory stimulation can play a fundamental role in the activation of the primary sensorimotor cortex (S1-M1), which can promote motor learning and M1 plasticity in stroke patients. However, studies have focused mainly on investigating the influence of brain lesion profiles on the activation patterns of S1-M1 during motor tasks instead of sensory tasks. Therefore, the objective of this study is to explore the lesion-specific activation patterns due to different brain lesion profiles and types during focal vibration (FV). METHODS In total 52 subacute stroke patients were recruited in this clinical experiment, including patients with basal ganglia hemorrhage/ischemia, brainstem ischemia, other subcortical ischemia, cortical ischemia, and mixed cortical-subcortical ischemia. Electroencephalograms (EEG) were recorded following a resting state lasting for 4 min and three sessions of FV. FV was applied over the muscle belly of the affected limb's biceps for 3 min each session. Beta motor-related EEG power desynchronization overlying S1-M1 was used to indicate the activation of S1-M1, while the laterality coefficient (LC) of the activation of S1-M1 was used to assess the interhemispheric asymmetry of brain activation. RESULTS (1) Regarding brain lesion profiles, FV could lead to the significant activation of bilateral S1-M1 in patients with basal ganglia ischemia and other subcortical ischemia. The activation of ipsilesional S1-M1 in patients with brainstem ischemia was higher than that in patients with cortical ischemia. No activation of S1-M1 was observed in patients with lesions involving cortical regions. (2) Regarding brain lesion types, FV could induce the activation of bilateral S1-M1 in patients with basal ganglia hemorrhage, which was significantly higher than that in patients with basal ganglia ischemia. Additionally, LC showed no significant correlation with the modified Barthel index (MBI) in all patients, but a positive correlation with MBI in patients with basal ganglia lesions. CONCLUSIONS These results reveal that sensory stimulation can induce lesion-specific activation patterns of S1-M1. This indicates FV could be applied in a personalized manner based on the lesion-specific activation of S1-M1 in stroke patients with different lesion profiles and types. Our study may contribute to a better understanding of the underlying mechanisms of cortical reorganization.
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Affiliation(s)
- Wei Li
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China
- State Key Laboratory of Multimodal Artificial Intelligence Systems, Institute of Automation, Chinese Academy of Sciences, Beijing, China
| | - Chong Li
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China.
- School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, China.
- Medical Research Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
| | - Aixian Liu
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing, China
| | - Ping-Ju Lin
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China
| | - Linhong Mo
- Neurological Rehabilitation Center, Beijing Rehabilitation Hospital Affiliated to Capital Medical University, Beijing, China
| | - Hongliang Zhao
- Department of Radiology, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China
| | - Quan Xu
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China.
- Department of Rehabilitation Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
| | - Xiangzun Meng
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China
| | - Linhong Ji
- Division of Intelligent and Biomechanical System, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China
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Zhong Y, Yao L, Wang Y. Enhanced Motor Imagery Decoding by Calibration Model-Assisted With Tactile ERD. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4295-4305. [PMID: 37883287 DOI: 10.1109/tnsre.2023.3327788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
OBJECTIVE In this study, we propose a tactile-assisted calibration method for a motor imagery (MI) based Brain-Computer Interface (BCI) system. METHOD In the proposed calibration, tactile stimulation was applied to the hand wrist to assist the subjects in the MI task, which is named SA-MI task. Then, classifier training in the SA-MI Calibration was performed using the SA-MI data, while the Conventional Calibration employed the MI data. After the classifiers were trained, the performance was evaluated on a common MI dataset. RESULTS Our study demonstrated that the SA-MI Calibration significantly improved the performance as compared with the Conventional Calibration, with a decoding accuracy of (78.3% vs. 71.3%). Moreover, the average calibration time could be reduced by 40%. This benefit of the SA-MI Calibration effect was further validated by an independent control group, which showed no improvement when tactile stimulation was not applied during the calibration phase. Further analysis showed that when compared with MI, greater motor-related cortical activation and higher R 2 value in the alpha-beta frequency band were induced in SA-MI. CONCLUSION Indeed, the SA-MI Calibration could significantly improve the performance and reduce the calibration time as compared with the Conventional Calibration. SIGNIFICANCE The proposed tactile stimulation-assisted MI Calibration method holds great potential for a faster and more accurate system setup at the beginning of BCI usage.
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Fattorini L, Rodio A, Filippi GM, Pettorossi VE. Effectiveness of Focal Muscle Vibration in the Recovery of Neuromotor Hypofunction: A Systematic Review. J Funct Morphol Kinesiol 2023; 8:103. [PMID: 37606398 PMCID: PMC10443241 DOI: 10.3390/jfmk8030103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/19/2023] [Accepted: 07/20/2023] [Indexed: 08/23/2023] Open
Abstract
Adequate physical recovery after trauma, injury, disease, a long period of hypomobility, or simply ageing is a difficult goal because rehabilitation protocols are long-lasting and often cannot ensure complete motor recovery. Therefore, the optimisation of rehabilitation procedures is an important target to be achieved. The possibility of restoring motor functions by acting on proprioceptive signals by unspecific repetitive muscle vibration, focally applied on single muscles (RFV), instead of only training muscle function, is a new perspective, as suggested by the effects on the motor performance evidenced by healthy persons. The focal muscle vibration consists of micro-stretching-shortening sequences applied to individual muscles. By repeating such stimulation, an immediate and persistent increase in motility can be attained. This review aims to show whether this proprioceptive stimulation is useful for optimising the rehabilitative process in the presence of poor motor function. Papers reporting RFV effects have evidenced that the motor deficits can be counteracted by focal vibration leading to an early and quick complete recovery. The RFV efficacy has been observed in various clinical conditions. The motor improvements were immediate and obtained without loading the joints. The review suggests that these protocols can be considered a powerful new advantage to enhance traditional rehabilitation and achieve a more complete motor recovery.
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Affiliation(s)
- Luigi Fattorini
- Department of Physiology and Pharmacology “V. Erspamer”, School of Medicine, Faculty of Medicine and Surgery, Sapienza Università di Roma, L.go A. Moro 5, 00185 Rome, Italy;
| | - Angelo Rodio
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, Loc. Folcara, 03043 Cassino, Italy
| | - Guido Maria Filippi
- Department of Neuroscience, School of Medicine, Faculty of Medicine and Surgery, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Vito Enrico Pettorossi
- Department of Medicine and Surgery, Human Physiology Section, Università degli Studi di Perugia, Piazzale Gambuli 1, 06129 Perugia, Italy;
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Wang W, Shi B, Wang D, Wang J, Liu G. Enhanced lower-limb motor imagery by kinesthetic illusion. Front Neurosci 2023; 17:1077479. [PMID: 37409102 PMCID: PMC10319417 DOI: 10.3389/fnins.2023.1077479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 05/30/2023] [Indexed: 07/07/2023] Open
Abstract
Brain-computer interface (BCI) based on lower-limb motor imagery (LMI) enables hemiplegic patients to stand and walk independently. However, LMI ability is usually poor for BCI-illiterate (e.g., some stroke patients), limiting BCI performance. This study proposed a novel LMI-BCI paradigm with kinesthetic illusion(KI) induced by vibratory stimulation on Achilles tendon to enhance LMI ability. Sixteen healthy subjects were recruited to carry out two research contents: (1) To verify the feasibility of induced KI by vibrating Achilles tendon and analyze the EEG features produced by KI, research 1 compared the subjective feeling and brain activity of participants during rest task with and without vibratory stimulation (V-rest, rest). (2) Research 2 compared the LMI-BCI performance with and without KI (KI-LMI, no-LMI) to explore whether KI enhances LMI ability. The analysis methods of both experiments included classification accuracy (V-rest vs. rest, no-LMI vs. rest, KI-LMI vs. rest, KI-LMI vs. V-rest), time-domain features, oral questionnaire, statistic analysis and brain functional connectivity analysis. Research 1 verified that induced KI by vibrating Achilles tendon might be feasible, and provided a theoretical basis for applying KI to LMI-BCI paradigm, evidenced by oral questionnaire (Q1) and the independent effect of vibratory stimulation during rest task. The results of research 2 that KI enhanced mesial cortex activation and induced more intensive EEG features, evidenced by ERD power, topographical distribution, oral questionnaire (Q2 and Q3), and brain functional connectivity map. Additionally, the KI increased the offline accuracy of no-LMI/rest task by 6.88 to 82.19% (p < 0.001). The simulated online accuracy was also improved for most subjects (average accuracy for all subjects: 77.23% > 75.31%, and average F1_score for all subjects: 76.4% > 74.3%). The LMI-BCI paradigm of this study provides a novel approach to enhance LMI ability and accelerates the practical applications of the LMI-BCI system.
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Affiliation(s)
- Weizhen Wang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Bin Shi
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Dong Wang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Jing Wang
- Institute of Robotics and Intelligent Systems, School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Gang Liu
- Henan Key Laboratory of Brain Science and Brain-Computer Interface Technology, School of Electrical Engineering, Zhengzhou University, Zhengzhou, China
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Won K, Kim H, Gwon D, Ahn M, Nam CS, Jun SC. Can vibrotactile stimulation and tDCS help inefficient BCI users? J Neuroeng Rehabil 2023; 20:60. [PMID: 37143057 PMCID: PMC10157902 DOI: 10.1186/s12984-023-01181-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
Brain-computer interface (BCI) has helped people by allowing them to control a computer or machine through brain activity without actual body movement. Despite this advantage, BCI cannot be used widely because some people cannot achieve controllable performance. To solve this problem, researchers have proposed stimulation methods to modulate relevant brain activity to improve BCI performance. However, multiple studies have reported mixed results following stimulation, and the comparative study of different stimulation modalities has been overlooked. Accordingly, this study was designed to compare vibrotactile stimulation and transcranial direct current stimulation's (tDCS) effects on brain activity modulation and motor imagery BCI performance among inefficient BCI users. We recruited 44 subjects and divided them into sham, vibrotactile stimulation, and tDCS groups, and low performers were selected from each stimulation group. We found that the latter's BCI performance in the vibrotactile stimulation group increased significantly by 9.13% (p < 0.01), and while the tDCS group subjects' performance increased by 5.13%, it was not significant. In contrast, sham group subjects showed no increased performance. In addition to BCI performance, pre-stimulus alpha band power and the phase locking values (PLVs) averaged over sensory motor areas showed significant increases in low performers following stimulation in the vibrotactile stimulation and tDCS groups, while sham stimulation group subjects and high performers showed no significant stimulation effects across all groups. Our findings suggest that stimulation effects may differ depending upon BCI efficiency, and inefficient BCI users have greater plasticity than efficient BCI users.
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Affiliation(s)
- Kyungho Won
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Heegyu Kim
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, South Korea
| | - Daeun Gwon
- Department of Computer Science and Electrical Engineering, Handong Global University, Pohang, South Korea
| | - Minkyu Ahn
- Department of Computer Science and Electrical Engineering, Handong Global University, Pohang, South Korea
- School of Computer Science and Electrical Engineering, Handong Global University, Pohang, South Korea
| | - Chang S Nam
- Edward P. Fitts Department of Industrial and Systems Engineering, North Carolina State University, North Carolina, USA
| | - Sung Chan Jun
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, South Korea.
- Artificial Intelligence Graduate School, Gwangju Institute of Science and Technology, Gwangju, South Korea.
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Safder SNUH, Akram MU, Dar MN, Khan AA, Khawaja SG, Subhani AR, Niazi IK, Gul S. Analysis of EEG signals using deep learning to highlight effects of vibration-based therapy on brain. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2023.104605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Manzo N, Ginatempo F, Belvisi D, Arcara G, Parrotta I, Leodori G, Deriu F, Celletti C, Camerota F, Conte A. Investigating the Effects of a Focal Muscle Vibration Protocol on Sensorimotor Integration in Healthy Subjects. Brain Sci 2023; 13:brainsci13040664. [PMID: 37190629 DOI: 10.3390/brainsci13040664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
Background: The ability to perceive two tactile stimuli as asynchronous can be measured using the somatosensory temporal discrimination threshold (STDT). In healthy humans, the execution of a voluntary movement determines an increase in STDT values, while the integration of STDT and movement execution is abnormal in patients with basal ganglia disorders. Sensorimotor integration can be modulated using focal muscle vibration (fMV), a neurophysiological approach that selectively activates proprioceptive afferents from the vibrated muscle. Method: In this study, we investigated whether fMV was able to modulate STDT or STDT-movement integration in healthy subjects by measuring them before, during and after fMV applied over the first dorsalis interosseous, abductor pollicis brevis and flexor radialis carpi muscles. Results: The results showed that fMV modulated STDT-movement integration only when applied over the first dorsalis interosseous, namely, the muscle performing the motor task involved in STDT-movement integration. These changes occurred during and up to 10 min after fMV. Differently, fMV did not influence STDT at rest. We suggest that that fMV interferes with the STDT-movement task processing, possibly disrupting the physiological processing of sensory information. Conclusions: This study showed that FMV is able to modulate STDT-movement integration when applied over the muscle involved in the motor task. This result provides further information on the mechanisms underlying fMV, and has potential future implications in basal ganglia disorders characterized by altered sensorimotor integration.
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Affiliation(s)
- Nicoletta Manzo
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Francesca Ginatempo
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
| | - Daniele Belvisi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Giorgio Arcara
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
| | - Ilaria Parrotta
- IRCCS San Camillo Hospital, Via Alberoni 70, 30126 Venice, Italy
- Movement Contral and Neuroplasticity Research Group, Tervuursevest 101, 3001 Leuven, Belgium
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Viale San Pietro 43c, 07100 Sassari, Italy
- Unit of Endocrinology, Nutritional and Metabolic Disorders, AOU Sassari, 07100 Sassari, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I University Hospital of Rome, 00185 Rome, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, Italy
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12
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Alashram AR, Annino G, Romagnoli C, Raju M, Padua E. Proprioceptive Focal Stimulation (Equistasi ®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review. Proc Inst Mech Eng H 2023; 237:179-189. [PMID: 36515387 DOI: 10.1177/09544119221141945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata," Rome, Italy
| | - Cristian Romagnoli
- Sport Engineering Lab, Department Industrial Engineering, University of Rome "Tor Vergata," Rome, Italy.,Science and Culture of Well-being and Lifestyle, "Alma Mater" University, Bologna, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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13
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Kolbaşı EN, Huseyinsinoglu BE, Bayraktaroğlu Z. Effect of upper limb focal muscle vibration on cortical activity: A systematic review with a focus on primary motor cortex. Eur J Neurosci 2022; 56:4141-4153. [PMID: 35673835 DOI: 10.1111/ejn.15731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
This systematic review aimed to investigate the effects of upper extremity focal muscle vibration (FMV) on cortical activity. A systematic literature search was conducted for articles published in English in the SCOPUS, PEDro, PUBMED, REHABDATA, MEDLINE, and Web of Science databases. Eighteen studies (6 controlled and 12 experimental studies) were included in the systematic review. A total of 264 individuals (20 to 68 years) participated in the studies. The outcome of this review showed that FMV might have contradictory effects on cortical areas: (a) Reduction of cortical activity in the primary motor cortex (M1) and somatosensory cortex (S1), (b) no changes in the cortical activity of M1, and (c) increased cortical activity of M1 and S1. These effects may depend on different factors such as frequency and amplitude of FMV, vibration exposure time, and muscle status. However, no single factor can definitely be accounted for the variance.
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Affiliation(s)
- Esma Nur Kolbaşı
- Department of Physiotherapy and Rehabilitation, Istanbul Medeniyet University, Istanbul, Turkey.,Institute of Graduate Studies, Physiotherapy and Rehabilitation Department, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Burcu Ersoz Huseyinsinoglu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Zübeyir Bayraktaroğlu
- Department of Physiology, International School of Medicine, Istanbul Medipol University, Istanbul, Turkey
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14
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Bedla M, Pięta P, Kaczmarski D, Deniziak S. Estimation of Gross Motor Functions in Children with Cerebral Palsy Using Zebris FDM-T Treadmill. J Clin Med 2022; 11:954. [PMID: 35207227 PMCID: PMC8880133 DOI: 10.3390/jcm11040954] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 12/10/2022] Open
Abstract
A standardized observational instrument designed to measure change in gross motor function over time in children with cerebral palsy is the Gross Motor Function Measure (GMFM). The process of evaluating a value for the GMFM index can be time consuming. It typically takes 45 to 60 min for the patient to complete all tasks, sometimes in two or more sessions. The diagnostic procedure requires trained and specialized therapists. The paper presents the estimation of the GMFM measure for patients with cerebral palsy based on the results of the Zebris FDM-T treadmill. For this purpose, the regression analysis was used. Estimations based on the Generalized Linear Regression were assessed using different error metrics. The results obtained showed that the GMFM score can be estimated with acceptable accuracy. Because the Zebris FDM-T is a widely used device in gait rehabilitation, our method has the potential to be widely adopted for objective diagnostics of children with cerebral palsy.
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Affiliation(s)
- Mariusz Bedla
- Faculty of Electrical Engineering, Automatic Control and Computer Science, Kielce University of Technology, al. Tysiąclecia Państwa Polskiego 7, 25-314 Kielce, Poland; (P.P.); (D.K.); (S.D.)
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15
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Shabat S, Meiner Z, Tsenter J, Schwartz I, Portnoy S. Correlations between Electro-Diagnostic Findings, the Severity of Initial Infection, and the Rehabilitation Outcomes among COVID-19 Patients. BIOLOGY 2022; 11:277. [PMID: 35205144 PMCID: PMC8869409 DOI: 10.3390/biology11020277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 11/30/2022]
Abstract
Patients with Coronavirus-2019 (COVID-19) manifest many neuromuscular complications. We evaluated the correlations between electromyography and nerve conduction measurements among COVID-19 patients and the severity of the initial infection, as well as the rehabilitation outcomes, and searched for the factors which best predict the rehabilitation outcomes. A total of 19 COVID-19 patients (16 men; mean ± SD age 59.1 ± 10.4), with WHO clinical progression scale of 6.8 ± 2.3, received rehabilitation for 3.9 ± 2.5 months. The Functional Independence Measure (FIM), the 10 m walk test, the 6 minute walk test, and grip force were collected before and after the rehabilitation period. Motor Nerve Conduction (MNC), Sensory Nerve Conduction (SNC) and electromyographic abnormalities were measured. All of the MNC measures of the median nerve correlated with the WHO clinical progression scale and duration of acute hospitalization. The MNC and SNC measures correlated with the rehabilitation duration and with FIM at discharge. The MNC distal latency of the median and the peroneal nerves and the MNC velocity of the median and tibial nerves predicted 91.6% of the variance of the motor FIM at discharge. We conclude that nerve conduction measurements, especially in COVID-19 patients with severe illness, are important in order to predict prognosis and rehabilitation outcomes.
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Affiliation(s)
- Sheer Shabat
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Zeev Meiner
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Jeanna Tsenter
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Isabella Schwartz
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 91905, Israel; (S.S.); (Z.M.); (J.T.); (I.S.)
- Department of Physical Medicine and Rehabilitation, Hadassah Medical Center, Jerusalem 9765418, Israel
| | - Sigal Portnoy
- Department of Occupational Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel
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16
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Pérez-de la Cruz S. Use of a Portable Inertial Measurement Unit as an Evaluation Method for Supraspinatus Muscle: Proposed Normative Values. SENSORS 2021; 21:s21227723. [PMID: 34833798 PMCID: PMC8625058 DOI: 10.3390/s21227723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 11/21/2022]
Abstract
Treatment protocols do not specify an appropriate weight for rehabilitating the shoulder joint. The purpose of this study was to establish normative values for the shoulder abduction range of motion and recommended weights to be used in the rehabilitation process after injury to the supraspinatus muscle. Fifty-eight volunteers were assessed using the DyCare system. A test was conducted by lifting the arm to a 90° angle and having the participants lift different weights. The range of motion was similar for both sexes, suggesting that sex had no influence on this variable. Regarding the use of weights, men did not show as much stability in their movement execution, with a high dispersion seen in values between zero and three kilograms of weight, reaching a maximum weight of six kilograms. However, women showed good joint stability from the beginning of the test, with values that remained constant as weight increased up to a maximum of five kilograms. In conclusion, no major differences were observed in supraspinatus muscle injury recovery according to sex. However, differences were observed in the amount of weight that was necessary and appropriate to allow the participants to recover their muscular strength and avoid relapses.
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Affiliation(s)
- Sagrario Pérez-de la Cruz
- Department of Nursing, Physical Therapy and Medicine, University of Almería, La Cañada de San Urbano, 04120 Almería, Spain
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17
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Chu C, Luo J, Tian X, Han X, Guo S. A P300 Brain-Computer Interface Paradigm Based on Electric and Vibration Simple Command Tactile Stimulation. Front Hum Neurosci 2021; 15:641357. [PMID: 33935672 PMCID: PMC8081187 DOI: 10.3389/fnhum.2021.641357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 03/09/2021] [Indexed: 12/15/2022] Open
Abstract
This paper proposed a novel tactile-stimuli P300 paradigm for Brain-Computer Interface (BCI), which potentially targeted at people with less learning ability or difficulty in maintaining attention. The new paradigm using only two types of stimuli was designed, and different targets were distinguished by frequency and spatial information. The classification algorithm was developed by introducing filters for frequency bands selection and conducting optimization with common spatial pattern (CSP) on the tactile evoked EEG signals. It features a combination of spatial and frequency information, with the spatial information distinguishing the sites of stimuli and frequency information identifying target stimuli and disturbances. We investigated both electrical stimuli and vibration stimuli, in which only one target site was stimulated in each block. The results demonstrated an average accuracy of 94.88% for electrical stimuli and 95.21% for vibration stimuli, respectively.
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Affiliation(s)
- Chenxi Chu
- Institute of Artificial Intelligence (AI) and Robotics, Academy for Engineering and Technology, Fudan University, as well as Engineering Research Center of AI & Robotics, Ministry of Education, Shanghai, China
- Guanghua Lingang Engineering Application and Technology R&D (Shanghai) Co., Ltd., Shanghai, China
| | - Jingjing Luo
- Institute of Artificial Intelligence (AI) and Robotics, Academy for Engineering and Technology, Fudan University, as well as Engineering Research Center of AI & Robotics, Ministry of Education, Shanghai, China
- Jihua Laboratory, Guangzhou, China
| | - Xiwei Tian
- Department of the State Key Laboratory of Reliability and Intelligence of Electrical Equipment and The Hebei Key Laboratory of Robot Perception and Human-Robot Interaction, Hebei University of Technology, Tianjin, China
| | - Xiangke Han
- Department of the State Key Laboratory of Reliability and Intelligence of Electrical Equipment and The Hebei Key Laboratory of Robot Perception and Human-Robot Interaction, Hebei University of Technology, Tianjin, China
| | - Shijie Guo
- Institute of Artificial Intelligence (AI) and Robotics, Academy for Engineering and Technology, Fudan University, as well as Engineering Research Center of AI & Robotics, Ministry of Education, Shanghai, China
- Guanghua Lingang Engineering Application and Technology R&D (Shanghai) Co., Ltd., Shanghai, China
- Department of the State Key Laboratory of Reliability and Intelligence of Electrical Equipment and The Hebei Key Laboratory of Robot Perception and Human-Robot Interaction, Hebei University of Technology, Tianjin, China
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18
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Kojima S, Otsuru N, Miyaguchi S, Yokota H, Nagasaka K, Saito K, Inukai Y, Shirozu H, Onishi H. The intervention of mechanical tactile stimulation modulates somatosensory evoked magnetic fields and cortical oscillations. Eur J Neurosci 2021; 53:3433-3446. [PMID: 33772899 DOI: 10.1111/ejn.15209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 02/28/2021] [Accepted: 03/16/2021] [Indexed: 11/30/2022]
Abstract
The different cortical activity evoked by a mechanical tactile stimulus depends on tactile stimulus patterns, which demonstrates that simple stimuli (i.e., global synchronous stimulation the stimulus area) activate the primary somatosensory cortex alone, whereas complex stimuli (i.e., stimulation while moving in the stimulus area) activate not only the primary somatosensory cortex but also the primary motor area. Here, we investigated whether the effects of a repetitive mechanical tactile stimulation (MS) on somatosensory evoked magnetic fields (SEFs) and cortical oscillations depend on MS patterns. This single-blinded study included 15 healthy participants. Two types interventions of MS lasting 20 min were used: a repetitive global tactile stimulation (RGS) was used to stimulate the finger by using 24 pins installed on a finger pad, whereas a sequential stepwise displacement tactile stimulation (SSDS) was used to stimulate the finger by moving a row of six pins between the left and right sides on the finger pad. Each parameter was measured pre- and post-intervention. The P50m amplitude of the SEF was increased by RGS and decreased by SSDS. The modulation of P50m was correlated with its amplitude before RGS and with the modulation of beta band oscillation at the resting state after SSDS. This study showed that the effects of a 20-min MS on SEFs and cortical oscillations depend on mechanical tactile stimulus patterns. Moreover, our results offer potential for the modulation of tactile functions and selection of stimulation patterns according to cortical states.
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Affiliation(s)
- Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Naofumi Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Hirotake Yokota
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Kazuaki Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Kei Saito
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Yasuto Inukai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
| | - Hiroshi Shirozu
- Department of Functional Neurosurgery, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata-City, Niigata, Japan
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Wearable Focal Muscle Vibration on Pain, Balance, Mobility, and Sensation in Individuals with Diabetic Peripheral Neuropathy: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052415. [PMID: 33801216 PMCID: PMC7967773 DOI: 10.3390/ijerph18052415] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/15/2023]
Abstract
People with diabetic peripheral neuropathy (DPN) experience a lower quality of life caused by associated pain, loss of sensation and mobility impairment. Current standard care for DPN is limited and lacking. This study explores the benefits of 4-week, in-home wearable focal muscle vibration (FMV) therapy on pain, balance, mobility, and sensation in people with DPN. Participants were randomized into three groups and received different FMV intensities. FMV was applied using a modified MyovoltTM wearable device to the tibialis anterior, distal quadriceps, and gastrocnemius/soleus muscles on both lower limbs for three days a week over four weeks. The outcomes included pain, balance, mobility, sensation, device usage log, feedback survey, and a semi-structured interview. In all, 23 participants completed the study. The results showed significant improvement in average pain (Pre: 4.00 ± 2.29; Post: 3.18 ± 2.26; p = 0.007), pain interference with walking ability (Pre: 4.14 ± 3.20; Post: 3.09 ± 1.976; p = 0.03), and standard and cognitive Timed Up-and-Go scores (Pre: 13.75 ± 5.34; Post: 12.65 ± 5.25; p = 0.04; Pre: 15.12 ± 6.60; Post: 12.71 ± 5.57; p = 0.003, respectively); the overall pain improvement was trending towards significance (Pre: 3.48 ± 2.56; Post: 2.87 ± 1.85; p = 0.051). Balance and sensations improved but not significantly. There was a trend towards significance (p = 0.088), correlation (r = 0.382) between changes in balance and baseline pain. The participants were highly satisfied with wearable FMV and were 100% compliant. FMV therapy was associated with improved pain, mobility, and sensation. Further study with a larger sample and better outcome measures are warranted.
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20
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Toscano M, Ricci M, Celletti C, Paoloni M, Ruggiero M, Viganò A, Jannini TB, Altarocca A, Liberatore M, Camerota F, Di Piero V. Motor Recovery After Stroke: From a Vespa Scooter Ride Over the Roman Sampietrini to Focal Muscle Vibration (fMV) Treatment. A 99mTc-HMPAO SPECT and Neurophysiological Case Study. Front Neurol 2020; 11:567833. [PMID: 33281704 PMCID: PMC7705992 DOI: 10.3389/fneur.2020.567833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 10/19/2020] [Indexed: 01/19/2023] Open
Abstract
Focal repetitive muscle vibration (fMV) is a safe and well-tolerated non-invasive brain and peripheral stimulation (NIBS) technique, easy to perform at the bedside, and able to promote the post-stroke motor recovery through conditioning the stroke-related dysfunctional structures and pathways. Here we describe the concurrent cortical and spinal plasticity induced by fMV in a chronic stroke survivor, as assessed with 99mTc-HMPAO SPECT, peripheral nerve stimulation, and gait analysis. A 72-years-old patient was referred to our stroke clinic for a right leg hemiparesis and spasticity resulting from a previous (4 years before) hemorrhagic stroke. He reported a subjective improvement of his right leg's spasticity and dysesthesia that occurred after a30-min ride on a Vespa scooter as a passenger over the Roman Sampietrini (i.e., cubic-shaped cobblestones). Taking into account both the patient's anecdote and the current guidelines that recommend fMV for the treatment of post-stroke spasticity, we then decided to start fMV treatment. 12 fMV sessions (frequency 100 Hz; amplitude range 0.2–0.5 mm, three 10-min daily sessions per week for 4 consecutive weeks) were applied over the quadriceps femoris, triceps surae, and hamstring muscles through a specific commercial device (Cro®System, NEMOCOsrl). A standardized clinical and instrumental evaluation was performed before (T0) the first fMV session and after (T1) the last one. After fMV treatment, we observed a clinically relevant motor and functional improvement, as assessed by comparing the post-treatment changes in the score of the Fugl-Meyer assessment, the Motricity Index score, the gait analysis, and the Ashworth modified scale, with the respective minimal detectable change at the 95% confidence level (MDC95). Data from SPECT and peripheral nerve stimulation supported the evidence of a concurrent brain and spinal plasticity promoted by fMV treatment trough activity-dependent changes in cortical perfusion and motoneuron excitability, respectively. In conclusion, the substrate of post-stroke motor recovery induced by fMV involves a concurrently acting multisite plasticity (i.e., cortical and spinal plasticity). In our patient, operant conditioning of both cortical perfusion and motoneuron excitability throughout a month of fMV treatment was related to a clinically relevant improvement in his strength, step symmetry (with reduced limping), and spasticity.
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Affiliation(s)
- Massimiliano Toscano
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Maria Ricci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Claudia Celletti
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Marco Paoloni
- Department of Physical Medicine and Rehabilitation, "Sapienza" University of Rome, Rome, Italy
| | - Marco Ruggiero
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | | | - Tommaso B Jannini
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy.,Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Alberto Altarocca
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Mauro Liberatore
- Department of Radiological, oncological and pathological Sciences - Radiometabolic Division, Umberto I Hospital, Rome, Italy
| | - Filippo Camerota
- Physical Medicine and Rehabilitation Division, Umberto I Hospital, Rome, Italy
| | - Vittorio Di Piero
- Department of Human Neurosciences, "Sapienza" University of Rome, Rome, Italy
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21
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Avvantaggiato C, Casale R, Cinone N, Facciorusso S, Turitto A, Stuppiello L, Picelli A, Ranieri M, Intiso D, Fiore P, Ciritella C, Santamato A. Localized muscle vibration in the treatment of motor impairment and spasticity in post-stroke patients: a systematic review. Eur J Phys Rehabil Med 2020; 57:44-60. [PMID: 33111513 DOI: 10.23736/s1973-9087.20.06390-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
INTRODUCTION During the last decades, many studies have been carried out to understand the possible positive effects of vibration therapy in post-stroke rehabilitation. In particular, the use of localized muscle vibration (LMV) seems to have promising results. The aim of this systematic review was to describe the use of LMV in post-stroke patients to improve motor recovery, reducing spasticity and disability in both upper and lower limb. EVIDENCE ACQUISITION A search was conducted on PubMed, Scopus, Pedro and REHABDATA electronic database. Only randomized controlled trials have been included, excluding no-localized vibratory treatments and other pathological conditions. Fourteen studies met the inclusion criteria and were included in this review. EVIDENCE SYNTHESIS Collectively, the studies involved 425 stroke patients. Most studies included chronic stroke patients (ten) and treated only the upper limb (eleven). There is evidence that LMV therapy is effective in reducing spasticity and improving motor recovery, especially when associated with conventional physical therapy. CONCLUSIONS LMV may be a feasible and safe tool to be integrated into traditional and conventional neurorehabilitation programs for post-stroke patients to reduce spasticity. Analysis of the available clinical trials do not allow us to indicate vibration therapy as effective in functional motor recovery, despite some studies showed encouraging results. Further studies, with larger size of homogeneous patients and with a shared methodology are needed to produce more reliable data, especially on the lower limb.
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Affiliation(s)
- Christian Avvantaggiato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy.,Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy
| | - Roberto Casale
- OPUS Medica Persons, Care and Research (PC&R), Piacenza, Italy
| | - Nicoletta Cinone
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Salvatore Facciorusso
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Antonio Turitto
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Lucia Stuppiello
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Alessandro Picelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Neuromotor and Cognitive Rehabilitation Research Center, University of Verona, Verona, Italy
| | - Maurizio Ranieri
- Department of Basic Sciences, Neuroscience and Sense Organs, Aldo Moro University, Bari, Italy
| | - Domenico Intiso
- Department of Neuro-Rehabilitation IRCCS, Casa Sollievo della Sofferenza Research Hospital, San Giovanni Rotondo, Foggia, Italy
| | - Pietro Fiore
- Istituti Clinici Scientifici Maugeri, IRCCS Institute of Bari, Bari, Italy.,Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Chiara Ciritella
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy
| | - Andrea Santamato
- Unit of Spasticity and Movement Disorders, Division of Physical Medicine and Rehabilitation, University Hospital of Foggia, Foggia, Italy -
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22
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Contemori S, Dieni CV, Sullivan JA, Ferraresi A, Occhigrossi C, Calabrese F, Pettorossi VE, Biscarini A, Panichi R. Sensory inflow manipulation induces learning-like phenomena in motor behavior. Eur J Appl Physiol 2020; 120:811-828. [PMID: 32062702 DOI: 10.1007/s00421-020-04320-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 02/07/2020] [Indexed: 12/26/2022]
Abstract
PURPOSE Perceptual and goal-directed behaviors may be improved by repetitive sensory stimulations without practice-based training. Focal muscle vibration (f-MV) modulating the spatiotemporal properties of proprioceptive inflow is well-suited to investigate the effectiveness of sensory stimulation in influencing motor outcomes. Thus, in this study, we verified whether optimized f-MV stimulation patterns might affect motor control of upper limb movements. METHODS To answer this question, we vibrated the slightly tonically contracted anterior deltoid (AD), posterior deltoid (PD), and pectoralis major muscles in different combinations in forty healthy subjects at a frequency of 100 Hz for 10 min in single or repetitive administrations. We evaluated the vibration effect immediately after f-MV application on upper limb targeted movements tasks, and one week later. We assessed target accuracy, movement mean and peak speed, and normalized Jerk using a 3D optoelectronic motion capture system. Besides, we evaluated AD and PD activity during the tasks using wireless electromyography. RESULTS We found that f-MV may induce increases (p < 0.05) in movement accuracy, mean speed and smoothness, and changes (p < 0.05) in the electromyographic activity. The main effects of f-MV occurred overtime after repetitive vibration of the AD and PD muscles. CONCLUSION Thus, in healthy subjects, optimized f-MV stimulation patterns might over time affect the motor control of the upper limb movement. This finding implies that f-MV may improve the individual's ability to produce expected motor outcomes and suggests that it may be used to boost motor skills and learning during training and to support functional recovery in rehabilitation.
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Affiliation(s)
- Samuele Contemori
- School of Human Movement and Nutrition Sciences, Centre for Sensorimotor Performance, The University of Queensland, Brisbane, Australia
| | - Cristina V Dieni
- Department of Ophthalmology, University of Alabama At Birmingham, Birmingham, AL, 35294, USA
| | | | - Aldo Ferraresi
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy
| | - Chiara Occhigrossi
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy
| | - Francesco Calabrese
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy
| | - Vito E Pettorossi
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy
| | - Andrea Biscarini
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy
| | - Roberto Panichi
- Department of Experimental Medicine, Section of Physiology and Biochemistry, University of Perugia, Via Gambuli 1, 06132, Perugia, Italy.
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23
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Effects of focal vibration on power and work in multiple wingate tests. Biol Sport 2019; 37:25-31. [PMID: 32205907 PMCID: PMC7075225 DOI: 10.5114/biolsport.2020.89938] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/14/2019] [Accepted: 10/17/2019] [Indexed: 12/27/2022] Open
Abstract
The aim of the study was to assess the effects of a specific protocol, based on a focal muscle vibration, on mechanical parameters in an exercise composed of five repeated bouts of sprint interval tests (Wingate Anaerobic Tests, 10 seconds duration). Twenty-eight young male healthy subjects were randomized to two groups (VIB and CTRL). Peak power (PP), average peak between bouts (aP) and total exercise work (TW) were measured. In both groups, three different exercise sessions were carried out, interspersed by seven days: T0, T1 and T2. Between the baseline (T0) and T1, in the VIB group the intervention was administered on three successive days on quadriceps muscles, whereas a placebo administration was carried out in the CTRL group at the same time. At T1 (30 minutes after intervention) and T2 (7 days after) CTRL did not show any significant change, whereas VIB showed significant increases in PP (11.4%–9.3%), aP (6.6%–6.9%) and TW (5.7%–7.9%) with respect to T0. The results could be explained by an ameliorative agonist-antagonist balance, and this hypothesis is coherent with the literature. On the basis of the present findings, the investigated intervention might be usefully adopted to increase muscular power and endurance.
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24
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Lucente G, Valls-Sole J, Murillo N, Rothwell J, Coll J, Davalos A, Kumru H. Noninvasive Brain Stimulation and Noninvasive Peripheral Stimulation for Neglect Syndrome Following Acquired Brain Injury. Neuromodulation 2019; 23:312-323. [PMID: 31725939 DOI: 10.1111/ner.13062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 07/10/2019] [Accepted: 09/10/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Hemispatial neglect is a frequent condition usually following nondominant hemispheric brain injury. It strongly affects rehabilitation strategies and everyday life activities. It is associated with behavioral and cognitive disability with a strong impact on patient's life. METHODS We reviewed the published literature on the use of noninvasive brain stimulation, including repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), and of noninvasive peripheral muscle stimulation, as therapeutic strategies for rehabilitation of neglect after acquired brain injury, such as in stroke or in traumatic injuries. The studies were grouped as controlled or uncontrolled studies in each stimulation techniques. RESULTS Thirty-four studies were identified and 16 on rTMS, 10 on tDCS, and 8 on vibration. All studies were conducted in adult patients who suffered a stroke, except for one that was conducted in a patient suffering traumatic acquired brain injury and another that was conducted in a patient with brain tumor. In spite of significant variability in treatment protocols, patients' features and assessment of neglect, improvement was reported in almost all studies with no side-effects. CONCLUSIONS Noninvasive brain stimulation and neuromuscular vibration are promising therapeutic neuromodulatory approaches for neglect. Further randomized-controlled studies are needed to corroborate their effectiveness as separate and combined techniques.
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Affiliation(s)
- Giuseppe Lucente
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Josep Valls-Sole
- EMG Department, Hospital Clinic, Carrer de Villarroel, 170, 08036 Barcelona, Spain
| | - Narda Murillo
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
| | - John Rothwell
- Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, University College London, London, UK
| | - Jaume Coll
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Grup de Recerca en Malalties Neuromusculars i Neuropediatriques, Department of Neurosciences, Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Antoni Davalos
- Department of Neuroscience, Hospital Germans Trias i Pujol, Badalona, Spain.,Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain
| | - Hatice Kumru
- Medicine Department, Universitat Autonoma de Barcelona, 08193, Bellaterra (Cerdanyola del Vallès), Spain.,Fundación Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, 08916, Badalona, Spain
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25
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Influence of focal vibration over Achilles tendon on the activation of sensorimotor cortex in healthy subjects and subacute stroke patients. Neuroreport 2019; 30:1081-1086. [PMID: 31503206 DOI: 10.1097/wnr.0000000000001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The modulation of cerebral activity could induce plastic changes in the cerebral cortex and contribute to motor rehabilitation. Focal vibration over lower-extremity muscles has therapeutic effects on the impaired motor function for stroke patients, but the modulatory effects of focal vibration on brain activity are less known. To explore this problem, this experiment was designed and conducted, in which focal vibration (75 Hz) was applied over the right Achilles tendon of 14 healthy subjects and the affected Achilles tendon of seven subacute stroke patients. Electroencephalography was recorded in the following phases: resting-state and three focal vibration sessions. Electroencephalographical analysis showed a significantly desynchronized power of contralateral primary sensorimotor cortex (S1-M1) in beta1 band (13-18 Hz) following all focal vibration sessions occurred in healthy subjects compared to resting-state, whereas a significantly desynchronized power of bilateral S1-M1 in the beta1 and beta2 band (18-21 Hz) was observed in stroke patients compared to resting-state. Besides, event-related power desynchronization of bilateral S1-M1 in stroke patients was significantly lower than healthy subjects in the beta2 and beta3 band (21-30 Hz) during focal vibration sessions. These results demonstrated that focal vibration over Achilles tendon could activate bilateral S1-M1 in stroke patients, which was different in healthy subjects. These indications contribute to a better understanding of the underlying mechanism of focal vibration on stroke rehabilitation.
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26
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Li W, Li C, Xiang Y, Ji L, Hu H, Liu Y. Study of the activation in sensorimotor cortex and topological properties of functional brain network following focal vibration on healthy subjects and subacute stroke patients: An EEG study. Brain Res 2019; 1722:146338. [PMID: 31323197 DOI: 10.1016/j.brainres.2019.146338] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/12/2019] [Accepted: 07/15/2019] [Indexed: 12/16/2022]
Abstract
Modulation on cerebral cortex and cerebral networks can induce reorganization of the brain, which contributes to rehabilitation. Previous studies have proved that focal vibration (FV) on limb muscles can modulate the activities of sensorimotor cortex in healthy subjects (HS). The objective of this paper is to study the modulatory effects of FV on the sensorimotor cortex and cerebral network in HS and subacute stroke patients (SP). An experiment was designed and conducted, during which FV of 75 Hz was applied over biceps muscle of right limb of 10 HS and 10 SP with right hemiplegia. Electroencephalography (EEG) was recorded in the following phases: before FV, control condition and three sessions of FV. EEG analysis showed a significant decrease in motor-related power desynchronization (MRPD) of contralesional primary sensorimotor cortex (contralesional S1-M1) in the beta2 band (18-21 Hz) for SP during FV sessions, as well as in MRPD of bilateral S1-M1 in the beta1 (13-18 Hz) and the beta2 band for HS. Moreover, MRPD of contralesional S1-M1 was significantly lower than MRPD of ipsilesional S1-M1 during FV. Besides, a significant increase of global efficiency (E) and decrease of characteristic path length (L) were identified in the beta1 band for SP, whereas a significant increase of L was identified for HS. The results indicated that FV could enhance the excitability of contralesional S1-M1 and alter topological properties of functional brain network for SP, which was different in HS. This indication can contribute to understanding the modulatory effects of FV on cerebral cortex and cerebral network.
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Affiliation(s)
- Wei Li
- Division of Intelligent and Biomechanical System, State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China.
| | - Chong Li
- Division of Intelligent and Biomechanical System, State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China.
| | - Yun Xiang
- Department of Rehabilitation Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, China
| | - Linhong Ji
- Division of Intelligent and Biomechanical System, State Key Laboratory of Tribology, Department of Mechanical Engineering, Tsinghua University, Haidian, Beijing, China.
| | - Hui Hu
- Department of Rehabilitation Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, China
| | - Yali Liu
- Department of Mechanical and Electrical Engineering, Beijing Institute of Technology, Haidian, Beijing, China
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27
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Pin TW, Butler PB, Purves S, Poon NCK. Feasibility of Whole Body Vibration Therapy in Individuals with Dystonic or Spastic Dystonic Cerebral Palsy: A Pilot Study. JOURNAL OF REHABILITATION MEDICINE - CLINICAL COMMUNICATIONS 2019; 2:1000021. [PMID: 33884122 PMCID: PMC8008730 DOI: 10.2340/20030711-1000021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/11/2019] [Indexed: 11/25/2022]
Abstract
Objective To examine the feasibility and practicality of whole body vibration therapy for individuals with dystonic or spastic dystonic cerebral palsy. Design Pilot study. Subjects Children and adults with dystonic or spastic dystonic cerebral palsy. Methods Study participants received total body vibration therapy when standing still on a vibration platform for 3 bouts, duration 3-min, of vibration (20 Hz, 2 mm amplitude), 4 days per week for 4 weeks in addition to their usual therapy. All participants were assessed at baseline and completion of the study using the Gross Motor Function Measure Item Set, Timed Up and Go test, Barry-Albright Dystonia Scale, Edinburgh Visual Gait Score, and Pediatric Evaluation of Disability Inventory. Results Ten participants (mean age 18.60 years (standard deviation (SD) 14.68); 9 males, Gross Motor Function Classification System level II-IV) completed the study with more than 90% attendance rate. All participants tolerated the protocol with no adverse events. Conclusion The vibration treatment protocol was feasible and safe for all participants. With no significant differences found in all the outcome measures, future studies with more rigorous study designs are required before this intervention is recommended for this population group.
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Affiliation(s)
- Tamis W Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | - Sheila Purves
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Nathan C-K Poon
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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28
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Škola F, Tinková S, Liarokapis F. Progressive Training for Motor Imagery Brain-Computer Interfaces Using Gamification and Virtual Reality Embodiment. Front Hum Neurosci 2019; 13:329. [PMID: 31616269 PMCID: PMC6775193 DOI: 10.3389/fnhum.2019.00329] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/06/2019] [Indexed: 12/28/2022] Open
Abstract
This paper presents a gamified motor imagery brain-computer interface (MI-BCI) training in immersive virtual reality. The aim of the proposed training method is to increase engagement, attention, and motivation in co-adaptive event-driven MI-BCI training. This was achieved using gamification, progressive increase of the training pace, and virtual reality design reinforcing body ownership transfer (embodiment) into the avatar. From the 20 healthy participants performing 6 runs of 2-class MI-BCI training (left/right hand), 19 were trained for a basic level of MI-BCI operation, with average peak accuracy in the session = 75.84%. This confirms the proposed training method succeeded in improvement of the MI-BCI skills; moreover, participants were leaving the session in high positive affect. Although the performance was not directly correlated to the degree of embodiment, subjective magnitude of the body ownership transfer illusion correlated with the ability to modulate the sensorimotor rhythm.
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Affiliation(s)
- Filip Škola
- Faculty of Informatics, Masaryk University, Brno, Czechia
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29
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Effects of Focal Vibration over Upper Limb Muscles on the Activation of Sensorimotor Cortex Network: An EEG Study. JOURNAL OF HEALTHCARE ENGINEERING 2019; 2019:9167028. [PMID: 31263527 PMCID: PMC6556786 DOI: 10.1155/2019/9167028] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 04/08/2019] [Accepted: 05/12/2019] [Indexed: 12/19/2022]
Abstract
Studying the therapeutic effects of focal vibration (FV) in neurorehabilitation is the focus of current research. However, it is still not fully understood how FV on upper limb muscles affects the sensorimotor cortex in healthy subjects. To explore this problem, this experiment was designed and conducted, in which FV was applied to the muscle belly of biceps brachii in the left arm. During the experiment, electroencephalography (EEG) was recorded in the following three phases: before FV, during FV, and two minutes after FV. During FV, a significant lower relative power at C3 and C4 electrodes and a significant higher connection strength between five channel pairs (Cz-FC1, Cz-C3, Cz-CP6, C4-FC6, and FC6-CP2) in the alpha band were observed compared to those before FV. After FV, the relative power at C4 in the beta band showed a significant increase compared to its value before FV. The changes of the relative power at C4 in the alpha band had a negative correlation with the relative power of the beta band during FV and with that after FV. The results showed that FV on upper limb muscles could activate the bilateral primary somatosensory cortex and strengthen functional connectivity of the ipsilateral central area (FC1, C3, and Cz) and contralateral central area (CP2, Cz, C4, FC6, and CP6). These results contribute to understanding the effect of FV over upper limb muscles on the brain cortical network.
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30
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Pin TW, Butler PB, Purves S. Use of whole body vibration therapy in individuals with moderate severity of cerebral palsy- a feasibility study. BMC Neurol 2019; 19:80. [PMID: 31043157 PMCID: PMC6495512 DOI: 10.1186/s12883-019-1307-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 04/15/2019] [Indexed: 01/08/2023] Open
Abstract
Background This pilot study was to examine the feasibility and tolerance of whole body vibration therapy (WBVT) for children and adults with moderate severity of cerebral palsy (CP) being graded as levels III or IV on the Gross Motor Function Classification Scale (GMFCS). Methods Study participants received the additional WBVT when standing still on the vibration platform for three 3-min bouts of vibration (20 Hz, 2 mm amplitude), 4 days per week for 4 weeks. In addition to questions relating to feasibility and participants’ opinions, assessment at baseline and completion of the intervention included the Gross Motor Function Measure-66 Item Set (GMFM-66 IS), 2-min walk test (2MWT), Timed Up and Go test (TUG) and Pediatric Evaluation of Disability Inventory (PEDI). Wilcoxon Signed Ranks test was used to compare the results. Results Fourteen participants (mean age = 25.25 years SD 3.71; 9 males, 64%; GMFCS level III n = 13, 92%) were recruited and completed the study. The attendance rate was over 90% with no adverse events. All participants tolerated the protocol which was satisfactorily delivered in a clinical setting. Conclusions The present WBVT protocol was feasible, safe and well-tolerated by the participants with moderate severity of CP, justifying future studies with larger samples and more rigorous study design. Trial registration The present study has been registered under the ClinicalTrials.gov (NCT03375736) and the date of registration commenced on 18 December 2017.
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Affiliation(s)
- Tamis W Pin
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
| | | | - Sheila Purves
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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31
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Shu X, Chen S, Meng J, Yao L, Sheng X, Jia J, Farina D, Zhu X. Tactile Stimulation Improves Sensorimotor Rhythm-based BCI Performance in Stroke Patients. IEEE Trans Biomed Eng 2018; 66:1987-1995. [PMID: 30452349 DOI: 10.1109/tbme.2018.2882075] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE BCI decoding accuracy plays a crucial role in practical applications. With accurate feedback, BCI-based therapy determines beneficial neural plasticity in stroke patients. In this study, we aimed at improving sensorimotor rhythm (SMR)-based BCI performance by integrating motor tasks with tactile stimulation. METHODS Eleven stroke patients were recruited for three experimental conditions, i.e., motor attempt (MA) condition, tactile stimulation (TS) condition, and tactile stimulation-assisted motor attempt (TS-MA) condition. Tactile stimulation was delivered to the paretic hand wrist during both task and idle states using a DC vibrator. RESULTS We observed that the TS-MA condition achieved greater motor-related cortical activation (MRCA) in alpha-beta band when compared with both TS and MA conditions. Consequently, online BCI decoding accuracies between task and idle states were significantly improved from 74.5% in the MA condition to 85.1% in the TS-MA condition (p < 0.001), whereas the accuracy in the TS condition was 54.6% (approaching to the chance level of 50%). CONCLUSION This finding demonstrates that sensory afferent from peripheral nerves benefits the neural process of sensorimotor cortex in stroke patients. With appropriate sensory stimulation, MRCA is enhanced and corresponding brain patterns are more discriminative. SIGNIFICANCE This novel SMR-BCI paradigm shows great promise to facilitate the practical application of BCI-based stroke rehabilitation.
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32
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Schirinzi T, Romano A, Favetta M, Sancesario A, Burattini R, Summa S, Della Bella G, Castelli E, Bertini E, Petrarca M, Vasco G. Non-invasive Focal Mechanical Vibrations Delivered by Wearable Devices: An Open-Label Pilot Study in Childhood Ataxia. Front Neurol 2018; 9:849. [PMID: 30356679 PMCID: PMC6189288 DOI: 10.3389/fneur.2018.00849] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/21/2018] [Indexed: 11/13/2022] Open
Abstract
Non-invasive focal mechanical vibrations (NIFMV) now represent a strategy of increasing interest to improve motor control in different neurological diseases. Nanotechnology allowed the creation of wearable devices transforming thermal variations into mechanical energy with focal vibrations. This kind of wearable stimulators (WS) has produced encouraging preliminary results when used in the treatment of movement disorders and ataxia in adults. In this open label pilot study we first evaluated the feasibility, safety and effectiveness of NIFMV by WS in a cohort of 10 patients with childhood ataxia, a phenomenological category including different conditions still lacking of effective symptomatic therapies. Through the assessment of both clinical rating scales and spatio-temporal gait parameters via standardized gait analysis, we observed that a 4 weeks long treatment with WS Equistasi® was safe and provided significantly different effects in stride features of patients with slow/non-progressive cerebellar ataxia and Friedreich's Ataxia. Although limited by the sample size, the absence of a placebo-controlled group, the poor compliance of enrolled population to the original experimental design and the partial accuracy of outcome measures in pediatric subjects, we suggest that NIFMV by WS could support locomotion of patients with childhood slow/non-progressive cerebellar ataxia with preserved sensory system and no signs of peripheral neuropathy. Future studies are definitely necessary to confirm these preliminary results and define criteria for successful NIFMV-based treatment
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Affiliation(s)
- Tommaso Schirinzi
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Alberto Romano
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Martina Favetta
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Andrea Sancesario
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy.,Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy
| | - Riccardo Burattini
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Susanna Summa
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Enrico Castelli
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Enrico Bertini
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Maurizio Petrarca
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
| | - Gessica Vasco
- Department of Neurosciences, Bambino Gesù Children's Hospital, Rome, Italy
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