The Effect of Vibratory Stimulation on Tissue Compliance and Muscle Activity in Elbow Flexor Spasticity

Development and Preliminary Validation of a Pneumatic Focal Vibration System to the Mitigation of Post-Stroke Spasticity

Some evidence has demonstrated that focal vibration (FV) plays an important role in the mitigation of spasticity. However, the research on developing the FV system to mitigate the spasticity effectively has been seldom reported. To relieve post-stroke spasticity, a new pneumatic FV system has been proposed in this paper. An image processing approach, in which the edge of vibration actuator was identified by the Canny edge detector, was utilized to quantify this system's parameters: the frequency ranging from 44 Hz to 128 Hz and the corresponding amplitude. Taking one FV protocol with the frequency of 87 Hz and the amplitude 0.28 mm of this system as an example, a clinical experiment was carried out. In the clinical experiment, FV was applied over the muscle belly of the antagonist of spastic muscle for twelve chronic spastic stroke patients. Spasticity was quantified by the muscle compliance and area under the curve for muscle (AUC_muscle). The result has demonstrated that, in the state of flexion of spastic muscle, the AUC_muscle and muscle compliance of the spastic muscle significantly increased immediately after FV compared with before-FV, illustrating the mitigation of the spasticity. This study will not only provide a potential tool to relieve post-stroke spasticity, but also contribute to improving the sensory and motor function of patients with other neurological diseases, e.g. spinal cord injury, multiple sclerosis, Parkinson and dystonia, etc.

A study on the immediate effects of plantar vibration on balance dysfunction in patients with stroke

The aim of this study was to estimate the immediate effects of plantar vibration, applied to the more affected foot, on balance impairment in patients post-stroke. This pretest-posttest clinical study included 18 patients (13 men) poststroke; mean age 56.0±8.9 years (range, 41-71 years). One session of 5-min vibratory stimuli (frequency, 100 Hz) was applied to the plantar region of the more affected foot of all participants. The plantar vibration significantly improved the Timed UP and Go test (P=0.03, Cohen d=0.15), ankle plantar flexor muscle spasticity (P=0.008), and ankle passive range of motion (P<0.001, Cohen d=0.74). The posturography measures and Functional Reach Test did not improve significantly (P>0.05). Vibration stimuli applied to the plantar region of the more affected foot had significant effects on spasticity, ankle passive range of motion and dynamic balance as evaluated by the Timed Up and Go test in patients poststroke. There was no effect on static balance performance. Based on the results, the focal vibratory stimuli applied directly to the plantar region of the more affected foot may be recommended to improve the functional mobility and dynamic balance in patients with stroke.

Effect of whole-body vibration exercise in a sitting position prior to therapy on muscle tone and upper extremity function in stroke patients

[Purpose] The purpose of this study was to determine the effect of whole-body vibration exercise in a sitting position prior to therapy in stroke patients. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. Prior to occupational therapy, whole-body exercise was performed for 10 minutes, 5 times per week, for a total of 8 weeks. Muscle tone and upper extremity function were measured. The Modified Ashworth Scale (MAS) was used to measure muscle tone, and the Manual Function Test (MFT) and Fugl-Meyer Assessment scale (FugM) were used to measure upper extremity function. [Results] MAS score was significantly decreased, and MFT and FugM were significantly increased. [Conclusion] These results indicate that whole-body vibration exercise in a sitting position prior to therapy had a positive effect on muscle tone, and upper extremity function in stroke patients.

Upper limb function evaluation scales for individuals with cerebral palsy: a systematic review

[Purpose] The aim of the present study was to perform a systematic review of the literature on the scales and methods most often used for the evaluation of upper limb function in individuals with cerebral palsy. [Materials and Methods] Searches were conducted in the Medline, PEDro, Lilacs, Scielo, and PubMed databases. The following inclusion criteria were used for the selection of articles: randomized controlled study, evaluation of upper limb function in individuals with cerebral palsy, and publication between 2006 and 2014. The methodological quality of the articles was evaluated using the PEDro evidence scale. [Results] Five articles met the inclusion criteria and achieved 6 points or higher on the PEDro scale of methodological quality. [Conclusion] The studies analyzed used different evaluation scales, but no consensus has been reached thus far on which scale is the most appropriate. Thus, further studies are needed to establish an adequate method for the evaluation of upper limb function in individuals with cerebral palsy.