Effectiveness of Proprioceptive Body Vibration Rehabilitation on Motor Function and Activities of Daily Living in Stroke Patients with Impaired Sensory Function

Didn't your competent? doctor already incorporate vibration therapy into your recovery? Or don't you have a competent doctor for the past decade?

• focal muscle vibration (4 posts to May2020)

• vibration (31 posts to February 2011)

• Whole Body Vibration Therapy (6 posts to January 2016)

Effectiveness of Proprioceptive Body Vibration Rehabilitation on Motor Function and Activities of Daily Living in Stroke Patients with Impaired Sensory Function 

by

Hyunsik Yoon

^1,2 and

Chanhee Park

^2,*

¹

Chungnam National University Hospital, Daejeon 35015, Republic of Korea

²

Department of Physical Therapy, Yonsei University, Wonju 26493, Republic of Korea

^*

Author to whom correspondence should be addressed.

Healthcare 2024, 12(1), 35; https://doi.org/10.3390/healthcare12010035

Submission received: 18 November 2023 / Revised: 14 December 2023 / Accepted: 21 December 2023 / Published: 23 December 2023

(This article belongs to the Special Issue New Approaches in Invasive and Non-invasive Rehabilitation: From Basic Science to Clinical Intervention)

Download keyboard_arrow_down Review Reports Versions Notes

Abstract

Stroke patients experience impaired sensory and motor functions, which impact their activities of daily living (ADL). The current study was designed to determine the best neurorehabilitation method to improve clinical outcomes, including the trunk-impairment scale (TIS), Berg balance scale (BBS), Fugl-Meyer assessment (FMA), and modified Barthel index (MBI), in stroke patients with impaired sensory function. Forty-four stroke survivors consistently underwent proprioceptive body vibration rehabilitation training (PBVT) or conventional physical therapy (CPT) for 30 min/session, 5 days a week for 8 weeks. Four clinical outcome variables–the FMA, TIS, BBS, and MBI–were examined pre- and post-intervention. We observed significant differences in the FMA, BBS, and MBI scores between the PBVT and CPT groups. PBVT and CPT showed significant improvements in FMA, BBS, TIS, and MBI scores. However, PVBT elicited more favorable results than CPT in patients with stroke and impaired sensory function. Collectively, this study provides the first clinical evidence of optimal neurorehabilitation in stroke patients with impaired sensory function.

Keywords:

stroke; somatosensory evoked potential; balance; ADL; proprioceptive body vibration training

1. Introduction

The human brain is constantly changing throughout life, and neurological conditions, such as stroke, are especially sensitive to this type of neuroplasticity [1,2,3]. Hemiparesis of the contralateral upper limb is the most prevalent impairment following stroke, affecting over 80% of patients with stroke immediately and over 40% chronically [4]. Stroke is a common impairment of sensory and motor function and activities of daily living (ADL) following a cerebrovascular accident. Additionally, stroke rehabilitation is a development that helps stroke victims with disabilities return to their regular lives and resume activities of daily living through a motor learning process [1,3]. The human brain can continue reorganizing in response to interventions that affect motor function recovery years after an initial stroke impairment [5]. Following a stroke, deficits in somatic sensations, such as touch, warmth, pain, and proprioception, are frequent, with estimated prevalence rates as high as 11–85% [2,3]. Abnormal synergy, including dystonia, spasticity, rigidity, aberrant muscular stress, and muscle weakness, are common problems that accompany a stroke. These impairments impair gait and balance, in addition to restricting daily activities. Functionally, motor issues arising from sensory deficits post-stroke can be summed up as follows: (1) reduced sensory information detection; (2) disrupted execution of somatosensory motor tasks; and (3) limited extremity rehabilitation [6]. Muscle contraction or weakness, alterations in joint laxity and muscle tone, and poor motor control are typical signs of motor impairment [7]. Disabilities in routine tasks, like reaching, picking up, and holding objects, are caused by these impairments. Motor impairments could be associated with additional neurological symptoms that impede the restoration of motor function and require targeted physical therapeutic intervention. Post-stroke deficits in ADL, including personal hygiene, bathing, feeding, toilet use, stair climbing, dressing, and ambulation rates, have been shown to range from 11 to 85% [8].

Conventional physical therapy (CPT) has been widely utilized in patients with stroke to improve sensory and motor functions and ADL, with variable outcomes reported [9]. Additionally, it tries to help patients comprehend their situation better, cope with the challenges brought on by their disability, and avoid secondary consequences. The CPT involved a number of manual interventions through key control points (trunk, pelvis, shoulder, hip, and head). Facilitation and assistance techniques have been used to support muscle activity as well as inhibition to maintain and control movement and posture [10,11]. The CPT was carried out in sitting and standing, supine, and side-lying positions. The focus was on the shoulder and pelvic patterns, as well as their combinations in the rotation trajectory. Chopping, lifting, and rotation of the upper and lower trunk are used in work with the trunk. Stabilization and balance exercises were carried out on a kinesiotherapy couch and rehabilitation ball [12].

Pumprasart et al. demonstrated that CPT could improve tactile sensation (2%) and proprioception (8%) for six weeks in 26 patients with stroke when compared with pretreatment [13]. Vliet et al. reported that CPT improved gross motor function (3%) and ADL (6%) for six months in 120 patients with stroke when compared with movement science therapy [14]. However, the CPT failed to show statistically significant differences in gross motor function, ADL, and sensory function. These inconsistent findings could be attributed to a lack of proprioception and motivation.

Recently, vibration techniques have been employed, in addition to conventional physiotherapy and rehabilitation techniques, as a kind of treatment. We developed proprioceptive body vibration rehabilitation training (PBVT) to enable ADL and motor function in stroke patients with impaired sensory function by providing ample proprioceptive intensity (vibration) for voluntary sensory and muscle movement. PBVT platforms were created and are now often used to improve muscular function in adults and athletes of all ages [15,16]. These platforms may produce mechanical vibrations at various frequencies and magnitudes [17,18]. PBVT provides a systemic vibration stimulus on a platform, with vertical and horizontal oscillatory movement. Patients with stroke have shown significant improvement in muscular function, muscle strength or weakness, and gait function when using PBVT [17,18]. Standing or performing vigorous movements on a vibration platform set on a static surface is the focus of PBVT training. PBVT training was proposed as a possible strategy for enhancing physical functions in earlier research. Additionally, it was proposed that by boosting muscle strength, PBVT enhances muscle function and balance [17]. Several studies have documented that PBVT treatment enhances trunk balance via multiple pathways, such as motor unit activation, modification of the spinal moto neuronal pool’s excitability, and enhanced proprioception [19,20]. When a patient is positioned on the whole-body vibrator’s platform, PBVT therapy produces either a vertical oscillation or horizontal movement. Vibration stimulation is sent from the feet to the whole body through the platform’s contact surface. Consequently, it is anticipated that PBVT therapy will affect postural control by stimulating muscle group Ia and II afferents [21]. Additionally, by identifying muscle stretching and triggering a tonic vibration reflex, PBVT therapy can enhance proprioceptive function. Priplata et al. stated that vibration therapy is an effective way to increase proprioception and can lead to long-lasting postural improvement [22]. A recent study has shown the positive effects of task-oriented training combined with PBVT therapy on certain components of chronic stroke patients’ sitting balance when they are seated [23,24]. Despite the important clinical ramifications of PBVT in stroke with impaired sensory, its beneficial effects on ADL and motor function remain unknown. The primary aim was to ascertain the therapeutic effects of PBVT on ADL and motor function in stroke patients with impaired sensory function. The secondary purpose was to compare the effects of PBVT on trunk stability and static and dynamic balance in stroke patients with impaired sensory.

 

More at link.