What will it take to get from 'can induce' TO THIS PROTOCOL WILL GET YOU RECOVERED?
Do you really think your competent? doctor can get research going to answer that question? NO? So you don't have a functioning stroke doctor, do you? Your doctor is living on the failed status quo taught in medical school? RUN AWAY!
Vibration-Induced Illusory Movement Task Can Induce Functional Recovery in Patients With Subacute Stroke
Published: August 12, 2024
DOI: 10.7759/cureus.66667
Cite this article as: Yukawa Y, Higashi T, Minakuchi M, et al. (August 12, 2024) Vibration-Induced Illusory Movement Task Can Induce Functional Recovery in Patients With Subacute Stroke. Cureus 16(8): e66667. doi:10.7759/cureus.66667
Abstract
In recent years, mental practice (MP), which involves repetitive motor imagery (MI), has been applied in rehabilitation to actively enhance exercise performance. MP is a method that involves repetitive MI, consciously evoking the intentions and content of the exercise without actual exercise. Combining actual exercise with MP promotes the development of exercise skills. However, it is possible that the MI recall ability differs greatly between individuals, affecting the therapeutic effect.
In contrast, the vibration-induced illusory movement (VIM) task acts as a method to induce a motor illusion by somatosensory stimuli without actual motor. VIM, actual movement, and MI are thought to share a common neural basis in the brain.
Therefore, it was hypothesized that the VIM task would complement the differences in MI recall in individual patients with hemiplegic stroke and may be a new treatment to enhance MI recall. Accordingly, in this study, we investigated the therapeutic effects of the VIM task in patients with hemiplegic stroke.
In Study I, the therapeutic effect of the VIM task in 14 patients with post-stroke hemiplegia was evaluated by motor function assessment. In Study II, treatment effects were investigated by examining the ability of the same group of patients to recall MI and by neurophysiological examination of the electroencephalogram (EEG) during MI recall in four patients who consented to the study. Motor function and MI were assessed four times: before the intervention, after occupational therapy, after the VIM task (which used the motor illusion induced by tendon vibration), and one month after acceptance of therapy. Compared with occupational therapy, the VIM task showed a statistically significant improvement in upper limb function and MI ability. In addition, we found an increase in event-related desynchronization intensity during MI in the affected hemisphere only after the VIM task.
It is possible that the VIM task facilitates motor function and MI. VIM task implementation of MI recall variability between individuals, which is a problem in mental practice, possible to increase the effectiveness of the brain-machine interface.
Introduction
In recent years, mental practice (MP), which involves repetitive motor imagery (MI), has been applied in rehabilitation to actively enhance exercise performance [1]. MP is a method that involves repetitive MI, consciously evoking the intentions and content of the exercise without actual exercise. Combining actual exercise with MP promotes the development of exercise skills [2]. However, there are reports that the treatment effects of MP are not allowed [3], that it is limited [4], and that it is currently not possible to have a consistent treatment effect. Several studies have reported differences in the recall ability of experienced and inexperienced MI in the sports field [5], differences in MI reminiscence ability due to age [6], and reduced MI reminiscence ability due to stroke [7]. It is possible that the recall ability differs greatly between individuals, affecting the therapeutic effect.
The vibration-induced illusory movement (VIM) task acts as a method to induce a motor illusion by somatosensory stimuli without actual motor [8]. The mechanism of the VIM task involves applying vibratory stimuli of approximately 80 Hz to tendons to excite muscle spindles (Ia afferent fibers) [9] and type II afferent sensory fibers in the skeletal muscle [10]. Consequently, the central nervous system interprets this input as muscle stretching, thereby creating the illusion of joint movement [11]. Naito et al. [12] examined brain activity during VIM tasks using functional magnetic resonance imaging (fMRI). The results indicated that kinesthetic illusory movement is experienced during vibratory tendon stimulation and this illusion activates motor-related areas, such as the primary motor cortex, primary somatosensory cortex (area 3a), dorsal premotor area, supplementary motor area, cingulate motor area, and ipsilateral cerebellum, on the opposite side of the stimulation, and that these activities correspond to the somatotopical sections. In our previous study [13], we used functional near-infrared spectroscopy to measure brain activity during a VIM task on the flexor carpi radialis tendon of the paralyzed limb in eight patients with hemiplegic stroke. Patients with mild sensory impairment were able to perceive VIM and showed significantly increased blood flow in motor-related areas, including the bilateral or contralateral primary sensory-motor cortices. In a study investigating the relationship between the VIM task and MI, motor-related areas were commonly activated when perceiving the VIM of palm dorsiflexion of the right wrist joint by vibration stimulation and when recalling the MI of one’s own palm dorsiflexion movement of the right wrist joint [14]. Similar motor-related regions are reportedly active during MI and actual exercise [15]. Therefore, actual movement, MI, and VIM are thought to share a common neural basis in the brain.
Accordingly, in this study, we investigated the therapeutic effects of the VIM task in patients with hemiplegic stroke using motor function assessment in Study I and assessment of MI recall ability and neurophysiological assessment during MI recall in Study II.
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