Effectiveness of a rehabilitation program involving functional proprioceptive stimulation for postural control and motor recovery among stroke patients: a double-blinded, randomized, controlled trial

Didn't your competent? doctor create a protocol on focal muscle vibration years ago? OH, you DON'T have a functioning stroke doctor, do you? Which means your board of directors is completely incompetent also! I'd fire everyone and reconstitute the hospital! I take no prisoners in getting stroke solved and will run over supposedly smart people in the process!

focal muscle vibration (9 posts to May 2020)

Effectiveness of a rehabilitation program involving functional proprioceptive stimulation for postural control and motor recovery among stroke patients: a double-blinded, randomized, controlled trial

• Agnieszka Wiśniowska-Szurlej,
• Justyna Leszczak,
• Justyna Brożonowicz,
• Gabriela Ciąpała,
• Héctor Hernández-Lázaro &
• Agnieszka Sozańska 

Journal of NeuroEngineering and Rehabilitation volume 22, Article number: 147 (2025) Cite this article

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Abstract

Background

Early and intensive rehabilitation is particularly important for increasing neuroplasticity in patients after stroke. The aim of this study was to evaluate the effects of a 4-week rehabilitation program involving functional proprioceptive stimulation (FPS) on postural control and functional recovery in patients with stroke.

Methods

This double-blinded, randomized controlled trial (RCT) was conducted at a tertiary care rehabilitation centre. Fifty patients with first stroke were recruited and randomly separated into a FPS Group (n = 25) or Sham Group (n = 25). Both groups underwent 3.5 h of rehabilitation, including physiotherapy, occupational therapy, verticalization and focal vibration on specific myotendinous junctions of the leg, for 5 days a week over 4 successive weeks. For the sham group, the focal vibrations had an amplitude of 0.1 mm with a fixed frequency of 40 Hz. For the FPS group, the stimulation consisted of focal vibrations of an amplitude of 2 mm with frequencies constantly changing between 40 and 85 Hz. Postural control evaluation was performed with the Berg Balance Scale (BBS), Functional Reach Test (FRT) and via the Alfa AC International East stabilometric platform; motor recovery was examined via the Barthel Index (BI) and ICF Rehabilitation Set. All assessments were performed at baseline and after intervention.

Results

Following the intervention, the FPS Group demonstrated clinically significant improvements in postural control and functional status (BBS p = 0.041 and BI p = 0.037). A statistically significant improvement was also obtained in the Sham Group in the FTR test. Patients in the FPS Group experienced significantly greater improvement than those in the Sham Group on D420 (transferring oneself) and D640 (performing housework activities).

Conclusions

Our study showed that conventional rehabilitation and rehabilitation combined with functional proprioceptive stimulation both improve balance and functional efficiency in people after.

Trial registration

The study was registered at ClinicalTrials.gov (NCT05550987).

Introduction

Stroke is a leading neurological disorder, affecting 15 million people globally each year a number expected to rise [1]. Poststroke disability is also increasing [2], with over 85% of survivors experiencing hemiplegia within 6–12 months, impairing mobility and independence [3]. Intensive rehabilitation during the acute phase of stroke can enhance spontaneous recovery [4] and actively stimulate neuroplasticity [5,6,7], thereby promoting more effective functional restoration. Optimal recovery, however, depends on a comprehensive assessment that integrates multiple dimensions of the patient’s condition including physical, psychological, environmental, social, and personal factors guided by the International Classification of Functioning, Disability and Health (ICF) framework.

The process of neuroplasticity involves molecular and cellular mechanisms that are responsible for the reconstruction of damaged neuronal networks [8]. This form of poststroke recovery involves axonal sprouting, tumorisation and strengthening of synapses, as well as compensatory mechanisms to restore lost functions [9]. The aim of early and intensive rehabilitation is to increase neuroplasticity in order to achieve better functional results [7]. Although several non-pharmacological methods are available to enhance the effects of therapy, such as electrotherapy, shockwave therapy, neuromodulation and stretching, evidence of their effectiveness is limited [10].

A promising and emerging method involves applying focal vibration near the muscle-tendon junction to elicit a kinaesthetic sensation of movement [11]. This type of stimulation is called functional proprioceptive stimulation (FPS). FPS activates muscle spindles, i.e., stretches receptors that signal changes in muscle length [12]. FPS at frequencies between 20 and 100 Hz induces a sensation of muscle stretching and causes the perception of movement [13]. It also increases the excitability of the sensorimotor cortex [14].

According to recent scientific reports, FPS has been shown to be safe, well tolerated, and easy to use. It can be an important complementary therapy for promoting motor recovery in patients who have recently had a stroke [15]. Wang et al. reported that vibration therapy effectively improves upper limb motor function in patients with subacute stroke. The effectiveness of sensory pathways is increased by the underlying mechanism of vibration, which reorganises and induces plastic changes in the motor and somatosensory cortex [16].

There is no consensus in the literature on the most effective rehabilitation protocol for improving the condition of poststroke patients. According to a review by Wang et al., further research is required to determine the optimal vibration parameters and dosage for FPS protocols in post-stroke patients [17].(Well fuck, write a provisional protocol on this you blithering idiots! So, we don't have repeated useless research on this done again!) Modern rehabilitation should incorporate both traditional methods and innovative technological solutions [18]. Therefore, it is crucial for specialists in clinical practice to identify the most effective rehabilitation method for helping poststroke patients regain lost function. Accordingly, the purpose of Dour study was to evaluate the effects of rehabilitati

on via functional proprioceptive stimulation, on top of conventional therapy, on postural control and functional performance in poststroke patients.

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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)

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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.

 

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Proprioceptive and Dual-Task Training: The Key of Stroke Rehabilitation, A Systematic Review

We don't need fucking lazy 'suggestions'.  We need recovery protocols created. GET THERE!

 Proprioceptive and Dual-Task Training: The Key of StrokeRehabilitation, A Systematic Review

w Rita Chiaramonte 1,* , Marco Bonfiglio 2 , Pierfrancesco Leonforte 1 , Giovanna Loriana Coltraro 3 , Claudia Savia Guerrera 1 and Michele Vecchio 1,3,* 1 Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, 95123 Catania, Italy; pierfra.leonforte@hotmail.it (P.L.); claguerre@hotmail.it (C.S.G.) 2 Provincial Health Department of Siracusa, 96014 Sicily, Italy; mrc.bnf@hotmail.it 3 Rehabilitation Unit, AOU Policlinico Vittorio Emanuele, 95123 Catania, Italy; loriana92ct@hotmail.it * Correspondence: ritachiaramd@gmail.com or uni213182@studium.unict.it (R.C.); michele.vecchio@unict.it (M.V.); Tel.: +39-(0)3782703 (M.V.); Fax: +39-0957315384 (R.C.) 

Abstract: 

 

This systematic review aims to reveal the effectiveness of proprioceptive exercise combined with dual-task training in stroke patients. The research was conducted using PubMed, Cochrane Library, Web of Science, and Scopus databases to evaluate studies of rehabilitation interventions with proprioceptive and dual-task exercises in patients with stroke. The keywords for the search were: “stroke” AND “proprioception” OR “proprioceptive” AND “rehabilitation” OR “training” OR “exercises” AND “dual-task” OR “task-performance” with the following inclusion criteria: comparative studies of rehabilitation interventions with proprioceptive and dual-task exercises in stroke patients. Of the 104,014 studies identified, 23 were included according to the inclusion criteria. Proprioceptive and dual-task exercises stimulate and promote postural balance, gait, and quality of life and reduce the risk of falls in stroke patients compared with traditional rehabilitation programs. In conclusion, this systematic review suggests that proprioceptive exercise combined with dual-task training is needed to improve balance and recover gait. Moreover, it provides a comprehensive overview of the literature on the various proprioceptive treatments with contextual dual-task exercises for imbalance after stroke, providing a guide for choosing a complete rehabilitation protocol(So where the fuck is that protocol you mention? You don't have one, do you?) that combines these two techniques. Keywords: stroke; task performance; rehabilitation; systematic review; proprioception.

Robot therapy for stroke survivors: proprioceptive training and regulation of assistance

 Pretty much useless research since it was done on chronic and survivors aren't on insurance anymore to pay for robotic stuff.

Robot therapy for stroke survivors: proprioceptive training and regulation of assistance

 Vittorio SANGUINETI a,1 , 

Maura CASADIO a,b, 

Elena VERGARO a, 

Valentina SQUERI a,b, 

Psiche GIANNONI c 

and Pietro G. MORASSO a,b
 
a  Department of Informatics, Systems and Telematics, University of Genoa, Genoa,  Italy
b  Italian Institute of Technology, Genoa, Italy
 
c  ART Education and Rehabilitation Center, Genoa, Italy
 

Abstract.

Robot therapy seems promising with stroke survivors, but it is unclear which exercises are most effective, and whether other pathologies may benefit from this technique. In general, exercises should exploit the adaptive nature of the nervous system, even in chronic patients. Ideally, exercise should involve multiple sensory modalities and, to promote active subject participation, the level of assistance should be kept to a minimum. Moreover, exercises should be tailored to the different degrees of impairment, and should adapt to changing performance. To this end, we designed three tasks: (i) a hitting task, aimed at improving the ability to perform extension movements; (ii) a tracking task, aimed at improving visuo-motor control; and (iii) a bimanual task, aimed at fostering inter-limb coordination. All exercises are conducted on a planar manipulandum with two degrees of freedom, and involve alternating blocks of exercises performed with and without vision. The degree of assistance is kept to a minimum, and adjusted to the changing subject’s performance. All three exercises were tested on chronic stroke survivors with different levels of impairment. During the course of each exercise, movements became faster, smoother, more precise, and required decreasing levels of assistive force. These results point to the potential benefit of that assist-as-needed training with a proprioceptive component in a variety of clinical conditions.
Keywords.
 Robot therapy, stroke, rehabilitation

Proprioceptive Based Training for stroke recovery. Proposal of new treatment modality for rehabilitation of upper limb in neurological diseases

I would love to have a proprioception protocol, mine is still off and I know of no way to recover it. Send your doctor after the actual exercises done.
Proprioceptive Based Training for stroke recovery. Proposal of new treatment modality for rehabilitation of upper limb in neurological diseases

The central nervous system (CNS) has plastic properties allowing its adaptation through development. These properties are still maintained in the adult age and potentially activated in case of brain lesion.

In the present study authors hypothesized that a significant recovery of voluntary muscle contraction in post stroke patients experiencing severe upper limb paresis can be obtained, when proprioceptive based stimulations are provided. Proprioceptive based training (PBT) is based on performing concurrent movements with both unaffected and affected arm, with the aim to foster motor recovery through some mutual connections of interhemispheric and transcallosal pathways.(With spasticity that is impossible! Where is the cure for spasticity? Leave no survivor behind!)

The aim of this pre-post pilot study was to evaluate the feasibility of PBT on recovery of voluntary muscle contraction in subacute phase after stroke.

Methods: The treatment lasted 1 h daily, 5 days per week for 3 weeks. The PBT consisted of multidirectional exercises executed synchronously with unaffected limb and verbal feedback.

The Medical Research Council scale (MRC), Dynamometer, Fugl-Meyer Upper Extremity scale (F-M UE), Functional Independence Measure scale (FIM) and modified Ashworth scale were administered at the beginning and at the end of training. Statistical significance was set at p < 0.05.

Results: Six patients with severe paresis of the upper limb within 6 months after stroke were enrolled in the study (5 ischemic and 1 hemorrhagic stroke, 3 men and 3 women, mean age 65.7 ± 8.7 years, mean distance from stroke 4.1 ± 1.5 months) and all of them well tolerated the training.

The clinical changes of voluntary muscle contraction after PBT were statistically significant at the MRC scale overall (p = 0.028), and dynamometer assessment overall (p = 0.028). Each patient improved muscle contraction of one or more muscles and in 4 out of 6 patients voluntary active movement emerged after therapy.

The functional outcomes (i.e. F-M UE and FIM) did not show significant change within group.

Conclusions: The findings of this preliminary research revealed that PBT may be a feasible intervention to improve the motricity of upper limb in stroke survivors.
Credits/Source: Archives of Physiotherapy 2015, 5:6