The vibratory stimulus as a neurorehabilitation tool for stroke patients: proof of concept and tolerability test.
BACKGROUND
Current scientific knowledge reinforces that successful reorganization of surviving nervous tissue supports cognitive and motor recovery after stroke. The development of new neurorehabilitation tools to modulate this physiologic process is needed. In this context, vibratory stimuli are a noninvasive form of proprioceptive stimulation of the nervous system and are freely available and easy to use at a low cost.


OBJECTIVE
To access the feasibility and tolerability of targeted vibratory stimuli delivered through a wearable device in an early post-stroke setting.


METHODS
Five stroke patients were recruited from a stroke unit setting having a first ever medial cerebral artery ischemic stroke with motor deficit. The stimulation device developed delivered external vibratory stimuli to major joints at preprogrammed arrays of intensity, duration and interval of actuation. The tolerability test was set for five-hour duration and during that period data on vital parameters, cognitive, motor and sensitive performance as well as anxiety scores were recorded.


RESULTS
The device remained in place throughout and none of the patients or relatives asked to interrupt the tolerability test. There were no major complications during the trial or the ensuing days. Attention to the affected side during stimulation was increased in four patients, and two were reported as clearly more awake during the test.


CONCLUSIONS
This is the first tolerability test focused on the use of targeted vibratory stimulus as a neurorehabilitation tool in stroke patients. There were no hazards to report and most interestingly the majority of patients showed increased awareness to the affected side of the body. These findings will be further analyzed under functional MRI control and on long-term ambulatory use trials.
Institute of Electronics and Telematics Engineering of Aveiro, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.
Virgílio F
VF
Bento
Vítor Tedim
VT
Cruz
David D
DD
Ribeiro
João P
JP
Cunha
D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000294:innervation; D002536:Cerebral Arteries / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000534:rehabilitation*; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014732:Vibration / Q000627:therapeutic use*; D014955:Wrist Joint / Q000294:innervation