Relief of post-stroke spasticity with acute vibrotactile stimulation: controlled crossover study of muscle and skin stimulus methods

Frontiers in Human Neuroscience

Human Neuroscience

Bingxian Chen¹  Chuzhang Han²  Laura Song Wu²  David Vacek²  Caitlyn Seim²  Allison Okamura²  Maarten Lansberg³ 

[1] Stanford University Department of Bioengineering, Stanford, CA, United States;Stanford University Department of Mechanical Engineering, Stanford, CA, United States;Stanford University Department of Neurology and Neurological Sciences, Stanford, CA, United States;

关键词: muscle spasticity;    vibration;    stimulation;    stroke;    stroke rehabilitation;   

DOI  :  10.3389/fnhum.2023.1206027

 received in 2023-04-14, accepted in 2023-08-02,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPrior work suggests that vibratory stimulation can reduce spasticity and hypertonia. It is unknown which of three predominant approaches (stimulation of the spastic muscle, antagonist muscle, or cutaneous regions) most reduces these symptoms.ObjectiveDetermine which vibrotactile stimulation approach is most effective at reducing spastic hypertonia among post-stroke patients.MethodsSham-controlled crossover study with random assignment of condition order in fourteen patients with post-stroke hand spasticity. All patients were studied in four conditions over four visits: three stimulation conditions and a sham control. The primary outcome measure was the Modified Ashworth Scale, and the secondary outcome measure was the Modified Tardieu Scale measured manually and using 3D motion capture. For each condition, measures of spastic hypertonia were taken at four time points: baseline, during stimulation, after stimulation was removed, and after a gripping exercise.ResultsA clinically meaningful difference in spastic hypertonia was found during and after cutaneous stimulation of the hand. Modified Ashworth and Modified Tardieu scores were reduced by a median of 1.1 (SD = 0.84, p = 0.001) and 0.75 (SD = 0.65, p = 0.003), respectively, during cutaneous stimulation, and by 1.25 (SD = 0.94, p = 0.001) and 0.71 (SD = 0.67, p = 0.003), respectively, at 15 min after cutaneous stimulation. Symptom reductions with spastic muscle stimulation and antagonist muscle stimulation were non-zero but not significant. There was no change with sham stimulation.ConclusionsCutaneous vibrotactile stimulation of the hand provides significant reductions in spastic hypertonia, compared to muscle stimulation.Clinical trial registrationwww.ClinicalTrials.gov, identifier: NCT03814889.

【 授权许可】

Unknown   
Copyright © 2023 Seim, Chen, Han, Vacek, Wu, Lansberg and Okamura.