Focal Vibration for Upper Limb Rehabilitation After Stroke

Abstract

Stroke is the fifth leading cause of death and a leading cause of disability in the state of Oklahoma and the United States. Although there are several approaches to stroke rehabilitation, most stroke survivors live with upper limb impairments, which causes difficulties for independent living and social participation. One promising method for rehabilitation of the upper limb following stroke is focal muscle vibration, thought to work by activating the Ia afferent muscle spindle fibers for somatosensory and motor cortex stimulation. In this thesis, I describe the development of a novel wearable focal vibration device, called FoVi. Then, I report the findings from a pilot study of the feasibility and efficacy of the FoVi device in a short-term intervention. The FoVi device was developed according to design criteria specified through a focus group, including being comfortable and easy to use, having vibration motor pods controlled by an app on the user’s smartphone, and recording usage logs for real-time communication with therapists. Short-term interventions with FoVi show promise in increasing upper limb mobility and function, evidenced through non-significant increases in Fugl-Meyer Upper Extremity score, Chedoke Arm- Hand Activity Inventory score, and grip strength. In conclusion, the FoVi device could be a helpful treatment method in stroke rehabilitation, and future long-term intervention studies with larger sample sizes and more robust outcome measures may show significant improvements in upper limb function. Combination with other treatment modalities, such as transcranial direct current stimulation, may enable a more effective treatment of the upper limb in stroke patients.