Retrospective study of effect of whole-body vibration training on balance and walking function in stroke patients

BACKGROUND Dysfunction in stroke patients has been a problem that we committed to solve and explore.Physical therapy has some effect to regain strength,balance,and coordination.However,it is not a complete cure,so we are trying to find more effective treatments.AIM To observe the effect of whole-body vibration training(WVT)on the recovery of balance and walking function in stroke patients,which could provide us some useful evidence for planning rehabilitation.METHODS The clinical data of 130 stroke participants who underwent conventional rehabilitation treatment in our hospital from January 2019 to August 2020 were retrospectively analyzed.The participants were divided into whole-body vibration training(WVT)group and non-WVT(NWVT)group according to whether they were given WVT.In the WVT group,routine rehabilitation therapy was combined with WVT by the Galileo Med L Plus vibration trainer at a frequency of 20 Hz and a vibration amplitude of 0+ACY-plusmn+ADs-5.2 mm,and in the NWVT group,routine rehabilitation therapy only was provided.The treatment course of the two groups was 4 wk.Before and after treatment,the Berg balance scale(BBS),3 m timed up-and-go test(TUGT),the maximum walking speed test(MWS),and upper limb functional reaching(FR)test were performed.RESULTS After 4 wk training,in both groups,the BBS score and the FR distance respectively increased to a certain amount(WVT=46.08±3.41 vs NWVT=40.22±3.75;WVT=20.48±2.23 vs NWVT=16.60±2.82),with P<0.05.Furthermore,in the WVT group,both BBS score and FR distance(BBS:18.32±2.18;FR:10.00±0.92)increased more than that in the NWVT group(BBS:13.29±1.66;FR:6.16±0.95),with P<0.05.Meanwhile,in both groups,the TUGT and the MWS were improved after training(WVT=32.64±3.81 vs NWVT=39.56±3.68;WVT=12.73±2.26 vs NWVT=15.04±2.27,respectively),with P<0.05.The change in the WVT group(TUGT:17.49±1.88;MWS:6.79±0.81)was greater than that in the NWVT group(TUGT:10.76±1.42;MWS:4.84±0.58),with P<0.05.CONCLUSION The WVT could effectively improve the balance and walking function in stroke patients,which may be good for improving their quality of life.

Constraint-induced movement therapy promotes brain functional reorganization in stroke patients with hemiplegia

Stroke patients with hemiplegia exhibit flexor spasms in the upper limb and extensor spasms in the lower limb, and their movement patterns vary greatly. Constraint-induced movement therapy is an upper limb rehabilitation technique used in stroke patients with hemiplegia; however, studies of lower extremity rehabilitation are scarce. In this study, stroke patients with lower limb hemiplegia underwent conventional Bobath therapy for 4 weeks as baseline treatment, followed by constraint-induced movement therapy for an additional 4 weeks. The 10-m maximum walking speed and Berg balance scale scores significantly improved following treatment, and lower extremity motor function also improved. The results of functional MRI showed that constraint-induced movement therapy alleviates the reduction in cerebral functional activation in patients, which indicates activation of functional brain regions and a significant increase in cerebral blood perfusJon. These results demonstrate that constraint-induced movement therapy promotes brain functional reorganization in stroke patients with lower limb hemiplegia.

Changes in a cerebellar peduncle lesion in a patient with Dandy-Walker malformation A diffusion tensor imaging study

We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients＇ functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg＇s balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.