Focal Muscle Vibration on Upper Limb Function in Subacute Post-stroke Patients
Focal Muscle Vibration on Upper Limb Function in Subacute Post-stroke Patients
Stroke is the second leading cause of death, accounting for 11.13 % of total deaths, and the
 main cause of disability worldwide. The major type of stroke is ischemic, which occurs in
 about 87% of all stroke cases Stroke has different risk factors, which can be grouped into
 modifiable and non-modifiable risk factors. Major risk factors for stroke include age,
 history of cerebrovascular event, smoking, alcohol consumption, physical inactivity,
 hypertension, diabetes mellitus, cardiovascular diseases, obesity, metabolic syndrome, diet,
 nutrition, and genetic risk factors. Many new technique used for rehabilitation after stroke
 includes Constraint-Induced Movement Therapy for Arm or Leg Paralysis, Mirror Therapy for
 Hand Recovery, Harness the Relentless Force etc. Segmental muscle vibration (SMV) is also a
 new technique and effective to decrease the hyper-toned muscles spasticity but still less
 work done on it. SMV with different frequencies have different effects for both flaccid and
 spastic patients of all 3 stages of stroke. In our study we will work with 60hz and 120hz
 frequencies to reduce the spasticity of upper limb and improves their functional level.
Evidence strongly suggest that a period of pure sensory stimulation can affect motor
 corticoids activity excitability.

 In 2019 segmental muscle vibration(SMV) used to improve upper extremity functional ability
 post stroke and concluded that patients in both groups improved significantly after treatment
 in Barthel index (BI), elbow Range of Motion (ROM) and elbow muscle strength. However muscle
 tone in elbow joint of hemiplegic upper extremity improved significantly after only in the
 experimental group. They suggested that with routine physiotherapy with extended exposure SMV
 will results in significant reduced spasticity and better improved Activities Of Daily
 Livings (ADLs).

 In 2019 a work done with SMV to improve gate performance in patients with foot drop after
 chronic stroke. Results of this study revealed moderate improvement in mean gate speed,
 normal side swing velocity, bilateral stride length and normal-side toe off in experimental
 group. Further studies needed to evaluate the optimal and minimum SMV dosage.

 Another study conducted in 2019 to see Results show that processing speed, inhibitory control
 and attention improved following SMV. But working memory between groups and also not show a
 association between executive functions course and fall risk, so they suggest further work to
 examine effects of vibration therapy on executive functions.

 In 2014 another therapist highlight the potential use of SMV to modulate electromyographic
 (EMG) for reaching movement in chronic stroke patients but needs to be confirmed by larger
 control perspective trials of SMV.

 In 2019 combined work done with repetitive focal muscle vibration with physiotherapy to
 improve the motor function even in very acute phase of stroke and finds it a valid
 complementary non pharmacological therapy In 2019 another study suggest that Whole Body
 Vibration (WBV) and Upper and Lower Cycle (ULC) effective upper for upper extremity motor
 function and grip strength in sub-acute stroke.

 In 2019 a study reported the risk factors (vibration injury to hands vascular components,
 intermediate blanching neurological components and lower back pain for drivers of work
 machines) and benefits (improvement in bone health and neuromuscular function). So is a room
 for research to design a balanced WBV protocol.

 A study in 2018 did a meta-analysis and compare the effects of WBV in stroke patients and
 concludes that it is a safe therapeutic method for improving symptoms.
Inclusion Criteria:

 -  Hemiplegic affected side spastic <3 on the Ashworth scale.

 -  History of stroke should be > 6 weeks and <12 weeks.

 Exclusion Criteria:

 -  Individuals with the other neurological deficit

 -  Diabetic ulcer, infection or amputation of limb

 -  Serious cardiovascular disease or unstable angina

 -  Serious orthopedic problem

 -  Chronic medical problems