Immediate Effects of Plantar Vibration on Fall Risk and Postural Stability in Stroke Patients: A Randomized Controlled Trial.

BACKGROUND: Local vibration can improve balance problems of individuals with stroke when applied to the plantar region. AIMS: This study aimed to determine the immediate effect of local vibration applied to the plantar region on fall risk and postural stability in patients with stroke. STUDY DESIGN: Randomized controlled study. METHODS: 30 patients (23 male,7 female) with stroke were randomized to either vibration (n = 15; 58.47 ± 8.23 years) or control (n = 15; 58.27 ± 9.50 years) groups. Before and after the intervention, the patients were evaluated using a Biodex Balance System. Local vibration was applied to the plantar region of two feet in the supine position using a vibration device for a total of 15 min to the individuals in the vibration group. While the patients in the placebo group were in the supine position, the device was brought into contact and no vibration was applied to the plantar region of two feet for 15 min. RESULTS: While significant improvements were observed in the postural stability and fall risk of the vibration group (p < 0.05), no significant change was observed in the placebo group (p > 0.05). Furthermore, significant improvements occurred in the SD values of the postural stability expressing postural oscillation in the vibration group (p < 0.05). CONCLUSION: As a result of local vibration applied to the plantar region, immediate (within 5 min) significant improvements in postural stability and fall risk values were detected.

Validity and intra- and inter-rater reliability of the Tinetti performance-oriented mobility assessment balance subscale using different tele-assessment methods in patients with chronic stroke.

INTRODUCTION: Balance assessments are an important component of rehabilitation. Considering the increasing use of telemedicine to meet rehabilitation needs, it is important to examine the feasibility of such assessments. This study aimed to examine the reliability and validity of the Tinetti Performance-Oriented Mobility Assessment Balance Subscale (POMA-B) when applied via synchronous and asynchronous tele-assessment. METHODS: Twenty-five patients with chronic stroke were included in the study. The first physiotherapist assessed the patients on the first day in a face-to-face clinical setting. Synchronous or asynchronous tele-assessment was applied the next day. The assessments were performed in the same time zone, with an interval of one day. The synchronous tele-assessment was done online in real time by the first and second physiotherapists. A reference assessment video was sent to the patients for asynchronous tele-assessment. They were asked to make a video recording while performing the evaluation activities according to the reference video. Then the first and second physiotherapists assessed these video recordings separately. All the tests were repeated 10 days later to determine the intra-rater reliability of the tele-assessment methods. RESULTS: The intra-class correlation coefficients ranged from 0.96 to 0.98 for inter-rater reliability and from 0.97 to 0.98 for intra-rater reliability for both tele-assessment methods. Both asynchronous and asynchronous tele-assessment methods were medium correlated with the face-to-face versions. CONCLUSIONS: We demonstrated the validity and reliability of the POMA-B in chronic stroke patients with different tele-assessment methods, typically using the internet and available devices.

The effect of local vibration applied to the forearm extensor muscles on hand function and muscle activation in stroke patients: a randomized controlled study.

OBJECTIVE: This study aims to reveal the effect of low-frequency local vibration applied to the forearm extensor muscles on stroke patients' muscle activation and hand functions. METHODS: Twenty-four stroke patients were randomized to the vibration group (n = 12) or control group (n = 12). The vibration was applied at a 30 Hz frequency to the forearm extensor muscles with a local vibration device three days a week after the routine, conventional physical therapy sessions for four weeks. Six vibration sets were applied, including one vibration for one minute and a rest for 2 min. Routine, traditional physical therapy was used for the control group in 60-min sessions for 4 weeks. Patients were assessed for muscle activation with surface electromyography (MVC) and The Wolf Motor Function Test (WMFT), Functional Independent Test (FIM) was applied to all patients before and after treatment. RESULTS: As a result of our study, MVC measurement, WMFT and FIM scores of the vibration group showed more improvement than the control group. Measurement results of vibration group; While MVC measurement increased from 10.21 to 13.79, WMFT-Functional Ability score increased from 42 to 50, WMFT-Performance Time duration increased from 68.78 to 61.83, and FIM score increased from 74.5 to 83. and the measurement results of the control group; MVC measurement increased from 12.28 to 12.22, WMFT-Functional Ability score increased from 48.5 to 51, WMFT-Performance Time duration increased from 70.39 to 70.61, and FIM score increased from 72.5 to 80.5. CONCLUSION: It was concluded that low-frequency local vibration applied to the forearm extensor muscles improve forearm extensor muscle activation and hand motor function. CLINICAL TRIAL REGISTRATION: NCT04562220.

Effect of plantar vibration on static and dynamic balance in stroke patients: a randomised controlled study.

OBJECTIVE: To investigate the effects of local vibration applied to the plantar region of the foot on static and dynamic balance in stroke patients. DESIGN: Randomised, controlled trial. SETTING: Inpatient. PARTICIPANTS: Thirty patients with stroke were randomised equally to the vibration and control groups. INTERVENTION: The control group underwent conventional physical therapy (CPT) for 4 weeks. The vibration group underwent local vibration therapy at a frequency of 80Hz and CPT for 4 weeks. OUTCOME MEASURES: The primary outcome measure was the Overall Stability Index (OSI). The secondary outcome measures were: the Anteroposterior Stability Index, Mediolateral Stability Index, fall risk, Berg Balance Scale, Functional Reach Test (FRT), and Timed Up and Go Test (TUG) to assess balance; the Trunk Impairment Scale to measure trunk function; and the 10-m Walk Test (10MWT) to measure walking speed. RESULTS: Participants receiving plantar vibration experienced greater improvements in static and dynamic balance assessments compared with participants in the control group. The mean change in OSI score between baseline and 4 weeks was 0.8 [standard deviation (SD) 0.8] for the vibration group and 0.02 (SD 0.6) for the control group [mean difference 0.4, 95% confidence interval (CI) 0.1 to 0.7]. The median change in fall risk score was 0.7 [interquartile range (IQR) 0.4 to 1.4] for the vibration group and 0.1 (IQR -0.1 to 0.6) for the control group (median difference 0.5, 95% CI 0.2 to 0.7). The median change in TUG time was 4 (IQR 1 to 7) seconds for the vibration group and 4 (IQR 0 to 2) seconds for the control group (median difference 2.5, 95% CI 1.5 to 3.5). CONCLUSION: These findings suggest that plantar vibration is useful in stroke patients. Plantar vibration can be applied to support CPT. GOV REGISTRATION NUMBER: NCT03784768.

The musculoskeletal problems and psychosocial status of teachers giving online education during the COVID-19 pandemic and preventive telerehabilitation for musculoskeletal problems.

BACKGROUND: Musculoskeletal and psychosocial problems have tended to increase during the COVID-19 pandemic. OBJECTIVE: To evaluate the changes in musculoskeletal problems and psychosocial status of teachers during the COVID-19 pandemic due to online education and to investigate the effects of preventive telerehabilitation applications for musculoskeletal problems. METHODS: Forty teachers who conducted online education during the pandemic volunteered to participate in the study. All assessments were performed via online methods. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), ProFitMap-Neck questionnaire, Oswestry Disability Index (ODI), and Upper Extremity Functional Index (UEFI) were used to evaluate musculoskeletal problems; the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI) were used to evaluate anxiety and depression, respectively; and the Work-Life Balance Scale (WLBS) was used to evaluate how well individuals achieve this balance. Information about before online education, during online education, and after training was obtained with the assessments. After the first assessment, telerehabilitation, which involved presentations and brochures, was applied to 18 participants willing to participate in the training. RESULTS: The ProFitMap, UEFI, and WLBS scores during the online education decreased significantly, while the scores of the CMDQ, ODI, BDI, and BAI during the online education increased significantly compared to the pre-online education scores (p < 0.05). In addition, the total CMDQ, ProFitMap, and ODI scores improved significantly after the training (p < 0.05). CONCLUSION: Musculoskeletal and psychosocial problems increased in teachers during online education. Preventive telerehabilitation methods will be beneficial for individuals who do not have access to face-to-face physiotherapy.