Rehabilitation of Motor Function After Stroke Assignment

Assignment Task

Research work needed for publication in Q1 journals of Rehabilitation

Hemiparesis is the most common pervasive and disabling impairment that results from stroke (Carr & Shepherd, 2010). There are 30-60% of stroke survivors who are unable to functionally use their affected arm in the sub-acute stage, during the 3-month post stroke period (Kwakkel, Kollen & Wagenaar, 1999). In their systematic review and meta-analysis, Alqahtani et al. (2020) stated that there are 29 stroke cases in every 100,000 people annually among the people living in Saudi Arabia. Destruction of the upper limb function is one of the most common problems for stroke survivors (Liu, Li & Lamontagne, 2018), which leads to serious physical dysfunction, and affects the quality of daily living activities. The following rehabilitation techniques have been researched and are advised for use with sub-acute stroke patients: muscle strengthening exercises, constraint-induced movement therapy, mental practice with motor imagery, high frequency-transcutaneous electrical nerve stimulation, passive neuromuscular electrical stimulation, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, and botulinum toxin (Hatem et al., 2016).

Vibration Therapy uses vibration as a physical tool during the treatment. It can be applied with different devices that transmit mechanical vibration throughout the whole or a part of the body. Focal Muscle Vibration (FMV) is a safe, well-tolerated and non-invasive technique, which may be an efficient intervention in reducing the upper extremity spasticity, whereas Whole Body Vibration (WBV) can provide proper somatosensory stimulation, and improve muscle strength and postural control in stroke patients (Oliveira et al., 2018). Yet, Mirror Therapy is a structured, inexpensive, simple and patient-directed treatment. Therefore, investigating other rehabilitation interventions, such as Vibration Therapy and Mirror Therapy and assessing their effectiveness on sub-acute stroke patients is crucial for enhancing the ability of stroke survivors to independently complete ADL activities (Subramaniam, Varghese & Bhatt, 2019).

Furthermore, another single blinded-RCT was conducted to identify the effect of whole-body vibration on 60 patients with sub-acute strokes. The first group of 30 participants received whole-body vibration (WBV), while the second group received upper- and lower-cycle (ULC), and each group of them received occupational therapy and physical therapy. The therapy lasted for 30 minutes 5 days per week for a 4-week duration. Both outcome measures of Manual Function Test (MFT) and Grip Strength (Jamar Hydraulic Hand Dynamometer) suggested that both study groups received effective therapy interventions. However, the WBV was more effective for improving the upper extremity motor function and grip strength in patients with sub-acute stroke, and both outcome measures showed statistically significant results, with both P value results of less than 0.05.

Moreover, a pilot RCT was conducted by Lee et al. (2016) to study the effect of WBV training by Galileo Tilting Table system, combined with task-related training on the arm function, spasticity and grip strength in stroke survivors. Forty-five participants were distributed into group A with WHB, group B with WBV and task-related training, and group C as the control group. The therapy included 3 sessions per week, and lasted 4 weeks. There was a significantly greater increase in the Wolf Motor Function Test and a decrease in the Modified Ashworth Spasticity, with the total scores in the subjects who had undergone WBV plus task-related training, compared with those in the other 2 groups. A systematic review will be conducted about the effectiveness of Vibration Therapy on patients with stroke.

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