Effects of Wrist Tendon Vibration on Targeted Upper-Arm Movements in Poststroke Hemiparesis
Megan O. Conrad, Robert A. Scheidt, Brian D. Schmit
Abstract
Background. Impaired motor control of the upper extremity after stroke may be related to lost sensory, motor, and integrative functions of the brain. Artificial activation of sensory afferents might improve control of movement by adding excitatory drive to sensorimotor control structures. The authors evaluated the effect of wrist tendon vibration (TV) on paretic upper-arm stability during point-to-point planar movements. Methods. TV (70 Hz) was applied to the forearm wrist musculature of 10 hemiparetic stroke patients as they made center-out planar arm movements. End-point stability, muscle activity, and grip pressure were compared as patients stabilized at the target position for trials completed before, during, and after the application of the vibratory stimulus. Results. Prior to vibration, hand position fluctuated as participants attempted to maintain the hand at the target after movement termination. TV improved arm stability, as evidenced by decreased magnitude of hand tangential velocity at the target. Improved stability was accompanied by a decrease in muscle activity throughout the arm as well as a mean decrease in grip pressure. Conclusions. These results suggest that vibratory stimulation of the distal wrist musculature enhances stability of the proximal arm and can be studied further as a mode for improving end-point stability during reaching in hemiparetic patients.
Tuesday, October 12, 2010
Sunday, July 18, 2010
Stroke statistics - cost and recovery
Total cost of stroke to the United States: estimated at about $43 billion per year
Direct costs for medical care and therapy: estimated at about $28 billion per year
Indirect costs from lost productivity and other factors: estimated at about $15 billion per year
Average cost of care for a patient up to 90 days after a stroke: $15,000
For 10 percent of patients, cost of care for the first 90 days after a stroke: $35,000
Percentage of direct cost of care for the first 90 days:
Initial hospitalization = 43 percent
Rehabilitation = 16 percent
Physician costs = 14 percent
Hospital readmission = 14 percent
Medications and other expenses = 13 percent.
The Effects of a Stroke (from the National Stroke Association):
10 percent of stroke survivors recover almost completely
25 percent recover with minor impairments
40 percent experience moderate to severe impairments that require special care
10 percent require care in a nursing home or other long-term facility
15 percent die shortly after the stroke.
In addition, approximately 14 percent of stroke survivors experience a second stroke in the first year following a stroke.
Direct costs for medical care and therapy: estimated at about $28 billion per year
Indirect costs from lost productivity and other factors: estimated at about $15 billion per year
Average cost of care for a patient up to 90 days after a stroke: $15,000
For 10 percent of patients, cost of care for the first 90 days after a stroke: $35,000
Percentage of direct cost of care for the first 90 days:
Initial hospitalization = 43 percent
Rehabilitation = 16 percent
Physician costs = 14 percent
Hospital readmission = 14 percent
Medications and other expenses = 13 percent.
The Effects of a Stroke (from the National Stroke Association):
10 percent of stroke survivors recover almost completely
25 percent recover with minor impairments
40 percent experience moderate to severe impairments that require special care
10 percent require care in a nursing home or other long-term facility
15 percent die shortly after the stroke.
In addition, approximately 14 percent of stroke survivors experience a second stroke in the first year following a stroke.
Sunday, January 3, 2010
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