Effects of galvanic vestibular stimulation combined with physical therapy on pusher behavior in stroke patients: A case series

Recovery of lower extremity (LE) function in chronic stroke patients is considered a barrier to community reintegration. An adequate training program is required to improve neural and functional performance of the affected LE in chronic stroke patients. The current study aimed to evaluate the effect of somatosensory rehabilitation on neural and functional recovery of LE in stroke patients. Thirty male and female patients were recruited and randomized to equal groups: control group (GI) and intervention group (GII). All patients were matched for age, duration of stroke, and degree of motor impairment of the affected LE. Both groups received standard program of physical therapy in addition to somatosensory rehabilitation for GII. The duration of treatment for both groups was eight consecutive weeks. Outcome measures used were Functional Independent Measure (FIM) and Quantitative Electroencephalography (QEEG), obtained pre- and post-treatment. A significant improvement was found in the FIM scores of the intervention group (GII), as compared to the control group (GI) (p < 0.001). Additionally, QEEG scores improved within the intervention group post-treatment. QEEG scores did not improve within the control group post-treatment, except for “Cz-AR”, compared to pretreatment, with no significant difference between groups. Adding somatosensory training to standard physical therapy program results in better improvement of neuromuscular control of LE function in chronic stroke patients.

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Effect of noisy galvanic vestibular stimulation on dynamic posture sway under visual deprivation in patients with bilateral vestibular hypofunction

Scientific Reports ◽

10.1038/s41598-021-83206-z ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Po-Yin Chen ◽

Ying-Chun Jheng ◽

Chien-Chih Wang ◽

Shih-En Huang ◽

Ting-Hua Yang ◽

...

Keyword(s):

Clinical Trial ◽

Light Exposure ◽

Light Condition ◽

Vestibular Stimulation ◽

Galvanic Vestibular Stimulation ◽

Lateral Deviation ◽

Clinical Trial Registration ◽

Vestibular Hypofunction ◽

Dark Conditions ◽

Bilateral Vestibular Hypofunction

AbstractA single-blind study to investigate the effects of noisy galvanic vestibular stimulation (nGVS) in straight walking and 2 Hz head yaw walking for healthy and bilateral vestibular hypofunction (BVH) participants in light and dark conditions. The optimal stimulation intensity for each participant was determined by calculating standing stability on a force plate while randomly applying six graded nGVS intensities (0–1000 µA). The chest–pelvic (C/P) ratio and lateral deviation of the center of mass (COM) were measured by motion capture during straight and 2 Hz head yaw walking in light and dark conditions. Participants were blinded to nGVS served randomly and imperceivably. Ten BVH patients and 16 healthy participants completed all trials. In the light condition, the COM lateral deviation significantly decreased only in straight walking (p = 0.037) with nGVS for the BVH. In the dark condition, both healthy (p = 0.026) and BVH (p = 0.017) exhibited decreased lateral deviation during nGVS. The C/P ratio decreased significantly in BVH for 2 Hz head yaw walking with nGVS (p = 0.005) in light conditions. This study demonstrated that nGVS effectively reduced walking deviations, especially in visual deprived condition for the BVH. Applying nGVS with different head rotation frequencies and light exposure levels may accelerate the rehabilitation process for patients with BVH.Clinical Trial Registration This clinical trial was prospectively registered at www.clinicaltrials.gov with the Unique identifier: NCT03554941. Date of registration: (13/06/2018).

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P5351In-Flight Stroke in Korea

European Heart Journal ◽

10.1093/eurheartj/ehz746.0318 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H Park

Keyword(s):

Cerebral Infarction ◽

Old Age ◽

Cryptogenic Stroke ◽

Case Series ◽

Flight Time ◽

Stroke Onset ◽

Large Artery ◽

Stroke Patients ◽

Poor Outcome ◽

Short Flight

Abstract Background During flight, atmospheric pressure drop, low humidity and restricted motion occur. The environmental change can evoke the stroke occurrence. However, description of in-flight stroke case series has been limited until now. We investigated the clinical and flight trip characteristics of in-flight stroke cases in Korea. Method Since the opening of Incheon international airport, which is used by about 50 million people a year, in 2001, our hospital branch has been located at the airport and all the emergency stroke patients have been referred to our hospital. We performed retrospective review of the prospectively collected stroke registry and the information about the flight from January 2001 to December 2018. Results During the study period, 31 in-flight stroke cases were identified among total 1,452 ischemic stroke patients (17 men, 62±15 years old). Twenty-six patients had cerebral infarction, and four patients had transient ischemic attack. On etiological classification of cerebral infarction, 19 large artery atherothrombosis (61.3%), 1 septic embolism, 3 cryptogenic stroke, 3 cardioembolism (9.7%) and 1 cerebral venous thrombosis were identified. Six patients had Patent Foramen Ovale. Twenty-two patients reported to experience symptom around landing. Fourteen patients had flight for six hours or longer. Compared to the patients with long flight time (≥6 hrs), those with short flight time had the higher incidence of stroke occurrence around landings (32 vs 68%) and low incidence of unclear stroke onset. Poor outcome, defined as mRS 4 or higher, was associated with old age, unclear stroke onset, and early neurologic deterioration. Conclusion In-flight stroke is uncommon, and can easily be neglected during flight, which result in poor outcome. The stroke risk seems to be relatively high around landing, especially in the travelers with short flight time. The possibility of paradoxical embolism related to motion restriction seems low for stroke occurrence. Old age and unclear stroke onset are associated with poor outcomes.

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