Immediate Effects of Functional Vibratory Stimulation on the Gait of Stroke Hemiplegia Patients

A large proportion of stroke survivors have gait disorders. Restoration of gait is an important goal of poststroke rehabilitation. The purpose of this study was to evaluate the immediate effect of stronger functional vibratory stimulation to the hemiplegic lower limb on gait speed and swing speed of the lower limbs of stroke patients with hemiplegia. Twelve stroke patients participated in this study. All were able to walk with or without walking aids. The functional vibratory stimulation system consists of a direct current motor enclosed in a plastic box. Two vibrators were fixed on the skin overlying the tibialis anterior and the gluteus medius muscles of the hemiplegic side and were applied continuously during measurement of gait. Subject's gait speed, stance and swing duration, and maximal angular velocity at the thigh, leg, and knee of both the paretic and nonparetic sides were used as outcome measures. Changes in gait movement in the hemiplegic patients by adding functional vibratory stimulation were as follows. The stance phase duration decreased from 0.94±0.04 s to 0.87±0.04 s on the paretic side (p < 0.01) and decreased from 1.08±0.05 s to 1.03±0.05 s on the nonparetic side (p < 0.01). The swing phase duration decreased from 0.67±0.02 s to 0.64±0.02 s on the paretic side and decreased from 0.52±0.02 s to 0.50±0.02 s on the non-paretic side (no significant differences). The gait speed significantly increased from 25.3±1.3 m/min to 28.2±1.5 m/min (p < 0.01). Peak leg angular velocity increased from 169.3±9.5 deg/s to 182.3±10.0 deg/s on the paretic side (p < 0.01) and also increased from 246.0±7.9 deg/s to 261.1±7.5 deg/s on the non-paretic side (p < 0.01). Peak thigh angular velocity decreased from 85.3±3.5 deg/s to 84.3±3.7 deg/s on the paretic side (no significant difference), but increased from 100.3±3.8 deg/s to 105.0±3.2 deg/s on the non-paretic side (p < 0.05). Enhanced functional vibratory stimulation to the targeted hemiplegic lower limb during walking significantly improved gait speed, stance phase duration and peak angular velocity at the lower extremities during the swing phase. Our results demonstrated that functional vibratory stimulation is useful as a treatment during therapeutic gait training for hemiplegic extremities.