Background: Cerebral Palsy (CP) is a neurodevelopmental disorder that encompasses multiple neurological disorders that appear in infancy or early childhood and persist through the lifespan of the individual. Early interventions for infants with CP utilizing assisted-motion robotic devices have shown promising effects in rehabilitation of the motor function skills. The impact of cognitive function during motor learning and skill acquisition in infants using robotic technologies is unclear.Purpose: To assess the impact of cognitive function of infants with and without CP on their motor learning using the Self-Initiated Prone Progression Crawler (SIPPC) robot.Methods: Statistical analysis was conducted on the data obtained from a randomized control trial in which the movement learning strategies in infants with or at risk for CP was assessed during a 16-week SIPPC robot intervention. Cognitive function was measured by the Bayley scales of Infant and Toddler Development–Third edition (Bayley-III) and motor function was measured by the Movement Observation Coding Scheme (MOCS). The infants were categorized into three distinct groups based on their cognitive scores at baseline: “above average” (n1 = 11), “below average” (n2 = 10), and “average” (n3 = 26). Tri-weekly averages of the MOCS scores (observations at five time points) were used for the analyses. This study involved computing descriptive statistics, data visualization, repeated measures analysis of variances (rmANOVA), and survival analyses.Results: The descriptive statistics were calculated for the MOCS and Bayley III scores. The repeated measures ANOVAs revealed that there was a statistically significant effect of time (p < 0.0001) on scores of all subscales of the MOCS. A statistically significant effect of interaction between group and time (p < 0.05) was found in MOCS scores of subscales 1 and 2. The survival analyses indicated that infants in different cognition groups significantly differed (p < 0.0001) in their ability to achieve the crawling milestone within the 16-week intervention period.Conclusion: The findings in this study reveal the key movement strategies required to move the SIPPC robot, assessed by the MOCS, vary depending on the infants’ cognition. The SIPPC robot is well-matched to cognitive ability of infants with CP. However, lower cognitive ability was related to delayed improvement in their motor skills.

People with diabetic peripheral neuropathy (DPN) experience lower quality of life caused by associated balance, posture, and gait impairments. While focal muscle vibration (FMV) has been associated with improvements in gait performance in individuals with neurological disorders, little is known about its effectiveness in patients with DPN. The purpose of this study was to investigate the effect of FMV on gait outcomes in patients with DPN. The authors randomized 23 participants into three FMV intervention groups depending upon the delivery of vibration. Participants applied wearable FMV to the bilateral quadriceps, gastrocnemius, and tibialis anterior, 10 min per muscle, three times per week over a four-week period. Spatiotemporal, kinematic, and kinetic gait parameters at baseline and post-intervention were calculated and analyzed. Gait speed, cadence, stride time, left and right stance time, duration of double limb support, and left and right knee flexor moments significantly improved after four weeks of FMV. Trends toward significant improvements were noted in maximum left and right knee flexion. Results indicate that FMV therapy was associated with improvements in gait parameters in individuals with DPN, warranting expanded study of FMV therapy for long-term gait performance improvement in these individuals.

Focal vibration therapy can provide neurophysiological benefits. Unfortunately, standardized protocols are non-existent. Previous research presents a wide range of protocols with a wide range of effectiveness. This paper is part of a broader effort to identify effective, standardized protocols for focal vibration therapy. In this study, the authors evaluated the vibration characteristics (frequency and peak-to-peak intensity) of four commercially available focal vibration devices: (1) Vibracool (wearable), (2) Novafon (hand-held), (3) Myovolt 3-actuator (wearable), and (4) Myovolt 2-actuator (wearable). An accelerometer was used for the measurements. Measurements were made under the following two conditions: (a) when the devices were free, i.e., unconstrained vibration, and (b) when the devices were strapped to the human body, i.e., constrained vibration. In the free vibration condition, frequency ranged from 120 to 225 Hz and peak-to-peak amplitude ranged from 2.0 to 7.9 g’s. When the devices were strapped to the body (constrained), vibration amplitude decreased by up to 65.7%. These results identify effective ranges of focal vibration frequency and amplitude. They illustrate the importance of identifying vibration environment, free or constrained, when quoting vibration characteristics. Finally, the inconsistency output of multi-actuator devices is discussed. These results will guide protocol development for focal vibration and potentially better focal vibration devices.

In this review, we present a narrative synthesis of studies on the use of focal muscle vibration (FMV) in stroke rehabilitation with a focus on vibration device, parameters, and protocols. A search was conducted via PubMed, SCOPUS, PEDro, REHABDATA, and Web of Science using the keywords “stroke and focal vibration” or “focal muscle vibration”. Inclusion and exclusion criteria to select the articles were determined. Twenty-two articles involving FMV and stroke were included in this review. Eight different vibration devices were used in the 19 articles that reported the vibration apparatuses. The vibration frequencies ranged from 30 Hz to 300 Hz with amplitudes ranging from 0.01 mm to 2 mm. The vibration treatment frequency ranged from a single treatment to 5 days/week. The session duration ranged from 14 s to 60 min/session with a duration of a single treatment to eight weeks. Twenty different muscles were targeted with 37 different outcome measures used to assess the effects of FMV. The clinical applications of FMV were not confirmed based on available evidence. More research is needed to improve the FMV technology, guide the selection of vibration parameters, optimize the vibration dosage, and develop standardized protocols for FMV therapy in patients with stroke.

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Stroke often leads to the significant impairment of upper limb function and is associated with a decreased quality of life. Despite study results from several interventions for muscle activation and motor coordination, wide-scale adoption remains largely elusive due to under-doses and low user compliance and participation. Recent studies have shown that focal vibration has a greater potential to increase and coordinate muscle recruitment and build muscle strength and endurance. This form of treatment could widely benefit stroke survivors and therapists. Thus, this study aimed to design and develop a novel wearable focal vibration device for upper limb rehabilitation in stroke survivors. A user participatory design approach was used for the design and development. Five stroke survivors, three physical therapists, and two occupational therapists were recruited and participated. This pilot study may help to develop a novel sustainable wearable system providing vibration-based muscle activation for upper limb function rehabilitation. It may allow users to apply the prescribed vibratory stimuli in-home and/or in community settings. It may also allow therapists to monitor treatment usage and user performance and adjust the treatment doses based on progression.

Hallux strength is associated with sports performance and balance across the lifespan, and independently predicts falls in older adults. In rehabilitation, Medical Research Council (MRC) Manual Muscle Testing (MMT) is the clinical standard for hallux strength assessment, but subtle weakness and longitudinal changes in strength may go undetected. To address the need for research-grade yet clinically feasible options, we designed a new load cell device and testing protocol to Quantify Hallux Extension strength (QuHalEx). We aim to describe the device, protocol and initial validation. In benchtop testing, we used eight precision weights to apply known loads from 9.81 to 78.5 N. In healthy adults, we performed three maximal isometric tests for hallux extension and flexion on the right and left sides. We calculated the Intraclass Correlation Coefficient (ICC) with 95% confidence interval and descriptively compared our isometric force–time output to published parameters. QuHalEx benchtop absolute error ranged from 0.02 to 0.41 (mean 0.14) N. Benchtop and human intrasession output was repeatable (ICC 0.90–1.00, p < 0.001). Hallux strength in our sample (n = 38, age 33.5 ± 9.6 years, 53% female, 55% white) ranged from 23.1 to 82.0 N peak extension force and 32.0 to 142.4 N peak flexion, and differences of ~10 N (15%) between toes of the same MRC grade (5) suggest that QuHalEx is able to detect subtle weakness and interlimb asymmetries that are missed by MMT. Our results support ongoing QuHalEx validation and device refinement with a longer-term goal of widespread clinical and research application.

Focal vibration therapy can provide neurophysiological benefits. Unfortunately, standardized protocols are non-existent. Previous research presents a wide range of protocols with a wide range of effectiveness. This paper is part of a broader effort to identify effective, standardized protocols for focal vibration therapy. The vibration characteristics of four commercially available focal vibration devices that have been used for research and clinically were measured. An accelerometer was used for the measurements. Frequency and peak-to-peak amplitude were measured. Measurements were made when the devices were free and then again when they were strapped to the human body. Vibration frequency ranged from 120 to 225 Hz. Free vibration amplitude ranged from 2.0 to 7.9 g&rsquo;s (peak-to-peak). When the devices were strapped to the body (constrained), vibration amplitude decreased by up to 65.7%. These results identify effective ranges of focal vibration frequency and amplitude. They illustrate the importance of identifying vibration environment, free or constrained, when quoting vibration characteristics. Finally, the inconsistency of multi-actuator devices is discussed. These results will guide protocol development for focal vibration and potentially better focal vibration devices.