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Keyword: stroke recovery

fingertips touchingSending imperceptible white-noise vibrations through the wrist could increase the dexterity of those recovering from stroke, according to an article published in Physiological Results July 14.

Patients who have experienced a stroke can have lasting side effects, such as a diminished tactile response in their fingers and hands. A decrease in sensory feedback from the fingers can cause insufficient grip force control, decreased dexterity, decreased fine object manipulation, and an unstable grip, often causing patients to drop objects.

Na Jin Seo, Ph.D., Assistant Professor in the Division of Occupational Therapy at MUSC Health, was the senior investigator for this study, which applied perceptible and imperceptible white-noise vibrations at various intensities and in separate locations on patients’ extremities to determine the optimal level of white-noise vibration needed to improve signal detection. V. Ramesh Ramakrishnan, Ph.D., and Abigail W. Lauer, M.S., in the Department of Public Health Sciences at MUSC Health performed the statistical analyses for the study. The patients’ non-dominant hands were used for the test because it was postulated to be more sensitive to somatosensory feedback. The vibration was then applied to areas of the palm, back of the hand, and inner wrists an attempt to increase sensitivity in the finger pads. The intensities of the vibration varied from 0% to 120% of the threshold.

At 60% of the threshold, the imperceptible white-noise vibrations significantly improved finger tactile sensation in the thumb and index finger when compared to 0%. At 80% of the threshold, no significant changes were seen, and at 120% of the threshold degraded sensory feedback was observed in the fingers, conforming to stochastic resonance behavior.

While the vibration stimuli would quickly decrease as it moved away from the application site, not reaching the fingertips, each site reacted similarly to the same intensities. According to the study, these results indicate that neuronal activity in the fingers is influenced by the vibration.

“This finding suggests a potential for a sensory orthotic that can be worn at the wrist,” says Seo. “It would provide minute vibration and enhance patients’ touch sensation and dexterity, improving their ability for activities of daily living.” 

This study suggests that patients who have experienced an injury or a stroke could gain access to the neuronal network in their hands through imperceptible white-noise vibrations. Wearing a vibrating device on their wrists could help these patients gain back some of the control they may have lost.

MUSC Awarded Four Million Dollar Grant to Study Health Disparities in Stroke Recovery

Stroke disparities blog post imageAfrican Americans are more likely to both experience a stroke and be more adversely affected by it than their white counterparts. In South Carolina, the buckle of the stroke belt, African Americans are twice as likely to die from stroke when compared to whites. Less well known is that recovery after stroke is poorer for African Americans than whites, and that access to rehabilitation (or lack thereof) does not completely account for this discrepancy.

With the support of a four million dollar grant from the American Heart Association (AHA), the largest AHA grant ever given to an institution in South Carolina, MUSC is endeavoring to improve stroke recovery in African Americans through a multidisciplinary project that brings together basic and translational researchers in regenerative medicine, neuroscience, and nursing. The four-year project, entitled Wide spectrum Investigation of Stroke Outcome Disparities on Multiple Levels (WISSDOM), includes research projects with the potential to not only improve our understanding of why African Americans don’t fare well in recovery but to use those insights to make a difference in the lives of stroke patients through community interventions.

Leonardo Bonilha, M.D., Ph.D. (photo, left), and Mark Kindy, Ph.D. (photo, center) of the College of Medicine and Gayenelle Magwood, Ph.D., R.N. (photo, right) of the  College of Nursing are all principal investigators of the subprojects being conducted through WISSDOM. Kindy is exploring whether known stroke risk factors such as hypertension and diabetes that disproportionately affect African Americans also play a role in their recovery from stroke. To do this, he will study the effect of such metabolic factors on vascular stiffness in animal models. Bonilha is using innovative neuroimaging techniques to assess the integrity of brain tissue and neuroplasticity (i.e., the ability of the brain to repair itself) in black and white patients so that questions about why African Americans have poorer stroke recovery than whites can be answered. Magwood is exploring whether a community-based intervention—a 12-week home-based intervention coordinated by a nurse and delivered by a community health worker— can improve stroke recovery after patients finish with rehabilitation.

As Director of WISSDOM, Robert Adams, M.D. will oversee the four-year project in its entirety and serve as its key contact. Daniel T. Lackland, Ph.D., a long-time collaborator of Adams who has devoted his 30-year career to addressing disparities in South Carolina and beyond, will serve as WISSDOM’s Training Director, and Bruce Ovbiagele, M.D., Chair of Neurology, as the head of its advisory committee.

This grant builds upon the 10.8 million dollar COBRE (Center Of Biomedical Research Excellence) grant awarded last year to MUSC to found the South Carolina Stroke Recovery Research Center. The COBRE grant is led by Steve Kautz, Ph.D., Chair of the Department of Health Sciences Research and Co-Director of the Center for Rehabilitation Research. (Read more about the COBRE grant here).

Photograph courtesy of Sarah Pack. 

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