Daily vibrotactile stimulation from a wearable device exhibits equal or greater spasticity relief than botulinum toxin in stroke.

ÌÇÐÄ´«Ã½

Abstract

OBJECTIVE: To test the feasibility and efficacy of the VibroTactile Stimulation (VTS) Glove, a wearable device that provides vibrotactile stimulation to the impaired limb to reduce spastic hypertonia.DESIGN: Prospective two-arm intervention study - including one group of patients who use Botulinum toxin (BTX-A) for spasticity and one group of patients who do not use BTX-A.SETTING: Participants were recruited through rehabilitation and neurology clinics.PARTICIPANTS: Patients with chronic stroke (N=20; mean age=54 years, mean time since stroke=6.9 years). Patients who were previously receiving the standard of care (BTX-A injection) were eligible to participate, and started the intervention 12 weeks after their last injection.INTERVENTION: Participants were instructed to use the VTS Glove for three hours daily, at home or during everyday activities, for 8 weeks.MAIN OUTCOME MEASURES: Spasticity was assessed with the Modified Ashworth Scale and the Modified Tardieu Scale at baseline and then at 2-week intervals for 12 weeks. Primary outcomes were the difference from baseline and at week 8 (end of VTS Glove use) and week 12 (four weeks after stopping VTS Glove use). Patients who were receiving BTX-A were also assessed during the 12 weeks preceding the start of VTS Glove use to monitor the effect of BTX-A on spastic hypertonia. Range of motion and participant feedback were also studied.RESULTS: A clinically meaningful difference in spastic hypertonia was found during and after daily VTS Glove use. Modified Ashworth and Modified Tardieu scores were reduced by an average of 0.9 (p=0.0014) and 0.7 (p=0.0003), respectively, at week 8 of daily VTS Glove use, and by 1.1 (p=0.00025) and 0.9 (p=0.0001), respectively, one month after stopping VTS Glove use. For participants who used BTX-A, 6 out of 11 showed greater change in Modified Ashworth ratings during VTS Glove use (Mean=-1.8 vs. Mean=-1.6 with BTX-A) and 8 out of 11 showed their lowest level of symptoms during VTS Glove use (vs. BTX-A).CONCLUSIONS: Daily stimulation from the VTS Glove provides relief of spasticity and hypertonia. For more than half of participants who had regularly used BTX-A, the VTS Glove provided equal or greater symptom relief.

View details for

View details for