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Background. Whole-body vibration (WBV) has increasingly been used as an adjunct treatment in neurological rehabilitation. However, how muscle activation level changes during exposure to different WBV protocols in individuals after stroke remains understudied. Objective. The purpose of this study was to examine the influence of WBV intensity on the magnitude of biceps femoris (BF) and tibialis anterior (TA) muscle activity and its interaction with exercise and with severity of motor impairment and spasticity among individuals with chronic stroke. Methods. Each of the 36 individuals with chronic stroke (mean age=57.3 years, SD=10.7) performed 8 different static exercises under 3 WBV conditions: (1) no WBV, (2) low-intensity WBV (frequency=20 Hz, amplitude=0.60 mm, peak acceleration=0.96#), and (3) high-intensity WBV (30 Hz, 0.44 mm, 1.61g). The levels of bilateral TA and BF muscle activity were recorded using surface electromyography (EMG). Results. The main effect of intensity was significant. Exposure to the low-intensity and high-intensity protocols led to a significantly greater increase in normalized BF and TA muscle electromyographic magnitude in both legs compared with no WBV. The intensity X exercise interaction also was significant, suggesting that the WBV-induced increase in EMG activity was exercise dependent. The EMG responses to WBV were similar between the paretic and nonparetic legs and were not associated with level of lower extremity motor impairment and spasticity. Limitations. Leg muscle activity was measured during static exercises only. Conclusions. Adding WBV during exercise significantly increased EMG activity in the TA and BF muscles. The EMG responses to WBV in the paretic and nonparetic legs were similar and were not related to degree of motor impairment and spasticity. The findings are useful for guiding the design of WBV training protocols for people with stroke., Stroke is a major public health issue that poses challenges to health care systems worldwide. (1) Muscle weakness is one of the most common physical poststroke impairments (2) and is [...]

Background. The Mini-Balance Evaluation Systems Test (Mini-BESTest) is a new balance assessment, but its psychometric properties have not been specifically tested in individuals with stroke. Objectives. The purpose of this study was to examine the reliability and validity of the Mini-BESTest and its accuracy in categorizing people with stroke based on fall history. Design. An observational measurement study with a test-retest design was conducted. Methods. One hundred six people with chronic stroke were recruited. Intrarater reliability was evaluated by repeating the Mini-BESTest within 10 days by the same rater. The Mini-BESTest was administered by 2 independent raters to establish interrater reliability. Validity was assessed by correlating Mini-BESTest scores with scores of other balance measures (Berg Balance Scale, one-leg-standing, Functional Reach Test, and Timed 'Up & Go' Test) in the stroke group and by comparing Mini- BESTest scores between the stroke group and 48 control participants, and between fallers (≥ 1 falls in the previous 12 months, n=25) and nonfallers (n=81) in the stroke group. Results. The Mini-BESTest had excellent internal consistency (Cronbach alpha =.89 -.94), intrarater reliability (intraclass correlation coefficient [3,1]=.97), and interrater reliability (intraclass correlation coefficient [2,1] =.96). The minimal detectable change at 95% confidence interval was 3.0 points. The Mini-BESTest was strongly correlated with other balance measures. Significant differences in Mini-BESTest total scores were found between the stroke and control groups and between fallers and nonfallers in the stroke group. In terms of floor and ceiling effects, the Mini-BESTest was significantly less skewed than other balance measures, except for one-leg-standing on the nonparetic side. The Berg Balance Scale showed significantly better ability to identify fallers (positive likelihood ratio=2.6) than the Mini-BESTest (positive likelihood ratio = 1.8). Limitations. The results are generalizable only to people with mild to moderate chronic stroke. Conclusions. The Mini-BESTest is a reliable and valid tool for evaluating balance in people with chronic stroke., Stroke is a major cause of disability and global disease burden. (1) Dysfunction in balance control is one of the most common physical impairments observed after stroke. (2,3) Compromised balance [...]

Background. Earlier studies show that whole-body vibration (WBV) has beneficial effects on neuromuscular performance in older adults and may be a viable treatment option for people with Parkinson disease (PD). Purpose. This systematic review was aimed at determining whether WBV improves sensorimotor performance in people with PD. Data Sources. The sources used in this review were MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Excerpta Medica database (EMBASE), the Cochrane Database of Systematic Reviews, and the Physiotherapy Evidence Database (PEDro) (last searched in April 2010). Study Selection. Randomized and nonrandomized controlled studies examining the effects of WBV in people with PD were selected. Six studies fulfilled the selection criteria and were included in this review. Data Extraction. The PEDro score was used to evaluate methodological quality. The effects of WBV on various sensorimotor outcomes were noted. Data Synthesis. Methodological quality was rated as good for 1 study (PEDro score of 6), fair for 4 studies (PEDro score of 4 or 5), and poor for 1 study (PEDro score of 2). Two studies showed that, compared with no intervention, WBV treatment led to significant reductions in tremor and rigidity, as measured with the Unified Parkinson Disease Rating Scale (UPDRS). The findings for other UPDRS cluster scores were conflicting, however. Two studies showed that longer-term WBV (3-5 weeks) did not result in better sensorimotor outcomes than conventional exercise training. Limitations. The studies reviewed here are limited by their methodological weaknesses and small, heterogeneous samples. Conclusions. There is insufficient evidence to prove or refute the effectiveness of WBV in enhancing sensorimotor performance in people with PD (ie, grade D recommendations). More good-quality trials are needed to establish the clinical efficacy of WBV in improving sensorimotor function in people with PD., People with Parkinson disease (PD) typically have varying degrees of muscular weakness, mobility deficits, postural instability, and other motor impairments (eg, rigidity, tremors), all of which render them highly susceptible [...]