Vibratory Stimulation Research Articles

Subthreshold white noise vibration alters trembling sway in older adults

BackgroundSomatosensory deficit is a significant contributor to falls in older adults. Stochastic resonance has shown promise in recent studies of somatosensation-based balance disorders, improving many measures of stability both inside and outside of the clinic. However, our understanding of this effect from a physiological perspective is poorly understood. Therefore, the primary goal of this study is to explore the influence of subthreshold vibratory stimulation on sway under the rambling-trembling framework. Methods10 Healthy older adults (60–65 years) volunteered to participate in this study. Each participant underwent two randomized testing sessions on separate days, one experimental and one placebo. During each session, the participants' baseline sway was captured during one 90-s quiet standing trial. Their sensation threshold was then captured using a custom vibratory mat and 4–2-1 vibration perception threshold test. Finally, participants completed another 90-s quiet standing trial while the vibratory mat vibrated at 90% of their measured threshold (if experimental) or with the mat off (if placebo). While they completed these trials, an AMTI force plate collected force and moment data in the anteroposterior (AP) and mediolateral (ML), from which the center of pressure (COP), rambling (RM), and trembling (TR) time series were calculated. From each of these time series, range, variability (root-mean-square), and predictability (sample entropy) were extracted. One-tailed paired t-tests were used to compare baseline and during-vibration measures. ResultsNo significant differences were found during the placebo session. For the experimental session, significant increases were found in AP TR range, ML TR RMS, AP COP predictability, and AP & ML TR predictability. The TR time series was particularly sensitive to vibration, suggesting a strong influence on peripheral/spinal mechanisms of postural control. SignificanceThough it is unclear whether observed effects are indicative of “improvements” or not, it does suggest that there was a measurable effect of subthreshold vibration on sway. This knowledge should be utilized in future studies of stochastic resonance, potentially acting as a mode of customization, tailoring vibration location, duration, magnitude, and frequency content to achieve the desired effect. One day, this work may aid in our ability to treat somatosensation-based balance deficits, ultimately reducing the incidence and severity of falls in older adults.

Enhanced lower-limb motor imagery by kinesthetic illusion.

Brain-computer interface (BCI) based on lower-limb motor imagery (LMI) enables hemiplegic patients to stand and walk independently. However, LMI ability is usually poor for BCI-illiterate (e.g., some stroke patients), limiting BCI performance. This study proposed a novel LMI-BCI paradigm with kinesthetic illusion(KI) induced by vibratory stimulation on Achilles tendon to enhance LMI ability. Sixteen healthy subjects were recruited to carry out two research contents: (1) To verify the feasibility of induced KI by vibrating Achilles tendon and analyze the EEG features produced by KI, research 1 compared the subjective feeling and brain activity of participants during rest task with and without vibratory stimulation (V-rest, rest). (2) Research 2 compared the LMI-BCI performance with and without KI (KI-LMI, no-LMI) to explore whether KI enhances LMI ability. The analysis methods of both experiments included classification accuracy (V-rest vs. rest, no-LMI vs. rest, KI-LMI vs. rest, KI-LMI vs. V-rest), time-domain features, oral questionnaire, statistic analysis and brain functional connectivity analysis. Research 1 verified that induced KI by vibrating Achilles tendon might be feasible, and provided a theoretical basis for applying KI to LMI-BCI paradigm, evidenced by oral questionnaire (Q1) and the independent effect of vibratory stimulation during rest task. The results of research 2 that KI enhanced mesial cortex activation and induced more intensive EEG features, evidenced by ERD power, topographical distribution, oral questionnaire (Q2 and Q3), and brain functional connectivity map. Additionally, the KI increased the offline accuracy of no-LMI/rest task by 6.88 to 82.19% (p < 0.001). The simulated online accuracy was also improved for most subjects (average accuracy for all subjects: 77.23% > 75.31%, and average F1_score for all subjects: 76.4% > 74.3%). The LMI-BCI paradigm of this study provides a novel approach to enhance LMI ability and accelerates the practical applications of the LMI-BCI system.

Influence of Combined Vibration and Electrical Stimulation on Latency of Kinesthetic Illusion

The application of vibration stimulation to muscles, via the skin surface, can generate the sensation of movement, when actually there is no motion. This phenomenon is called kinesthetic illusion. Recently, in the fields of rehabilitation and virtual-reality technology, research has been conducted to utilize kinesthetic illusions to feel body movements, when there are none. To apply kinesthetic illusions in the above fields, it is necessary to develop techniques to improve the occurrence rates of the kinesthetic illusions and shorten the latency, which is the time lag from the onset of stimulation to the occurrence of the illusion. In a previous study, the authors reported that the occurrence rate of kinesthetic illusion could be improved by simultaneously applying vibration and electrical stimulations to the antagonistic muscles. In this study, the influence of this technique on the latency of the generated kinesthetic illusion is investigated by applying a combination of vibration and electrical stimulations. Three different electrical-stimulation voltages are used in the combined stimulation to induce the kinesthetic illusion, and the latency is studied for each voltage condition and the vibration-only condition. The effects of the voltage change on latency are evaluated from a regression analysis performed using the generalized linear mixed model. The results suggest that the change in the electrical stimulation voltage can shorten the latency of kinesthetic illusion.

Notch signaling pathway inhibitor DAPT improves alcohol-induced neuronal differentiation impairment in zebrafish

To explore the role of the Notch signaling pathway in regulating neuronal differentiation and sensorimotor ability in a zebrafish model of fetal alcohol spectrum disorder. Zebrafish embryos treated with DMSO or 50 μmol/L DAPT (a Notch signaling pathway inhibitor) were examined for mortality rate, hatching rate, malformation rate, and body length at 15 days post fertilization (dpf). The mRNA expression levels of sox2, neurogenin1 and huc in the treated zebrafish embryos were detected using in situ hybridization and qRT-PCR, and their behavioral responses to strong light and vibration stimulation were observed. The zebrafish embryos were then exposed to DMSO, 1.5% ethanol, DAPT, or both ethanol and DAPT, and the changes in mRNA expression levels of sox2, neurogenin1, huc, and the Notch signaling pathway genes as well as behavioral responses were evaluated. Exposure to 50 μmol/L DAPT significantly increased the mortality rate of 1 dpf zebrafish embryos (P < 0.01), decreased the hatching rate of 2 dpf embryos (P < 0.01), increased the malformation rate of 3 dpf embryos (P < 0.001), and reduced the body length of 15 dpf embryos (P < 0.05). DAPT treatment significantly downregulated sox2 mRNA expression (P < 0.01) and increased neurogenin1 (P < 0.05) and huc (P < 0.01) mRNA expressions in zebrafish embryos. The zebrafish with DAPT treatment exhibited significantly shortened movement distance (P < 0.001) and lowered movement speed (P < 0.05) in response to all the stimulation conditions. Compared with treatment with 1.5% ethanol alone, which obviously upregulated notch1a, her8a and NICD mRNA expressions in zebrafish embryos (P < 0.05), the combined treatment with ethanol and DAPT significantly increased neurogenin1 and huc mRNA expression, decreased sox2 mRNA expression (P < 0.01), and increased the moving distance and moving speed of zebrafish embryos in response to strong light stimulation (P < 0.05). Ethanol exposure causes upregulation of the Notch signaling pathway and impairs neuronal differentiation and sensorimotor ability of zebrafish embryos, and these detrimental effects can be lessened by inhibiting the Notch signaling pathway.

Vascular response to the microcirculation in the fingertip by local vibration with varied amplitude.

Objectives: We investigated the effect of local vibration intensity on the vascular response to the microcirculation of the finger. Materials and methods: We performed hand-transmitted vibration experiments combined with laser Doppler flowmetry (LDF) to measure the blood perfusion signals of fingertips in the vibrated hand and the contralateral middle finger under the same frequency and different amplitude vibration, and to analyze the changes of microcirculatory blood perfusion levels in the fingers, and to investigate the effects of vibration stimulation on the endothelial, neural and myogenic regulatory frequency ranges of fingertips based on wavelet analysis. Furthermore, the transparent silicone films were fabricated and cultured with vascular endothelial cell (EC), which will undergo the local vibration with varied amplitude. And the expression of inflammatory factors was detected in the ECs. Results: Low-frequency vibration leads to a decreased blood flow in fingertip, and the degree of reduction in fingertip blood flow increases as the amplitude gradually increases, and the period required for blood flow to return to normal level after hand-transmitted vibration gradually increases. The decrease in blood flow is more pronounced in the vibrating hand than in the contralateral hand. In addition, nuclear factor-κB (NF-κB) expression increased significantly with the increase of vibration amplitude. Conclusion: High amplitude vibrations caused the inflammatory reaction of ECs which will lead to the altered endothelial regulatory activity. The endothelial regulatory activity is closely related to the blood perfusion in the microcirculation.

(183) Global Trends in Prevalence and Outcomes of Penile Vibrator Stimulation: A Systematic Review

Abstract Introduction Penile vibrator stimulation is a robust and applicable treatment for various male sexual disorders including, delayed ejaculation, anejaculation, decreased penile sensation, and erectile dysfunction. Even though penile vibrators, amongst other sexual aids, are important tools for sexual function wellness, scientific literature describing the global prevalence and outcomes of penile vibrator stimulation remains sparse. Objective To systematically review and summarize the current literature regarding penile vibrator usage to study trends in penile vibrator stimulation and to analyze penile vibrator prevalence and satisfaction. Methods A systematic review of PubMed, EMBASE, CENTRAL, and ClinicalTrials.gov was performed for studies assessing trends and outcomes in penile vibrator stimulation from database inception through June 2022. The search was based on the keywords: “vibrator”, “vibration”, “sexual enrichment aids”, “sex toys”, “external penile devices”, “sexual health”, “erectile function”, “infertility”, “fertility”, “ejaculation”, “sex”, “sexual satisfaction”. 843 relevant articles were identified. Studies that met inclusion criteria: original research, male subjects, and vibrators studied for male sexual health benefits were reviewed. Studies were excluded if the study was a case report or did not report sexual health outcomes associated with vibrator use. A total of 66 studies met the criteria for full-text review (Figure 1). Results Thirty studies were identified during the systematic review, comprising 14,750 males reported to utilize penile vibrator stimulation from 1984 to 2021, with a steady increase in published studies over time (Figure 2). Nineteen of these studies reported penile vibrator stimulation in 1,198 males with spinal cord injuries. A total of 8 studies assessed vibrator stimulation as the primary intervention: five in men with spinal cord injuries and 3 in men without. Amongst studied in males with spinal cord injuries: sixteen assessed impacts on ejaculation, four assessed pregnancy outcomes, three assessed impacts on sperm quality, and two assessed patient satisfaction and preference. In the eleven studies assessing men without spinal cord injuries: three looked at the impact of vibrator stimulation on improving erectile function, two looked specifically at homosexual men, and three looked at the impact on ejaculation and orgasm disorders, and four looked at penile vibrator usage prevalence. Out of the thirty studies, only one study assessed the prevalence of recreational use of vibrators specifically in heterosexual men, and only three assessed personal satisfaction. Overall, an overwhelming majority of studies reported positive outcomes, including anterograde ejaculation amongst males with spinal cord injuries and erection rigidity amongst males with erectile dysfunction with vibrator utilization. Conclusions Penile vibratory stimulation remains a viable option for the treatment of delayed ejaculation or anejaculation following spinal cord injury. Moreover, in neurologically intact males, penile vibratory stimulation has demonstrated many benefits in the studies identified. While more research efforts are needed to fully investigate the potential of penile vibrators; in light of the many sexual wellness benefits identified, urologists should recommend them to males presenting with sexual concerns or dysfunction. Disclosure No

Galvanic Vestibular Stimulation Activates the Parietal and Temporal Cortex in Humans: A functional near-infrared spectroscopy (fNIRS) Study.

Galvanic Vestibular Stimulation (GVS) helps stabilize subjects when balance and posture are compromised. This work aimed to define the cortical regions that GVS activates in normal subjects. We used Functional Near-Infrared Spectroscopy (fNIRS) to test the hypothesis that GVS activates similar cortical areas as a passive movement. We used transcranial current stimulation (cathode in the right mastoid process and anode in the FPz frontopolar point) of bipolar direct current (2 mA), false GVS (sham), vibration (neutral stimulus), and back and forth motion (positive control of vestibular movement) in 18 clinically healthy volunteers. Seventy-two brain scans were performed, applying a crossover-type experimental design. We measured the heart rate, blood pressure, body temperature, head capacitance, and resistance before and after the experiment. The hemodynamic changes of the cerebral cortex were recorded with an arrangement of 26 channels in four regions to perform an ROI-level analysis. The back-and-forth motion produced the most significant oxygenated Hemoglobin (HbO2 ) increase. The response was similar for the GVS stimulus on the anterior and posterior parietal and right temporal regions. Sham and vibrational conditions did not produce significant changes ROI-wise. The results indicate that GVS produces a cortical activation coherent with displacement percept.

Clinical efficacy of vibration stimulation therapy to relieve acute exercise fatigue.

Previous studies showed that local vibration stimulation therapy was effective in relieving fatigue, and the effects of different modes of vibration stimulation therapy were further investigated. This study aimed to examine the effects of different vibration stimulation modes on relieving acute exercise fatigue based on the multiphysiological indicators such as heart rate variability (HRV), skin conductance level (SCL), and ratings of perceived exertion (RPE) subjective scale. Sixty participants selected from the dragon boat team of the Shanghai University of Traditional Chinese Medicine were divided into acupoint stimulation group (20 participants), muscle stimulation group (20 participants), and control group (20 participants) by complete randomization. (1) RPE: both stimulation groups showed a significant increase compared to the control group. (2) Heart rate values: the difference between muscle stimulation group and control group was statistically significant; (3) SCL: the two stimulation groups had significantly higher and statistically significant differences in SCL (max) and SCL (mean) values compared to the control group; the muscle stimulation group had statistically significant differences in SCL (min) compared to the control group, and the acupoint stimulation group had statistically significant differences in SCL (v) compared to the control group; (4) HRV (hf): The difference between the acupoint stimulation group and the muscle stimulation group was statistically significant. (1) Both stimulation groups are part of vibration therapy, which can relieve sympathetic tension and regulate the vegetative nervous system's relaxation effect. (2) The meridian-vessel theory may be related to the acupoint stimulation group. The low-level visceral regulation centers in the spinal nerve segment region, where the acupoints are located, trigger changes in autonomic tone and enhance parasympathetic nerve activity to relieve acute motor fatigue. (3) The muscle stimulation group may be due to the 30-Hz vibration frequency's ability to raise muscle epidermal temperature, which increases blood flow and reflexively inhibits sympathetic excitation.

Sonomechanobiology: Vibrational stimulation of cells and its therapeutic implications.

All cells possess an innate ability to respond to a range of mechanical stimuli through their complex internal machinery. This comprises various mechanosensory elements that detect these mechanical cues and diverse cytoskeletal structures that transmit the force to different parts of the cell, where they are transcribed into complex transcriptomic and signaling events that determine their response and fate. In contrast to static (or steady) mechanostimuli primarily involving constant-force loading such as compression, tension, and shear (or forces applied at very low oscillatory frequencies ( Hz) that essentially render their effects quasi-static), dynamic mechanostimuli comprising more complex vibrational forms (e.g., time-dependent, i.e., periodic, forcing) at higher frequencies are less well understood in comparison. We review the mechanotransductive processes associated with such acoustic forcing, typically at ultrasonic frequencies ( kHz), and discuss the various applications that arise from the cellular responses that are generated, particularly for regenerative therapeutics, such as exosome biogenesis, stem cell differentiation, and endothelial barrier modulation. Finally, we offer perspectives on the possible existence of a universal mechanism that is common across all forms of acoustically driven mechanostimuli that underscores the central role of the cell membrane as the key effector, and calcium as the dominant second messenger, in the mechanotransduction process.

Innovative Therapy Combining Neck Muscle Vibration and Transcranial Direct Current Stimulation in Association with Conventional Rehabilitation in Left Unilateral Spatial Neglect Patients: HEMISTIM Protocol for a Randomized Controlled Trial

Unilateral spatial neglect (USN) rehabilitation requires the development of new methods that can be easily integrated into conventional practice. The aim of the HEMISTIM protocol is to assess immediate and long-term recovery induced by an innovative association of left-side neck-muscle vibration (NMV) and anodal transcranial Direct Current Stimulation (tDCS) on the ipsilesional posterior parietal cortex during occupational therapy sessions in patients with left USN. Participants will be randomly assigned to four groups: control, Left-NMV, Left-NMV + sham-tDCS or Left-NMV + anodal-tDCS. NMV and tDCS will be applied during the first 15 min of occupational therapy sessions, three days a week for three weeks. USN will be assessed at baseline, just at the end of the first experimental session, after the first and third weeks of the protocol and three weeks after its ending. Our primary outcome will be the evolution of the functional Catherine Bergego Scale score. Secondary outcome measures include five tests that investigate different neuropsychological aspects of USN. Left NMV, by activating multisensory integration neuronal networks, might enhance effects obtained by conventional therapy since post-effects were shown when it was combined with upper limb movements. We expect to reinforce lasting intermodal recalibration through LTP-like plasticity induced by anodal tDCS.

ИССЛЕДОВАНИЕ ПАРАМЕТРОВ ИЗГИБНЫХ КОЛЕБАНИЙ И АНАЛИЗ МЕТОДОВ ИХ ПОДАВЛЕНИЯ В КУЗОВАХ СОВРЕМЕННЫХ ПАССАЖИРСКИХ ВАГОНОВ

The issues of increasing the passenger comfort level during railway transportation are considered. It is found out that the key factors for the comfort level are vertical vibrations of the body, and their intensity directly depends on the body bending stiffness. In turn, the first frequency and form of bending vibrations of the body can be taken as a criterion for evaluating bending stiffness. Design concepts aimed at increasing the comfort level of passengers and reducing the intensity of vibrations of car bodies are considered. Methods are analyzed that give the opportunity to increase the intrinsic frequency of the body bending vibrations by strengthening the metal structure of the body and making changes to the structure of its power frame, as well as by introducing specific inter-car connections. Methods of vibration isolation of the car bodies are reviewed by controlling damping in the car suspension system, as well as by reducing vibrations associated with the imbalance of wheel pairs. The experience of increasing the level of the com-fort due to the introduction of additional damping and the use of dynamic vibration damping systems has been studied. Advantages and disadvantages of the considered technical solutions are identified, as well as the experience of their use in real operation is evaluated. The analysis of the problem under consideration concerning engineering solutions for reducing bending vibrations of passenger car bodies shows the complexity of solving this problem, requiring the use of a set of theoretical and experimental studies, the choice of methods that take into account the features of the car designs and sources of vibration stimulation.

Visual feedback-dependent modulation of arousal, postural control, and muscle stretch reflexes assessed in real and virtual environments.

The mechanisms regulating neuromuscular control of standing balance can be influenced by visual sensory feedback and arousal. Virtual reality (VR) is a cutting-edge tool for probing the neural control of balance and its dependence on visual feedback, but whether VR induces neuromodulation akin to that seen in real environments (eyes open vs. closed or ground level vs. height platform) remains unclear. Here we monitored 20 healthy young adults (mean age 23.3 ± 3.2 years; 10 females) during four conditions of quiet standing. Two real world conditions (eyes open and eyes closed; REO and REC) preceded two eyes-open virtual 'low' (ground level; VRL) and 'high' (14 m height platform; VRH) conditions. We measured arousal via electrodermal activity and psychosocial questionnaires rating perceived fear and anxiety. We recorded surface electromyography over the right soleus, medial gastrocnemius, and tibialis anterior, and performed force plate posturography. As a proxy for modulations in neural control, we assessed lower limb reflexive muscle responses evoked by tendon vibration and electrical stimulation. Physiological and perceptual indicators of fear and anxiety increased in the VRH condition. Background soleus muscle activation was not different across conditions; however, significant increases in muscle activity were observed for medial gastrocnemius and tibialis anterior in VRH relative to REO. The mean power frequency of postural sway also increased in the VRH condition relative to REO. Finally, with a fixed stimulus level across conditions, mechanically evoked reflexes remained constant, while H-reflex amplitudes decreased in strength within virtual reality. Notably, H-reflexes were lower in the VRL condition than REO, suggesting that these ostensibly similar visual environments produce different states of reflexive balance control. In summary, we provide novel evidence that VR can be used to modulate upright postural control, but caution that standing balance in analogous real and virtual environments may involve different neural control states.

V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY

You have accessJournal of UrologyCME1 Apr 2023V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY Emad Ibrahim Emad IbrahimEmad Ibrahim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Spinal cord injury (SCI) is the leading cause of anejaculation in young men. After SCI 90% of men with SCI will need a method of assisted ejaculation to achieve biological fatherhood. Penile vibratory stimulation (PVS) was popularized in 1994 after the production of the first vibrator specifically designed for semen retrieval in men with SCI. The success of this device was based on a calculated amplitude of 2.5 mm which was proven to be optimal for successfully producing an ejaculate. PVS is safe, reliable, can be performed by the male partner at home after an initial evaluation by a health care provider and yields the best sperm quality.A newly designed vibrator was produced in 2019 and was tested by a group of international experts for safety and efficacy. The study concluded the device was safe and effective in inducing ejaculation in men suffering from anejaculation after SCI. METHODS: Initial encounter: standard history, physical exam and level of injury determination using the International Standards for Neurological Classification of Spinal Cord Injury were performed. In addition, assessment of Hip Flexor Reflex and Bulbocavernosus Reflex was performed. Procedure: Patients with a level of injury at or rostral to T6 were pretreated with 10-40 mg of sublingual nifedipine to mange autonomic dysreflexia. The patient lied supine on the exam table and the vibrator was applied to the dorsum or frenulum of the glans penis. Stimulation was delivered in 2-minute increments to a maximum of 10 minutes per visit. Stimulation using 2 vibrators (Sandwich technique) or with abdominal electrical stimulation can be performed in select patients. Semen: Ejaculated semen was collected in a sterile cup and a semen analysis was performed after liquefaction. Bladder preparation using sperm wash medium was performed in patients suspected of having retrograde ejaculation. RESULTS: PVS was successful in 86% of men whose level of injury was T10 or rostral. A total of 3,698 PVS procedures were successfully performed by our group. The total motile sperm count in antegrade ejaculates produced by PVS was >5 million (lower limit considered for IUI) in 71% of ejaculates. CONCLUSIONS: PVS is a safe and effective method to manage anejaculation in men with SCI. Sperm can be obtained non surgically from most men with SCI. Sufficient sperm are available for simple insemination procedures. PVS should be considered as the method of choice for semen retrieval in this patient population. Source of Funding: Paralyzed Veterans of America (PVA) Educational Grant #877 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1001 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emad Ibrahim More articles by this author Expand All Advertisement PDF downloadLoading ...

Effectiveness and electrophysiological mechanisms of focal vibration on upper limb motor dysfunction in patients with subacute stroke: A randomized controlled trial

Upper limb motor dysfunction is a common complication after stroke, which has a negative impact on the daily life of the patients. Focal vibration (FV) has been used to improve upper limb motor function in acute and chronic stroke patients, but its application in subacute stroke patients has not been extensively explored. Therefore, the purpose of this study was to explore the therapeutic effect of FV on upper limb motor function in subacute stroke patients and its underlying electrophysiological mechanism. Twenty-nine patients were enrolled and randomized into two groups: a control group and a vibration group. The control group were treated with conventional therapy including passive and active physical activity training, standing and sitting balance exercises, muscle strength training, hand extension and grasping exercises. The vibration group were given conventional rehabilitation and vibration therapy. A deep muscle stimulator (DMS) with a frequency of 60 Hz and an amplitude of 6 mm was used to provide vibration stimulation, which was sequentially applied along the biceps muscle to the flexor radialis of the affected limb for 10 min, once a day, and 6 times a week. Both groups received treatments for 4 consecutive weeks. In the vibration group, the motor evoked potential (MEP) latency and the somatosensory evoked potential (SEP) latency were significantly shortened (P < 0.05) immediately and 30 min after vibration; the SEP amplitude and MEP amplitude were significantly increased (P < 0.05) immediately and 30 min after vibration. The MEP latency (P = 0.001) and SEP N20 latency (P = 0.001) were shortened, and the MEP amplitude (P = 0.011) and SEP N20 amplitude (P = 0.017) were significantly increased after 4 weeks in the vibration group. After 4 consecutive weeks, the vibration group showed significant improvements in Modified Ashworth Scale (MAS) (P = 0.037), Brunnstrom stage for upper extremity (BS-UE) (P = 0.020), Fugl-Meyer assessment for upper extremity (FMA-UE) (P = 0.029), Modified Barthel Index (MBI) (P = 0.024), and SEP N20 (P = 0.046) compared to the control group. The Brunnstrom stage for hand (BS-H) (P = 0.451) did not show significant differences between the two groups. This study showed that FV was effective in improving upper limb motor function in subacute stroke patients. The underlying mechanism of FV may be that it enhances the efficacy of sensory pathways and induces plastic changes in the sensorimotor cortex.

Resonance-Enhanced Pulsing Water Injection for Improved Oil Recovery: Micromodel Experiments and Analysis

Enhanced oil recovery (EOR) is a crucial technology in the petroleum industry, influenced by several factors, including flooding fluids and methods. The adjustment of injection strategies and the application of vibration stimulation can significantly impact oil recovery, especially residual oil. In this study, we conducted experiments using a glass micromodel to investigate the effect of pulsing water injection on oil recovery. Our results show that when the pulse frequency matches the natural frequency of the micromodel, resonance occurs during the two-phase flow of pulse driving, which causes an increase in the amplitude of oscillation, enhances the mobility of oil, and improves recovery. The efficiency of the kinetic energy of displacement is also improved. However, when the frequency is 3 Hz, the absence of resonance leads to the opposite effect. In addition, we found that a greater amplitude increases the fluidity of oil. These findings have significant implications for the design of EOR strategies and methods. Our experimental results provide insight into the effect of pulse water injection on oil recovery and offer a potential strategy for the optimization of EOR techniques.

Effect of Self-Directed Home Therapy Adherence Combined with TheraBracelet on Poststroke Hand Recovery: A Pilot Study.

Hand impairment is a common consequence of stroke, resulting in long-term disability and reduced quality of life. Recovery may be augmented through self-directed therapy activities at home, complemented by the use of rehabilitation devices such as peripheral sensory stimulation. The objective of this study was to determine the effect of adherence to self-directed therapy and the use of TheraBracelet (subsensory random-frequency vibratory stimulation) on hand function for stroke survivors. In a double-blind, randomized controlled pilot trial, 12 chronic stroke survivors were assigned to a treatment or control group (n = 6/group). All participants were instructed to perform 200 repetitions of therapeutic hand tasks 5 days/week while wearing a wrist-worn device 8 hours/day for 4 weeks. The treatment group received TheraBracelet vibration from the device, while the control group received no vibration. Home task repetition adherence and device wear logs, as well as hand function assessment (Stroke Impact Scale Hand domain), were obtained weekly. Repetition adherence was comparable between groups but varied among participants. Participants wore the device to a greater extent than adhering to completing repetitions. A linear mixed model analysis showed a significant interaction between repetition and group (p = 0.01), with greater adherence resulting in greater hand function change for the treatment group (r = 0.94; R 2 = 0.88), but not for the control group. Secondary analysis revealed that repetition adherence was greater for those with lower motor capacity and greater self-efficacy at baseline. This pilot study suggests that adherence to self-directed therapy at home combined with subsensory stimulation may affect recovery outcomes in stroke survivors. This trial is registered with NCT04026399.

Immediate Effects of Vibration Stimulation on the Range of Motion and Proprioception in Patients with Chronic Ankle Instability: Randomized Crossover Study

Immediate Effects of Vibration Stimulation on the Range of Motion and Proprioception in Patients with Chronic Ankle Instability: Randomized Crossover Study

Penile Rehabilitation after Prostate Cancer Treatment: Which Is the Right Program?

The management of sexual complications after treatment of localized prostate cancer, such as erectile dysfunction, changes in the length of the penis, pain during sexual intercourse, and lack of orgasm, is still an unsolved problem with an important impact on patients’ quality of life. In this review, we summarize the current scientific literature about the rehabilitation of erectile dysfunction after prostate cancer treatment. The therapy for penile rehabilitation includes different types of treatments: the combination of phosphodiesterase type 5 inhibitors (PDE5-I) and the vacuum erectile device (VED) are considered first-line treatment options. When therapy begins, the duration of treatment, the dosage and the drug used all play very important roles in the treatment outcome. Intracavernous injection (ICI) therapy represents the second-line option for patients ineligible for PDE5-I therapy. Technological development has led to the emergence of devices for the stimulation of the penis without the use of drugs, such as penile vibratory stimulation (PVS) for stimulation of ejaculation in spinal cord injury and low-intensity extracorporeal shockwave therapy (LIESWT). The rapid diffusion of the latter, thanks to its easy use, attains good results without side effects. The panorama of penile rehabilitation after PC treatments is vast and many studies are needed, especially on new technologies, to find the best therapeutic regimen possible, personalized to the patient’s characteristics and the type of treatment for PC.

Effect of Fractional Carbon Dioxide vs Sham Laser on Sexual Function in Survivors of Breast Cancer Receiving Aromatase Inhibitors for Genitourinary Syndrome of Menopause

Survivors of breast cancer present more severe symptoms of genitourinary syndrome of menopause (GSM) than patients without history of breast cancer. Recently, new treatments, such as vaginal laser therapy, have appeared, but evidence of their efficacy remains scarce. To assess the safety and efficacy of carbon dioxide (CO2) vs sham vaginal laser therapy after 6 months of follow-up in survivors of breast cancer with GSM receiving aromatase inhibitors. This prospective double-blind sham-controlled randomized clinical trial with two parallel study groups was performed during October 2020 to March 2022 in a tertiary referral hospital. Survivors of breast cancer using aromatase inhibitors were assessed for eligibility, and eligible patients were randomized into the 2 treatment groups. Follow-up was conducted at 6 months. Data were analyzed in July 2022. All patients from both groups were instructed to use the first-line treatment (FLT) based on nonhormonal moisturizers and vaginal vibrator stimulation. Patients for each group were allocated to 5 monthly sessions of fractional CO2 laser therapy (CLT) or sham laser therapy (SLT). The primary outcome was sexual function, evaluated through Female Sexual Function Index (FSFI) score. Other subjective measures of efficacy included a visual analog scale of dyspareunia, vaginal pH, a Vaginal Health Index, quality of life (assessed via Short-Form 12), and body image (assessed with the Spanish Body Image Scale). Objective measures of efficacy included vaginal maturation index, vaginal epithelial elasticity (measured in Pascals) and vaginal epithelial thickness (measured in millimeters). Measures were assessed before and after the intervention. Tolerance (measured on a Likert scale), adverse effects, and estradiol levels were recorded. Among 211 survivors of breast cancer assessed, 84 women were deemed eligible and 72 women (mean [SD] age, 52.6 [8.3] years) were randomized to CLT (35 participants) or SLT (37 participants) and analyzed. There were no statistically significant differences between groups at baseline. At 6 months, both groups showed improvement in FSFI (mean [SD] score at baseline vs 6 months: CLT, 14.8 [8.8] points vs 20.0 [9.5] points; SLT, 15.6 [7.0] points vs 23.5 [6.5] points), but there was no significant difference between CLT and SLT groups in the improvement of sexual function evaluated through the FSFI test overall (mean [SD] difference, 5.2 [1.5] points vs 7.9 [1.2] points; P = .15) or after excluding women who were not sexually active (mean [SD] difference, 2.9 [1.4] points vs 5.5 [1.1] points; P = .15). There were also no differences between improvement of the 2 groups at 6 months of follow-up in the other assessed subjective outcomes, including dyspareunia (mean [SD] difference, -4.3 [3.4] vs -4.5 [2.3]; P = .73), Vaginal Health Index (mean [SD] difference, 3.3 [4.1] vs 5.0 [4.5]; P = .17), body image (mean [SD] difference, -3.7 [4.5] vs -2.7 [4.8]; P = .35), and quality of life (mean [SD] difference, -0.3 [3.6] vs -0.7 [3.2]; P = .39). Similarly, there were no differences in improvements in objective outcomes, including vaginal pH (mean [SD] difference, -0.6 [0.9] vs -0.8 [1.2]; P = .29), vaginal maturation index (mean [SD] difference, 10.2 [17.4] vs 14.4 [17.1]; P = .15), vaginal epithelial thickness (mean [SD] difference, 0.021 [0.014] mm vs 0.013 [0.012] mm; P = .30), vaginal epithelial elasticity (mean [SD] difference, -1373 [3197] Pascals vs -2103 [3771] Pascals; P = .64). There were significant improvements in the overall analysis regardless of group in many outcomes. The 2 interventions were well tolerated, but tolerance was significantly lower in the CLT group than the SLT group (mean [SD] Likert scale score, 3.3 [1.3] vs 4.1 [1.0]; P = .007). No differences were observed in complications or serum estradiol levels. In this randomized clinical trial, vaginal laser treatment was found to be safe after 6 months of follow-up, but no statistically significant differences in efficacy were observed between CLT and SLT. ClinicalTrials.gov identifier: NCT04619485.

Changes in the BOLD signal of S1 and BA3 per finger/phalanx as a response to high-frequency vibratory stimulation

Purpose and Method The purpose of this study was to determine the changes in the Blood Oxygen Level Dependent signal of Primary somatosensory area (S1) and Brodmann area 3 (BA3) per finger and phalanx in comparison to the activation voxel when 250 Hz vibratory stimulation with high sensitivity for the Pacinian corpuscle was given to the four fingers and three phalanges. Results The result of analyzing the activation voxel showed a significant difference for S1 per finger and phalanx, but for BA3, no significant difference was observed despite a similar trend to S1. In contrast, the activation intensity (BOLD) displayed a significant difference for S1 per finger and phalanx and for BA3, where the activation voxel had no significant variation. In addition, while the result of S1 did not indicate whether the index or the little fingers had the highest sensitivity based on the BOLD signal per finger, the result of BA3 marked the strongest BOLD signal for the little finger as a response to 250 Hz vibratory stimulation. The activation intensity per phalanx was the highest for the intermediate phalanx for S1 and BA3, which was in line with a previous study comparing the activation voxel. Conclusions The method based on the intensity of the nerve activation is presumed to have high sensitivity as the signal intensity is monitored within a specific, defined area. Thus, for the extraction of brain activation patterns of micro-domains, such as BA3, monitoring the BOLD signal that reflects the nerve activation intensity more sensitively is likely to be advantageous.