Clinical Research Directory

Effect of Early Tendon Vibrations on Upper Limb Motor Recovery After a Stroke

Strokes often induce a motor deficit. The resulting immobilization is in itself an aggravation factor since it worsens the motor deficit induced by the stroke itself. Amongst the different sensory stimulations, the use of tendon vibratory stimulations (TVS) that activate proprioceptive pathways (muscle spindle fibers) is gaining increasing interest in the rehabilitation world. Tendon vibratory stimulation (TVS) can be used on patients with little to no voluntary motor functions. Therefore, it seems particularly suited to significant upper limb deficits, and especially as early as possible after a stroke occurs when motor skills are severely affected. Various studies have shown the interest of using vibratory stimulations in the management of post-stroke motor disorders. The majority were conducted in the chronic stroke stage. Only one small scale study has been conducted on the acute stroke stage.

Prediction of Post-stroke Motor Recovery

The prediction of motor recovery in the acute phase of stroke is crucial for several clinical reasons: (i) informing the patient and his relatives, (ii) helping to identify the patient's endorsement (return home or rehabilitation) as well as the adaptation of the rehabilitation program to what can be expected from it. To date, an algorithm (decision tree) proposed by C. Stinear's team named PREP2 is the best predictive tool with 75% of patients well classified at 3 months. It predicts the functional recovery of the upper limb after stroke 3 months before the episode by categorizing recovery as "excellent", "good", "limited" as well as "minor" (poor). With two data (SAFE score, age) or three (SAFE score, Motor evoked potential, NIHSS), the prediction is effective three times out of 4. In the study the team is proposing "PREP-UCV", it would like to validate this algorithm as it is with patients in the active file who are victims of stroke. The expected accuracy is 75% or more. As a secondary objective, the team would like to confirm that it find the same algorithm starting from the initial data from PREP 2 (side of the stroke, type of stroke (ischemic and / or hemorrhagic), involvement of the corticospinal tract on MRI, sex at birth ) as well as two other factors which are also very important: cognitive status (dysexecutive / aphasia / neglect), as well as the neutrophils on lymphocytes ratio.