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Open Access Research

Remote vibrotactile noise improves light touch sensation in stroke survivors’ fingertips via stochastic resonance

Leah R Enders1*, Pilwon Hur1, Michelle J Johnson2 and Na Jin Seo13

Author Affiliations

1 Department of Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee, Milwaukee, USA

2 Department of Physical Medicine and Rehabilitation, Medical College of Wisconsin, Milwaukee, WI, USA

3 Department of Occupational Science and Technology, University of Wisconsin-Milwaukee, Milwaukee, WI, USA

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Journal of NeuroEngineering and Rehabilitation 2013, 10:105  doi:10.1186/1743-0003-10-105

Published: 11 October 2013

Abstract

Background and purpose

Stroke rehabilitation does not often integrate both sensory and motor recovery. While subthreshold noise was shown to enhance sensory signal detection at the site of noise application, having a noise-generating device at the fingertip to enhance fingertip sensation and potentially enhance dexterity for stroke survivors is impractical, since the device would interfere with object manipulation. This study determined if remote application of subthreshold vibrotactile noise (away from the fingertips) improves fingertip tactile sensation with potential to enhance dexterity for stroke survivors.

Methods

Index finger and thumb pad sensation was measured for ten stroke survivors with fingertip sensory deficit using the Semmes-Weinstein Monofilament and Two-Point Discrimination Tests. Sensation scores were measured with noise applied at one of three intensities (40%, 60%, 80% of the sensory threshold) to one of four locations of the paretic upper extremity (dorsal hand proximal to the index finger knuckle, dorsal hand proximal to the thumb knuckle, dorsal wrist, volar wrist) in a random order, as well as without noise at beginning (Pre) and end (Post) of the testing session.

Results

Vibrotactile noise of all intensities and locations instantaneously and significantly improved Monofilament scores of the index fingertip and thumb tip (p < .01). No significant effect of the noise was seen for the Two-Point Discrimination Test scores.

Conclusions

Remote application of subthreshold (imperceptible) vibrotactile noise at the wrist and dorsal hand instantaneously improved stroke survivors’ light touch sensation, independent of noise location and intensity. Vibrotactile noise at the wrist and dorsal hand may have enhanced the fingertips’ light touch sensation via stochastic resonance and interneuronal connections. While long-term benefits of noise in stroke patients warrants further investigation, this result demonstrates potential that a wearable device applying vibrotactile noise at the wrist could enhance sensation and grip ability without interfering with object manipulation in everyday tasks.

Keywords:
Stroke; Sensory deficit; Biomechanics; Stochastic resonance; Noise