***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background It is thought that therapy should be functional , be highly repetitive , and promote afferent input to best stimulate h and motor recovery after stroke , yet patients struggle to access such therapy . We developed the MusicGlove , an instrumented glove that requires the user to practice gripping-like movements and thumb-finger opposition to play a highly engaging , music-based , video game . The purpose of this study was to 1 ) compare the effect of training with MusicGlove to conventional h and therapy 2 ) determine if MusicGlove training was more effective than a matched form of isometric h and movement training ; and 3 ) determine if MusicGlove game scores predict clinical outcomes . Methods 12 chronic stroke survivors with moderate hemiparesis were r and omly assigned to receive MusicGlove , isometric , and conventional h and therapy in a within-subjects design . Each subject participated in six one-hour treatment sessions three times per week for two weeks , for each training type , for a total of 18 treatment sessions . A blinded rater assessed h and impairment before and after each training type and at one-month follow-up including the Box and Blocks ( B & B ) test as the primary outcome measure . Subjects also completed the Intrinsic Motivation Inventory ( IMI ) . Results Subjects improved h and function related to grasping small objects more after MusicGlove compared to conventional training , as measured by the B & B score ( improvement of 3.21±3.82 vs. -0.29±2.27 blocks ; P=0.010 ) and the 9 Hole Peg test ( improvement of 2.14±2.98 vs. -0.85±1.29 pegs/minute ; P=0.005 ) . There was no significant difference between training types in the broader assessment batteries of h and function . Subjects benefited less from isometric therapy than MusicGlove training , but the difference was not significant ( P>0.09 ) . Subjects sustained improvements in h and function at a one month follow-up , and found the MusicGlove more motivating than the other two therapies , as measured by the IMI . MusicGlove games scores correlated strongly with the B & B score . Conclusions These results support the hypothesis that h and therapy that is engaging , incorporates high numbers of repetitions of gripping and thumb-finger opposition movements , and promotes afferent input is a promising approach to improving an individual ’s ability to manipulate small objects . The MusicGlove provides a simple way to access such therapy BACKGROUND Segmental muscle vibration ( SMV ) improves motor performances in neurological conditions , including stroke . OBJECTIVE To determine if SMV modifies upper limb muscular activity in chronic stroke patients performing a reaching movement . METHODS We r and omized 22 chronic stroke patients to an experimental group ( EG ; n = 12 ) , receiving 10 sessions of exercise + 120 Hz SMV over the biceps brachii ( BB ) and the flexor carpi ulnaris ( FCU ) muscles , or to a control group ( CG ; n = 10 ) receiving exercise only  . All subjects performed a reaching movement with the affected side before and 4 weeks after therapy ended . We recorded  surface EMG activity of the anterior deltoid ( AD ) , posterior deltoid ( PD ) , BB , triceps brachii ( TB ) , FCU and extensor carpi radialis ( ECR ) muscles . We calculated muscular onset times , modulation ratio , co-contractions and degree of contraction . RESULTS After SMV , onset times of the PD ( p = 0.03 ) , BB ( p = 0.02 ) and ECR ( p = 0.04 ) in the EG were less anticipated than at baseline ; the modulation ratio increased in AD ( p = 0.003 ) and BB ( p = 0.01 ) ; co-contractions decreased in the pairs BB/TB ( p = 0.007 ) , PD/BB ( p = 0.004 ) and AD/BB ( p = 0.01 ) ; and the degree of contraction decreased in BB ( p = 0.01 ) . CONCLUSIONS The modulation of muscular function induced by SMV may aid to explain its action on smoothness and coordination of movements Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more BACKGROUND AND PURPOSE To improve the accuracy of early postonset prediction of motor recovery in the flaccid hemiplegic arm , the effects of change in motor function over time on the accuracy of prediction were evaluated , and a prediction model for the probability of regaining dexterity at 6 months was developed . METHODS In 102 stroke patients , dexterity and paresis were measured with the  Action Research Arm Test , Motricity Index , and Fugl-Meyer motor evaluation .  For model development , 23 c and i date determinants were selected . Logistic regression analysis was used for prognostic factors and model development . RESULTS At 6 months , some dexterity in the paretic arm was found in 38 % , and complete functional recovery was seen in 11.6 % of the patients . Total anterior circulation infa rcts , right hemisphere strokes , homonymous hemianopia , visual gaze deficit , visual inattention , and paresis were statistically significant related to a poor arm function . Motricity Index leg scores of at least 25 points in the first week and Fugl-Meyer arm scores of 11 points in the second week increasing to 19 points in the fourth week raised the probability of developing some dexterity ( Action Research Arm Test > or=10 points ) from 74 % ( positive predictive value [ PPV ] , 0.74 ; 95 % confidence interval [ CI ] , 0.63 to 0.86 ) to 94 % ( PPV , 0.83 ; 95 % CI , 0.76 to 0.91 ) at 6 months . No change in probabilities of prediction dexterity was found after 4 weeks . CONCLUSIONS Based on the Fugl-Meyer scores of the flaccid arm , optimal prediction of arm function outcome at 6 months can be made within 4 weeks after onset . Lack of voluntary motor control of the leg in the first week with no emergence of arm synergies at 4 weeks is associated with poor outcome at 6 months The present experiment addressed the time course of corticospinal excitability changes following interventional muscle tendon vibration .  Using transcranial magnetic stimulation , motor evoked potentials of the flexor carpi radialis and extensor carpi radialis brevis muscle were recorded for a period of 60 min after cessation of vibration ( 80 Hz , 0.5 mm , 30 min ) to the distal wrist flexor tendons . A delayed corticospinal excitability increase in both the vibrated and non-vibrated antagonistic muscle was observed , with lasting levels of facilitation for the latter . No changes were observed following interventional cutaneous vibration . These results underscore a facilitatory influence of prolonged Ia-afferent activation on corticospinal excitability . Findings are discussed in light of recent advances in promoting motor recovery after brain injury by somatosensory stimulation BACKGROUND Stroke is one of the leading causes for disability worldwide . Exercise therapy is a key element of stroke rehabilitation but no evidence are present in literature . Moreover recently focal muscle vibrationis described as a useful therapeutic approach in the post stroke recovery . In this study the efficacy of the vibration therapy in association to progressive modular re balancing rehabilitative approach has been evaluated and compared to the conventional therapy alone and associated to the muscle vibration . METHODS A pilot r and omized controlled trial , using a pragmatic triple-blind , parallel-group study design in chronic stroke patients upper limb function . RESULTS Functional outcomes result ed increased in the group treated with vibration therapy and in particular in the group associated to progressive modular rebalancing approach . CONCLUSION The combining neurophysiologically-based rehabilitative technique and vibration therapy may improve functional recovery in chronic stroke patients BACKGROUND Physical modalities such as vibration has been suggested as possible non-pharmacological way to control spasticity .  AIMS The hypotheses tested were : 1 ) can a selective vibration of the upper limb flexor antagonist , triceps brachii , reduce the spasticity of the flexor biceps brachii muscle ; 2 ) is its association with physiotherapy better than physiotherapy alone in reducing spasticity and improving function , 3 ) can this possible effect last for longer than the stimulation period . DESIGN R and omized double-blind study . SETTING Rehabilitation Institute , inward patients . POPULATION Thirty hemiplegic patients affected by upper limb spasticity . METHOD ( VIB + PT ) group received physiotherapy plus vibration by means of a pneumatic vibrator applied over the belly of the triceps brachii of the spastic side ( contact surface 2 cm2 ; frequency 100 Hz ; amplitude 2 mm ; mean pressure 250 mBar ) . ( SHAM + PT ) group received physiotherapy and sham vibration . Both groups had 60 minutes of physiotherapy ( Kabat techniques ) for 5 days a week ( from Monday to Friday ) for 2 weeks . MAIN OUTCOME MEASURE Ashworth modified scale for spasticity and robot-aided motor tasks changes for functional modifications were evaluated before starting treatment ( T0 ) , 48 hours after the fifth session ( T1 ) and 48 hours after the last session ( T2 ) . RESULTS Fisher 's exact test showed a statistically significant greater improvements in the ( VIB + PT ) group ( P=0.0001 ) compared to in the ( SHAM + PT ) group after 1 week , as well as after 2 weeks of treatment ( P=0.0078 ) at the Ashworth scale . CONCLUSION 1 ) 100 Hz vibration applied to the triceps brachii of a spastic upper limb in association with physiotherapy is able to reduce the spasticity of the flexor agonist , biceps brachii ; 2 ) this association is better than physiotherapy alone in controlling spasticity and improving function ; 3 ) this clinical ly perceivable reduction of spasticity and function improvement extends ( for at least 48 hours ) beyond the period of application of the vibration , supporting its possible role in the rehabilitation of spastic hemiplegia . CLINICAL REHABILITATION IMPACT 100 Hz antagonist muscle vibration , a non-pharmacological treatment , can help physiotherapy to reduce flexors spasticity and improve functions in the rehabilitation of upper limb spasticity BACKGROUND Segmental muscle vibration ( SMV ) has been used to improve gait and to reduce spasticity in stroke patients . No data exist about the possibility to improve upper limb motor function by using SMV . METHODS Forty-four patients with hemiparesis following chronic stroke were r and omized to an experimental ( n = 24 ) and a control group ( n = 20 ) . Patients in the experimental group received two weeks of general physical therapy and SMV over the biceps brachii and flexor carpi ulnaris muscles of the paretic side , while those in the control group received two weeks of general physical therapy .  Kinematic analysis of reaching movement was performed at baseline and two weeks after treatment ended . RESULTS Normalized jerk , indicating the smoothness of movement , significantly improved in the experimental group , with significant difference emerging between groups at the post-treatment evaluation . Patients in the experimental group also displayed a significant improvement for mean linear velocity , mean angular velocity at shoulder , distance to target at the end of movement and movement duration . No differences emerged between baseline and post-treatment evaluations in the control group . CONCLUSIONS when added to general physical therapy , SMV is effective in improving , in a short-term period , upper limb motor performances of reaching movement in chronic stroke patients OBJECTIVE To examine the clinical effect of repetitive focal muscle vibration ( rMV ) on the motor function of the upper extremity 1 month after treatment in patients with chronic stroke . DESIGN We performed a pilot r and omized controlled trial using a double-blind , parallel-group study design . SETTING Medical center . PARTICIPANTS Patients with chronic stroke ( N=49 ) . INTERVENTIONS Patients r and omly assigned to the study group ( SG ) received rMV , while patients in the control group ( CG ) received a placebo vibratory treatment . The patients and the clinical examiner were blind to the intervention . MAIN OUTCOME MEASURES The primary endpoint was an improvement of more than .37 points on the Functional Ability Scale of the Wolf Motor Function Test ( WMFT FAS ) . The Modified Ashworth Scale and the visual analog scale were the secondary outcome measures . All measures were administered before the treatment ( t0 ) and 1 week ( t1 ) and 1 month ( t2 ) after the treatment . RESULTS Twenty-eight patients were allocated to the SG and 21 to the CG . The analysis of variance for repeated measurements revealed a significant difference in the expression of the WMFT FAS score over time only in the SG ( P=.006 ) . The treatment was successful for 7 ( 33 % ) of 21 patients recruited in the SG and for 2 ( 13 % ) of 15 patients recruited in the CG . The relative risk was 2.5 ( 95 % confidence interval , .60 - 10.39 ) , and the number needed to treat was 5 . The Wilcoxon test showed a statistically significant difference between t0 and t2 in the SG ( P=.02 ) . No adverse event was observed in the 2 groups . CONCLUSIONS Our results suggest that rMV treatment of the upper limb may improve the functional ability of chronic stroke patients , but a larger , multicenter , r and omized controlled study is needed BACKGROUND In recent years , local muscle vibration received considerable attention as a useful method for muscle stimulation in 
    Output:
    
FMV showed some evidence in reducing hemiplegic upper extremity spasticity in patients with stroke .
CONCLUSIONS The FMV may an efficient intervention in reducing upper extremity spasticity in the stroke population .