Noise-enhanced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy Wen Liu, PhD, Lewis A. Lipsitz,

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Noise-enhanced vibrotactile sensitivity in older adults, patients with stroke, and patients with diabetic neuropathy Wen Liu, PhD, Lewis A. Lipsitz, MD, Manuel Montero-Odasso, MD, Jonathan Bean, MD, D.Casey Kerrigan, MD, James J. Collins, PhD Archives of Physical Medicine and Rehabilitation Volume 83, Issue 2, Pages 171-176 (February 2002) DOI: 10.1053/apmr.2002.28025 Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 1 A schematic representation of the experimental set-up. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 2 Representative samples of the 30-Hz vibration stimulus (upper trace) and the mechanical noise signal (lower trace). Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 3 Representative results—vibration stimulus amplitude versus presentation number—from 1 trial for 1 elderly subject. Each trial consisted of 50 presentations at the fingertip: 25 for the no-noise condition, consisting of 20 vibration stimuli (solid triangles) and 5 null stimuli (*), and 25 for the noise condition, consisting of 20 vibration stimuli plus mechanical noise (open circles) and 5 null stimuli plus mechanical noise (*). The upper dashed line corresponds to the subject's determined detection threshold for the vibration stimulus without noise; the lower dashed line corresponds to the subject's determined detection threshold for the vibration stimulus with noise. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 4 Detection thresholds for the vibration stimulus without and with mechanical noise for 3 representative subjects. Shown are results from (A) the 9 fingertip trials for an elderly subject, (B) the 9 fingertip trials for a patient with stroke, and (C) the 5 fingertip trials and 5 foot trials for a patient with diabetic neuropathy. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 5 Means and standard deviations (SDs) of the detection thresholds at the fingertip for the vibration stimulus without and with mechanical noise over the 9 trials for each of the elderly subjects. Paired Student t tests showed that for each subject the detection threshold for the vibration stimulus with noise was significantly lower (P <.05) than that for the vibration stimulus without noise. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 6 Means and SDs of the detection thresholds at the fingertip for the vibration stimulus without and with mechanical noise over the 9 trials for each of the patients with stroke. Paired Student t tests showed that for each patient (except patient 3) the detection threshold for the vibration stimulus with noise was significantly lower (P <.05) than that for the vibration stimulus without noise. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 7 Means and SDs of the detection thresholds at (A) the fingertip and (B) the foot for the vibration stimulus without and with mechanical noise over the 5 trials for each of the patients with diabetic neuropathy. Paired Student t tests showed that for each patient the detection threshold for the vibration stimulus with noise was significantly lower (P <.05) than that for the vibration stimulus without noise. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions

Fig. 8 Group means and SDs of the elderly subjects' detection thresholds for the vibration stimulus without and with mechanical noise for trials 1 to 3, 4 to 6, and 7 to 9. Note that the results for the respective detection thresholds do not change considerably across the trials. Similar results were obtained for patients with stroke and patients with diabetic neuropathy. Archives of Physical Medicine and Rehabilitation 2002 83, 171-176DOI: (10.1053/apmr.2002.28025) Copyright © 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation Terms and Conditions