Comparison of Single-Session Dose Response Effects of Whole Body Vibration on Spasticity and Walking Speed in Persons with Spinal Cord Injury

Neurotherapeutics. 2018 Jul;15(3):684-696. doi: 10.1007/s13311-018-0644-1.

Abstract

Spasticity affects approximately 65% of persons with spinal cord injury (SCI) and negatively impacts function and quality of life. Whole body vibration (WBV) appears to reduce spasticity and improve walking function; however, the optimal dose (frequency/duration) is not known. We compared single-session effects of four different WBV frequency/duration dose conditions on spasticity and walking speed, in preparation for a planned multi-session study. Thirty-five participants with motor-incomplete SCI received four different doses of WBV: high frequency (50 Hz)/short duration (180 s), high frequency/long duration (360 s), low frequency (30 Hz)/short duration, and low frequency/long duration, plus a control intervention consisting of sham electrical stimulation. In all conditions, participants stood on the WBV platform for 45-s bouts with 1 min rest between bouts until the requisite duration was achieved. The frequency/duration dose order was randomized across participants; sessions were separated by at least 1 week. Quadriceps spasticity was measured using the pendulum test at four time points during each session: before, immediately after, 15 min after, and 45 min after WBV. Walking speed was quantified using the 10-m walk test at three time points during each session: baseline, immediately after, and 45 min after WBV. In the full group analysis, no frequency/duration combination was significantly different from the sham-control condition. In participants with more severe spasticity, a greater reduction in stretch reflex excitability was associated with the high frequency/long duration WBV condition. The sham-control condition was associated with effects, indicating that the activity of repeated sitting and standing may have a beneficial influence on spasticity.

Trial registration: NCT02340910 (assigned 01/19/2015).

Keywords: Afferent input; Hyperreflexia; Oscillation; Pendulum test; Stimulation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Human Body*
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / therapy*
  • Physical Therapy Modalities
  • Psychophysics / methods
  • Severity of Illness Index
  • Spinal Cord Injuries / physiopathology*
  • Spinal Cord Injuries / therapy*
  • Time Factors
  • Vibration / therapeutic use*
  • Walking Speed / physiology
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02340910