Continuous and intermittent protocols of whole body vibration on decreasing spasticity in people with spinal cord injury: a crossover study Protocols of whole body vibration on decreasing spasticity in people with spinal cord injury
Description
Article highlights:
- Given the lack of consensus about which WBV protocol is effective in decreasing lower limb spasticity, which is still present in the literature, and the poor viability of implementing intensive intervention protocols in rehabilitation centers, the findings presented in our paper will appeal to the therapists and clinicians involved in the rehabilitation process.
- The research hypothesis is whether continuous or intermittent WBV protocols can reduce spasticity of the lower limbs in people with spinal cord injury.
- WBV could be used as a complementary intervention of rehabilitation, by facilitating the exercises performance, since it provides enhanced afferent inputs to modulate the stretch reflex pathway.
Abstract
BACKGROUND: Whole body vibration (WBV) seems to modulate the excitability of neuronal circuits involved in the stretch reflex and has shown positive outcomes in reducing spasticity, but the best parameters of application remain unknown. AIM: To compare the effects of each WBV protocol, through clinical, self-related, and electrophysiological measures, on reducing spasticity in people with SCI. METHODOLOGY: Eight participants, all male, aged 33.5±9.6, presented spasticity on quadriceps, hamstrings, hip adductor, or gastrocnemius muscles due to complete (AIS A; n=5) and incomplete (AIS B-D; n=3) spinal cord injury. Participants were allocated to both intervention groups, continuous WBV (single session, 6 minutes duration, 30Hz) and intermittent WBV (two alternated sessions of 4 bouts of 45 seconds, with 1-minute rest, 30Hz), within a randomized sequence, and a washout of 15 days. KIKOS P20 vibrating platform was used. Spasticity was assessed by the Modified Ashworth Scale, Tardieu Scale, Visual Analog Scale, and Surface Electromyograph (sEMG), using Trigno Wireless EMG System (Delsys Inc.), at three time points: before, after, and 1-week follow-up.
RESULTS: No significant differences were found between cWBV and iWBV groups. In the intragroup analysis, although a decrease in the median values of spasticity could be seen in all muscles, there was no statistical significance in the clinical scales scores. The amplitude of the sEMG signal decreased on the rectus femoris (p<0.05) after both protocols and on the biceps femoris after continuous WBV (p<0.05). Median frequency increased in the gastrocnemius muscle after continuous WBV (p=0.01). CONCLUSIONS: Both parameter settings of WBV training showed the potential to reduce spasticity. The clinical and subjective scales presented similar results but were not sensitive to changes in electrical muscle activity.
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