University of Miami, Miami, FL, USA.
Restor Neurol Neurosci. 2009;27(6):621-31. doi: 10.3233/RNN-2009-0487.
Individuals with spinal cord injury (SCI) often have involuntary, reflex-evoked muscle activity resulting in spasticity. Vibration may modulate reflex activity thereby decreasing spasticity. This study suggests feasibility of using whole-body vibration (WBV) to decrease quadriceps spasticity in individuals with SCI.
Participants were individuals (n=16) with spastic quadriceps hypertonia due to chronic SCI (> 1 year). Quadriceps spasticity was measured by gravity-provoked stretch (Pendulum Test) before (initial) and after (final) a 3 day/week, 12-session WBV intervention. In addition, differences between immediate (immediate post-WBV) and delayed (delayed post-WBV) within-session effects were quantified. Finally, we assessed response differences between subjects who did and those who did not use antispastic agents.
There was a significant reduction in quadriceps spasticity after participation in a WBV intervention that persisted for at least eight days. Within a WBV session, spasticity was reduced in the delayed post-WBV test compared to the immediate post-WBV test. The WBV intervention was associated with similar changes in quadriceps spasticity in subjects who did and those who did not use antispastic agents.
Vibration may be a useful adjunct to training in those with spasticity. Future studies should directly compare the antispastic effects of vibration to those of antispastic agents.
脊髓损伤(SCI)患者常伴有不自主的反射性肌肉活动,导致痉挛。振动可能会调节反射活动,从而降低痉挛程度。本研究表明,全身振动(WBV)可降低 SCI 患者股四头肌痉挛的可行性。
参与者为因慢性 SCI(> 1 年)而出现股四头肌痉挛性高张力的个体(n=16)。在为期 3 天/周、12 次 WBV 干预前后(初始和最终),通过重力诱发的伸展(摆锤试验)测量股四头肌痉挛程度。此外,还量化了单次治疗过程中即刻(立即进行 WBV 后)和延迟(延迟进行 WBV 后)之间的效果差异。最后,我们评估了使用抗痉挛药物和不使用抗痉挛药物的患者之间的反应差异。
参加 WBV 干预后,股四头肌痉挛程度显著降低,且至少持续 8 天。在 WBV 治疗过程中,与即刻进行 WBV 后相比,延迟进行 WBV 后测试中痉挛程度降低。在使用和不使用抗痉挛药物的患者中,WBV 干预与股四头肌痉挛程度的相似变化相关。
振动可能是痉挛患者训练的有用辅助手段。未来的研究应直接比较振动和抗痉挛药物对痉挛的抗痉挛作用。