Shepherd Center - Crawford Research Institute, Atlanta, GA, USA.
Department of Physical Therapy, University of Miami - Miller School of Medicine, Coral Gables, FL, USA.
Neurotherapeutics. 2018 Jul;15(3):684-696. doi: 10.1007/s13311-018-0644-1.
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.
NCT02340910 (assigned 01/19/2015).
痉挛影响大约 65%的脊髓损伤 (SCI) 患者,并对功能和生活质量产生负面影响。全身振动 (WBV) 似乎可以降低痉挛程度并改善步行功能;然而,最佳剂量(频率/持续时间)尚不清楚。我们比较了四种不同 WBV 频率/持续时间剂量条件对痉挛和步行速度的单次治疗效果,为计划的多疗程研究做准备。35 名运动不完全性 SCI 参与者接受了四种不同剂量的 WBV:高频 (50Hz)/短持续时间 (180s)、高频/长持续时间 (360s)、低频 (30Hz)/短持续时间和低频/长持续时间,以及由假电刺激组成的对照干预。在所有条件下,参与者在 WBV 平台上站立 45 秒,每个回合之间休息 1 分钟,直到达到所需的持续时间。参与者的频率/持续时间剂量顺序是随机的;疗程之间至少间隔 1 周。在每次治疗的四个时间点使用钟摆试验测量股四头肌痉挛:治疗前、治疗后即刻、治疗后 15 分钟和治疗后 45 分钟。在每次治疗的三个时间点使用 10 米步行测试量化步行速度:治疗前、治疗后即刻和治疗后 45 分钟。在全组分析中,没有任何一种频率/持续时间组合与假对照条件有显著差异。在痉挛程度更严重的参与者中,高频/长持续时间 WBV 条件与较大的牵张反射兴奋性降低相关。假对照条件与效果相关,表明反复坐立的活动可能对痉挛有有益的影响。
NCT02340910(于 2015 年 1 月 19 日分配)。