Martinache Florence, de Crouy Anne-Claire, Boutin Arnaud, Duranteau Jacques, Vigué Bernard
CIAMS, Université Paris-Saclay, Orsay, France.
Département d'Anesthésie Réanimation, Service de Rééducation Post-Réanimation (SRPR), Hôpital Universitaire de Bicêtre, APHP, Université Paris-Saclay, Le Kremlin-Bicêtre, France.
Front Rehabil Sci. 2025 Feb 26;6:1490904. doi: 10.3389/fresc.2025.1490904. eCollection 2025.
The first months following a spinal cord injury (SCI) are crucial for promoting recovery. However, patients with high SCIs often require prolonged stays in intensive care units (ICUs), delaying optimal rehabilitation due to limited resources. This study examined the safety, feasibility, and effects on spasticity and muscle atrophy of an early rehabilitation technique using non-invasive sensory stimulation and called functional proprioceptive stimulation (FPS).
Ten SCI patients were included in this randomized pilot study, with five receiving early FPS and five receiving sham stimulation. Both groups were treated using the Vibramoov, consisting of 12 computer-synchronized vibrators placed on the lower limbs. Treatment sessions lasted 30 min, four times a week, for up to 8 weeks. Spasticity was assessed using the Modified Ashworth Scale, Tardieu Scale, Spinal Cord Assessment Tool for Spastic Reflexes, and a patient self-evaluation with a visual analog scale. Muscle atrophy was evaluated through ultrasonography of rectus femoris thickness and cross-sectional area. The duration of the follow-up period ranged from 6 months to 1 year.
Treatment began early, with a median of 4 days post-injury for both groups. The number of adverse events was similar between groups, with none linked to the intervention. No medium-term effects on spasticity or muscle atrophy could be identified. However, our results show a tendency toward a beneficial short-term effect of FPS on spasticity, observed for all spasticity measurements.
This pilot study shows that early FPS is feasible and safe for SCI as early as the intensive care unit stage. We demonstrated that FPS induced a transient relaxation and spasticity reduction that could potentially enhance a rehabilitation session administered shortly after it, but larger studies are needed to determine the medium and long-term effects.
ClinicalTrials.gov, identifier (NCT05094752).
脊髓损伤（SCI）后的头几个月对促进恢复至关重要。然而，高位脊髓损伤患者通常需要在重症监护病房（ICU）长时间住院，由于资源有限，最佳康复治疗被推迟。本研究探讨了一种使用非侵入性感觉刺激的早期康复技术——功能性本体感觉刺激（FPS）的安全性、可行性及其对痉挛和肌肉萎缩的影响。
本随机试点研究纳入了10名脊髓损伤患者，其中5名接受早期FPS治疗，5名接受假刺激。两组均使用Vibramoov进行治疗，该设备由12个置于下肢的计算机同步振动器组成。治疗疗程持续30分钟，每周4次，最长持续8周。使用改良Ashworth量表、Tardieu量表、脊髓痉挛反射评估工具以及视觉模拟量表进行患者自我评估来评估痉挛情况。通过超声测量股直肌厚度和横截面积来评估肌肉萎缩。随访期为6个月至1年。
两组均在伤后中位数4天开始治疗。两组不良事件数量相似，且均与干预措施无关。未发现对痉挛或肌肉萎缩的中期影响。然而，我们的结果显示，对于所有痉挛测量指标，FPS在短期内对痉挛有有益作用的趋势。
这项试点研究表明，早期FPS在重症监护病房阶段对脊髓损伤患者既可行又安全。我们证明，FPS可引起短暂的放松和痉挛减轻，这可能会增强在其之后不久进行的康复治疗效果，但需要更大规模的研究来确定其中长期影响。
ClinicalTrials.gov，标识符（NCT05094752）。
