Efficacy of Transcutaneous Spinal Stimulation versus Whole Body Vibration for Spasticity Reduction in Persons with Spinal Cord Injury

• Type of Material: Article
• Authors: Evan B Sandler, Crawford Research Institute; Kyle Condon, Crawford Research Institute; Edelle Field-Fote, Emory University
• Language: English
• Date: 2021-08-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/jcm10153267
• Title of Journal or Parent Work: JOURNAL OF CLINICAL MEDICINE
• Volume: 10
• Issue: 15
• Grant/Funding Information: This research was funded by NIH National Institute of Child Health and Human Development (NICHD) R01 HD079009-02 (E.C.F.-F.).
• Keywords: Science & Technology; ELECTRICAL-STIMULATION; antispasmodic; PRESYNAPTIC INHIBITION; INDIVIDUALS; General & Internal Medicine; neuromodulation; PENDULUM TEST; electrical stimulation; MUSCLE; MOVEMENT; Medicine, General & Internal; H-REFLEX; BACLOFEN; paraplegia; tetraplegia; pendulum test; SENSITIVITY; AFFERENTS; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Medicine and Surgery; Biology, General

Abstract

Transcutaneous spinal stimulation (TSS) and whole-body vibration (WBV) each have a robust ability to activate spinal afferents. Both forms of stimulation have been shown to influence spasticity in persons with spinal cord injury (SCI), and may be viable non-pharmacological approaches to spasticity management. In thirty-two individuals with motor-incomplete SCI, we used a randomized crossover design to compare single-session effects of TSS versus WBV on quadriceps spasticity, as measured by the pendulum test. TSS (50 Hz, 400 µs, 15 min) was delivered in supine through a cathode placed over the thoracic spine (T11-T12) and an anode over the abdomen. WBV (50 Hz; eight 45-s bouts) was delivered with the participants standing on a vibration platform. Pendulum test first swing excursion (FSE) was measured at baseline, immediately post-intervention, and 15 and 45 min post-intervention. In the whole-group analysis, there were no between-or within-group differences of TSS and WBV in the change from baseline FSE to any post-intervention timepoints. Significant correlations between baseline FSE and change in FSE were associated with TSS at all timepoints. In the subgroup analysis, participants with more pronounced spasticity showed significant decreases in spasticity immediately post-TSS and 45 min post-TSS. TSS and WBV are feasible physical therapeutic interventions for the reduction of spasticity, with persistent effects.