Abstract
Study design:
This was a cross-over efficacy study design.
Objective:
To determine spasticity differences between static and dynamic standing training in individuals with spinal cord injury (SCI).
Setting:
Vancouver, Canada.
Methods:
Ten individuals with SCI who could stand with or without bracing or supports participated in both dynamic and static standing training (one session each, 2 days apart) using a Segway. The primary outcome was spasticity as measured by Visual Analog Scale (VAS), Modified Ashworth Scale (MAS) and electromyography (EMG) of the quadriceps, hamstrings, adductors and gastrocnemius.
Results:
There was no statistically detectable difference in spasticity between dynamic and static standing training in individuals with SCI as measured by VAS, MAS or EMG, although there was a trend towards decreased spasticity after the dynamic training.
Conclusion:
There is no significant difference in spasticity outcomes between static and dynamic standing training on a Segway for individuals with SCI.
Sponsorship:
This research was funded by Natural Sciences and Engineering Research Council of Canada and International Collaboration on Repair Discoveries.
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References
Bakheit AMO, Maynard V, Shaw S . The effects of isotonic and isokinetic muscle stretch on the excitability of the spinal alpha motor neurones in patients with muscle spasticity. Eur J Neurol 2005; 12: 719–724.
Lance JW . The control of muscle tone, reflexes, and movement: Robert Wartenberg lecture. Neurology 1980; 30: 1303–1313.
Dietz V . Spasticity-spastic movement disorder. Spinal Cord 2008; 46: 588.
Young RR . Spasticity: a review. Neurology 1994; 44: S12–S20.
Decq P . [Pathophysiology of spasticity]. Neurochirurgie 2003; 49: 163–184.
Adams MM, Hicks AL . Spasticity after spinal cord injury. Spinal Cord 2005; 43: 577–586.
Newman M, Barker K . The effect of supported standing in adults with upper motor neurone disorders: a systematic review. Clin Rehabil 2012; 26: 1059–1077.
McGibbon CA, Sexton A, Jones M, O’Connell C . Elbow spasticity during passive stretch-reflex: clinical evaluation using a wearable sensor system. J Neuroeng Rehabil 2013; 10: 61.
Tsai KH, Yeh CY, Chang HY, Chen JJ . Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients. Proc Natl Sci Counc Repub China B 2001; 25: 76–81.
Sawatzky B, Denison I, Langrish S, Richardson S, Hiller K, Slobogean B . The segway personal transporter as an alternative mobility device for people with disabilities: a pilot study. Arch Phys Med Rehabil 2007; 88: 1423–1428.
Boutilier G, Sawatzky BJ, Grant C, Wiefelspuett S, Finlayson H . Spasticity changes in SCI following a dynamic standing program using the Segway. Spinal Cord 2012; 50: 595–598.
Adams MM, Hicks AL . Comparison of the effects of body-weight-supported treadmill training and tilt-table standing on spasticity in individuals with chronic spinal cord injury. J Spinal Cord Med 2011; 34: 488–494.
Hsieh JTC, Wolfe DL, Miller WC, Curt A, SCIRE Research Team. Spasticity outcome measures in spinal cord injury: psychometric properties and clinical utility. Spinal Cord 2008; 46: 86–95.
Sköld C, Harms-Ringdahl K, Hultling C, Levi R, Seiger A . Simultaneous Ashworth measurements and electromyographic recordings in tetraplegic patients. Arch Phys Med Rehabil 1998; 79: 959–965.
Segway Company Milestones [Internet]. (cited 30 Mar 2015). Available from http://www.segway.com/about-segway/segway-milestones.php.
Field-Fote EC, Brown KM, Lindley SD . Influence of posture and stimulus parameters on post-activation depression of the soleus H-reflex in individuals with chronic spinal cord injury. Neurosci Lett 2006; 410: 37–41.
Bohannon RW . Tilt table standing for reducing spasticity after spinal cord injury. Arch Phys Med Rehabil 1993; 74: 1121–1122.
Zupan B, Stokić DS, Bohanec M, Priebe MM, Sherwood AM . Relating clinical and neurophysiological assessment of spasticity by machine learning. Int J Med Inform 1998; 49: 243–251.
Laessøe L, Nielsen JB, Biering-Sørensen F, Sønksen J . Antispastic effect of penile vibration in men with spinal cord lesion. Arch Phys Med Rehabil 2004; 85: 919–924.
Kawashima N, Sekiguchi H, Miyoshi T, Nakazawa K, Akai M . Inhibition of the human soleus Hoffman reflex during standing without descending commands. Neurosci Lett 2003; 345: 41–44.
Acknowledgements
This research was funded by Natural Sciences and Engineering Research Council of Canada (NSERC) and International Collaboration on Repair Discoveries (ICORD). We acknowledge participation and help of the University of British Columbia undergraduate student Harleen Karla and graduate student Mehdi Eshraghi for data collection and completion of this research study.
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Sadeghi, M., Mclvor, J., Finlayson, H. et al. Static standing, dynamic standing and spasticity in individuals with spinal cord injury. Spinal Cord 54, 376–382 (2016). https://doi.org/10.1038/sc.2015.160
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DOI: https://doi.org/10.1038/sc.2015.160
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