Shepherd Center Studies the Effects of Whole-body Vibration on Walking and Spasticity

Simply standing on a specialized vibrating platform could promote better mobility,. Studies show whole-body vibration revs up the nervous system, priming the nerves and muscles for motion. For people with motor-incomplete spinal cord injury, that can mean improved walking speed and reduced muscle spasms, or spasticity.

But how long should you stand on a whole-body vibration device to get the best results? Typically, rehabilitation therapists vary the duration, hoping to find a level that leads to improvement while minimizing fatigue.

A new five-year study at Shepherd Center’s Hulse Spinal Cord Injury Lab aims to find a research-based answer to questions about the best use of the technique.

“We know that physical training is very effective, and in many cases more effective than any drug to improve walking ability,” says Edelle Field-Fote, PT, Ph.D., director of spinal cord injury research at Shepherd Center. “Whole-body vibration may enhance that training. But just as with drug studies, it is important to determine the proper dose. Too much or too little vibration could undermine the treatment.”

Whole-body vibration involves a device that looks like a cross between a large bathroom scale and an exercise machine. As the platform vibrates rapidly up and down, the motion activates reflexes that cause muscles to contract, much as they do during exercise.

First developed in the space program, the devices have been used to boost athletic training. Studies show some benefits for cerebral palsy and stroke patients, as well as those with spinal cord injury.

The first phase of the five-year Shepherd study, funded by the National Institutes of Health, is testing the short-term effects of four different doses of whole-body vibration – high frequency or low frequency at different durations.

The 38 individuals who participate in Phase 1 also will receive electrical stimulation therapy as a comparison. Each episode will be followed by a walking evaluation and test of reflexes, which is an indication of spasticity.

Phase 2 will look for long-term effects after 10 sessions of whole-body vibration once a day and twice a day, at the optimal frequency found in Phase 1. It will measure pain and leg strength, as well as walking speed and spasticity in 59 individuals with motor-incomplete spinal cord injury. A post-test two weeks after the vibration therapy will measure whether the benefits persist.

The study builds on prior research by Dr. Field-Fote that showed whole-body vibration decreased the level of spinal reflex activity (which is the basis for spasticity) even with just four rounds of 45 seconds, each followed by a one-minute rest.

“We feel there’s strong evidence that whole-body vibration can affect both reflex circuits that underlie spasticity and the central pattern-generating circuits that underlie walking,” she says. “So the purpose of this study is to identify the vibration parameters that have the largest effects, as well as the characteristics of subjects who do and do not respond.”

Therapists already use whole-body vibration in Shepherd Center’s Spinal Cord Injury Day Program and in the Beyond Therapy^® program, the post-rehabilitation activity-based wellness program at Shepherd Center. The treatment makes a big difference for some clients but has little or no effect on others, says Nick Evans, lead exercise specialist in Beyond Therapy^®.

“The work [Dr. Field-Fote] is doing is going to be extremely valuable for us because it’s been a matter of trial and error to this point,” Evans says.

Study enrollment begins in January 2015, and recruitment of participants is under way. To be eligible, study participants must:

• Be between the ages of 16 and 65
• Have had a spinal cord injury at least six months before enrolling in this study
• Have a spinal cord injury level of T-12 or above, with spasticity in their legs
• Have the ability to stand (using their arms for balance) for at least 1 minute
• Have the ability to take at least one step with one leg using whatever assistive devices are typical for the participant

To complete a research intake form to be considered for this study, visit shepherd.org/research/intake-form. Or, you may call researcher Temple Moore at 404-350-7522 or email her at temple_moore@shepherd.org.

Written by Michele Cohen Marill
Photos by Louie Favorite