Site-Specific Transmission of a Floor-Based, High-Frequency, Low-Magnitude Vibration Stimulus in Children With Spastic Cerebral Palsy

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• 作者：Harshvardhan Singh ; PhD ; BPT^a ; Daniel G. Whitney ; BS^a ; Christopher A. Knight ; PhD^a ; Freeman Miller ; MD^b ; Kurt Manal ; PhD^c ; Paul Kolm ; PhD^d ; Christopher M. Modlesky ; PhD^a ; ^{modlesky@udel.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Bone and bones ; Cerebral palsy ; Muscle spasticity ; Rehabilitation ; Vibration
• 刊名：Archives of Physical Medicine and Rehabilitation
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：97
• 期：2
• 页码：218-223
• 全文大小：689 K

文摘

To determine the degree to which a high-frequency, low-magnitude vibration signal emitted by a floor-based platform transmits to the distal tibia and distal femur of children with spastic cerebral palsy (CP) during standing.

Design

Cross-sectional study.

Setting

University research laboratory.

Participants

Children with spastic CP who could stand independently (n=18) and typically developing children (n=10) (age range, 4–12y) participated in the study (N=28).

Interventions

Not applicable.

Main Outcome Measures

The vibration signal at the high-frequency, low-magnitude vibration platform (approximately 33Hz and 0.3g), distal tibia, and distal femur was measured using accelerometers. The degree of plantar flexor spasticity was assessed using the Modified Ashworth Scale.

Results

The high-frequency, low-magnitude vibration signal was greater (P<.001) at the distal tibia than at the platform in children with CP (.36±.06g vs .29±.05g) and controls (.40±.09g vs .24±.07g). Although the vibration signal was also higher at the distal femur (.35±.09g, P<.001) than at the platform in controls, it was lower in children with CP (.20±.07g, P<.001). The degree of spasticity was negatively related to the vibration signal transmitted to the distal tibia (Spearman ρ=−.547) and distal femur (Spearman ρ=−.566) in children with CP (both P<.05).

Conclusions

A high-frequency, low-magnitude vibration signal from a floor-based platform was amplified at the distal tibia, attenuated at the distal femur, and inversely related to the degree of muscle spasticity in children with spastic CP. Whether this transmission pattern affects the adaptation of the bones of children with CP to high-frequency, low-magnitude vibration requires further investigation.