The effect of passive cycling movements on spasticity after spinal cord injury: preliminary results.

OBJECTIVE: To investigate the influence of rhythmic passive movements of the legs on the reduction of spasticity after spinal cord injury (SCI). SETTING: Swiss Paraplegic Centre Nottwil, Switzerland. METHODS: A total of 10 subjects with motor complete SCI were treated with a cycling device for half an hour. Before and after cycling their spasticity was tested with an isokinetic dynamometer. The subjects were tested one week later by exactly the same procedure with a half an hour break instead of the cycling. Subjects were asked about their spasticity before and after the cycling and break. RESULTS: There was no significant difference in elicited peak torque either before and after the cycling, or before and after the break (MANOVA, P<0.05). Six out of 10 subjects estimated their spasticity as less after the cycling. CONCLUSION: With the isokinetic dynamometer, it was not possible to show an effect of passive cycling on spasticity reduction. However, six out of 10 of the subjects estimated their spasticity to be less after cycling. This positive effect might be attributed to a reduced spasticity in the trunk and/or to the attention the subjects perceived during the intervention.

The short-term effect of hippotherapy on spasticity in patients with spinal cord injury.

STUDY DESIGN: Assessment of spasticity before and after hippotherapy treatment. OBJECTIVE: To evaluate the short-term effect of hippotherapy on spasticity of spinal cord injured patients (SCIs). SETTING: Swiss Paraplegic Centre, Nottwil. METHODS: 32 patients with spinal cord injury with various degrees of spasticity had repeated sessions (mean 11) of Hippotherapy-K. Spasticity of the lower extremities was scored according to the Ashworth Scale. RESULTS: In primary rehabilitation patients Ashworth values after hippotherapy were significantly lower than before (Wilcoxon's signed-rank test: P<0.001). Highest improvements were observed in SCIs with very high spasticity. No significant difference between short-term effect in paraplegic and short-term effect in tetraplegic subjects was found. CONCLUSIONS: Hippotherapy significantly reduces spasticity of lower extremities in SCIs.

Effect of electrical stimulation-induced cycling on bone mineral density in spinal cord-injured patients.

BACKGROUND: Bone atrophy in spinal cord-injured people (SCI) is, among other factors, caused by immobilization and is initiated shortly after the injury. The present study measured the effect of an functional electrical stimulation (FES)-cycling intervention on bone mineral density (BMD) of the tibia in recently injured SCI people. METHODS: As soon as possible after the injury (mean 4.5 weeks), para- and tetraplegic patients were recruited into an intervention and control group comparable with regard to gender, age, and lesion level. The intervention consisted of 30-min functional electrical stimulation-cycling three times a week for the duration of their primary rehabilitation (mean = 6 months). Computed tomography (CT) scans of the right tibia diaphysis were taken at the beginning and at the end of the intervention. Bone mineral density of cortical bone was calculated from the CT scans. RESULTS: A total of 38 subjects (19 in each group) were included in the study. Both groups showed a reduction in tibial cortical BMD of 0-10% of initial values within 3-10 months. The mean decrease in BMD was 0.3% (+/- 0.6) per month in the intervention group and 0.7% (+/- 0.8) in the control group. This difference did not reach statistical significance. Decrease of BMD was linearly correlated to initial BMD and age in the pooled data of both groups; subjects who had a high initial BMD and/or were older lost more bone. In neither group was bone loss associated with duration of immobilization nor lesion level. CONCLUSIONS: Functional electrical stimulation-cycling applied shortly after SCI did not significantly attenuate bone loss.