Effects of Continuous Passive Motion on Reversing the Adapted Spinal Circuit in Humans With Chronic Spinal Cord Injury

Chang, Ya‐Ju; Liang, Jing Nong; Hsu, Mei‐Yu; Lien, Hen-Yu; Fang, Chiung‐Yao; Lin, Ching-Sheng

doi:10.1016/j.apmr.2012.11.035

Cited by 34 publications

(48 citation statements)

References 34 publications

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“…Previous studies found that 50 cycles/ min could reduce hypertonia [10,34]. This speed is comparable to that reported in an in vitro study that found that cyclic passive exercise at 1 Hz changed the mRNA levels of MyoG and MyoD, which are associated with myogenic differentiation [35].…”

Section: Introductionsupporting

confidence: 83%

“…Animal studies have reported that spinal circuitry functions improved with RT in mice with complete SCI [15,16]. In humans, repeated passive motions have been shown to reduce hypertonia and lead to spinal circuitry plasticity of spinal circuitry [10]. However, the effect, optimal dose, and adverse effects of active systems on patients with complete SCI are not clear.…”

Section: Introductionmentioning

confidence: 97%

“…Studies found that robotassisted passive stretching combined with active movement training reduced hypertonia and improved balance and ankle range of motion in patients with cerebral palsy [32] and stroke [33]. For individuals with severe impairment of voluntary motor control, such as individuals with SCI, robot-assisted passive exercise reduced reflex excitability [34], improved MAS scores [10,34], and restored spinal circuitry function [10].…”

Section: Introductionmentioning

confidence: 99%

“…In passive systems, limbs are passively stabilized in the range of motion. Passive systems can be used to stretch tight tissue but cannot induce neuroplasticity [10]. Active robot system and interactive robot system can produce limbs passive movements and active-assistive movements, respectively.…”

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Passive Exercise for Ankle Hypertonia in Individuals with Chronic Spinal Cord Injury

et al. 2015

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Hypertonia is one of the major causes of movement disorders in individuals with central nervous system lesions. Robot-assisted therapy can minimize the immobilization side-effect such as severe hypertonia by providing repetitive motor practice with minimal labor assistance. The purpose of this study was to design a robotassisted passive exercise device and establish optimal parameter settings for reducing both reflexive and non-reflexive muscle tone. A custom-made device with a built-in force transducer was developed to provide ankle cyclic passive exercise at various speeds and measure the total resistance during stretching. Ten individuals with spinal cord injury received 8 min of low-speed passive exercise (20 cycles/min), 8 min of high-speed (50 cycles/min) passive exercise, and repeated contractions elicited by electrical stimulation (ES), in randomized order over 3 consecutive weeks. Maximum ES-elicited isometric torque, M waves, H reflexes, and total resistance during stretching were measured before and after each of the treatments. The results show that the H reflex was reduced after passive exercise at both speeds but not after repeated ES-elicited contractions. The reduction of the total resistance during stretching was speed-dependent. Significant fatigue was induced only after repeated ES-elicited contractions. This study successfully developed a robot-assisted passive exercise device, evaluated parameter settings, and provided evidence of the reduction of both reflexive excitability and total muscle tone in hypertonia muscles.

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Section: Introductionsupporting

confidence: 83%

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robot-Assisted Passive Exercise for Ankle Hypertonia in Individuals with Chronic Spinal Cord Injury

et al. 2015

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“…Table 2 and Figure 1 show the reporting of each CONSORT item. The median (IQR) number of CONSORT items per trial that was 'fully reported' was 11/37 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20). The median (IQR) number of CONSORT items per trial that was either 'fully reported' or 'not relevant' or 'not reported but unable to determine if relevant/done' was 20/37 items (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27).…”

Section: Resultsmentioning

confidence: 99%

How well do randomised controlled trials of physical interventions for people with spinal cord injury adhere to the CONSORT guidelines? An analysis of trials published over a 10-year period

et al. 2014

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Robot controlled, continuous passive movement of the ankle reduces spinal cord excitability in participants with spasticity: a pilot study

et al. 2019

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Spasticity of the ankle reduces quality of life by impeding walking and other activities of daily living. Robot-driven continuous passive movement (CPM) is a strategy for lower limb spasticity management but effects on spasticity, walking ability and spinal cord excitability (SCE) are unknown. The objectives of this experiment were to evaluate (1) acute changes in SCE induced by 30 min of CPM at the ankle joint, in individuals without neurological impairment and those with lower limb spasticity; and, (2) the effects of 6 weeks of CPM training on SCE, spasticity and walking ability in those with lower limb spasticity. SCE was assessed using soleus Hoffmann (H-) reflexes, collected prior to and immediately after CPM for acute assessments, whereas a multiple baseline repeated measures design assessed changes following 18 CPM sessions. Spasticity and walking ability were assessed using the Modified Ashworth Scale, the 10 m Walk test, and the Timed Up and Go test. Twenty-one neurologically intact and nine participants with spasticity (various neurological conditions) were recruited. In the neurologically intact group, CPM caused bi-directional modulation of H-reflexes creating ‘facilitation’ and ‘suppression’ groups. In contrast, amongst participants with spasticity, acute CPM facilitated H-reflexes. After CPM training, H-reflex excitability on both the more-affected and less-affected sides was reduced; on the more affected side H@Thres, H@50 and H@100 all significantly decreased following CPM training by 96.5 ± 7.7%, 90.9 ± 9.2%, and 62.9 ± 21.1%, respectively. After training there were modest improvements in walking and clinical measures of spasticity for some participants. We conclude that CPM of the ankle can significantly alter SCE. The use of CPM in those with spasticity can provide a temporary period of improved walking, but efficacy of treatment remains unknown.

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Effects of Continuous Passive Motion on Reversing the Adapted Spinal Circuit in Humans With Chronic Spinal Cord Injury

Cited by 34 publications

References 34 publications

Robot-Assisted Passive Exercise for Ankle Hypertonia in Individuals with Chronic Spinal Cord Injury

Robot-Assisted Passive Exercise for Ankle Hypertonia in Individuals with Chronic Spinal Cord Injury

How well do randomised controlled trials of physical interventions for people with spinal cord injury adhere to the CONSORT guidelines? An analysis of trials published over a 10-year period

Robot controlled, continuous passive movement of the ankle reduces spinal cord excitability in participants with spasticity: a pilot study

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