Does galvanic vestibular stimulation decrease spasticity in clinically complete spinal cord injury?

Abstract

The aim of this study was to determine changes in clinical and biomechanical measures of spasticity after administering galvanic vestibular stimulation in patients with a complete spinal cord injury (SCI). The spasticity in the lower limbs was assessed using the Modified Ashworth Scale and the pendulum test in seven SCI patients (grade A on the ASIA Impairment Scale) before (0), immediately after (0), and at 5 and 30 min after the real versus sham galvanic vestibular stimulation (15 s each, anode over the right mastoid). Overall, the changes in spasticity were not significantly different between the real and sham galvanic vestibular stimulation. However, the Modified Ashworth Scale and the pendulum test indicated a reduction in spasticity in two out of seven patients. The results suggest that galvanic vestibular stimulation may modify spasticity in some patients with complete SCI, presumably through the residual vestibulospinal influences. Future studies should determine clinical and neurophysiological profiles of responders versus nonresponders and optimize parameters of galvanic vestibular stimulation.

Residual descending motor pathways influence spasticity after spinal cord injury

“…This is consistent with previous findings showing that a large proportion of humans with complete SCI develop spasticity . This is also consistent with evidence showing that the MAS is sensitive for assessing limb spasticity after chronic complete SCI . Limitations have been highlighted in the inter‐rater reliability and validity of the MAS.…”

“…[2][3][4][5] This is also consistent with evidence showing that the MAS is sensitive for assessing limb spasticity after chronic complete SCI. 29 Limitations have been highlighted in the inter-rater reliability 30 and validity 31 of the MAS. Therefore, the pendulum test offers a controlled alternative to detect the severity of spasticity in the quadriceps femoris muscle.…”

The role of electrical stimulation for rehabilitation and regeneration after spinal cord injury

“… Čobeljić et al. [ 148 ] Transcranial direct current stimulation Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS) Lefaucheur et al. [ 149 ] Cortical vs. afferent stimulation as an adjunct to functional task practice training: a randomized, comparative pilot study in people with cervical spinal cord injury Gomes-Osman et al.…”

“…GVS can modulate the vestibulospinal tract and has been used to supplement the neurological examination by diagnosing and quantifying vestibulospinal deficits in patients with incomplete SCI [ 146 ]. GVS has been shown to reduce spasticity in SCI patients, and increase postural stability [ 147 , 148 ].…”

Galvanic vestibular stimulation and its applications: a systematic review

“… 36 Among the central diseases, Parkinson's disease, 37 , 38 , 39 , 40 , 41 , 42 central ischemic lesions 43 , 44 and motor myelopathies stand out. 45 GVS is also applied in anxiety disorders 46 and to improve cognition 47 and memory. 48 , 49 This advance in research on the use of GVS in clinical practice stems from favorable characteristics for its usage, such as objectivity, safety, easy performance, low cost, fastness and minimal discomfort for the patient.…”