Differential Effects of Whole-Body and Focal Achilles Tendon Vibration on H-Reflex Excitability in Chronic Spinal Cord Injury

Abstract

Objective

To compare the acute effects of whole-body vibration (WBV) and focal Achilles tendon vibration on spinal motor neuron excitability in individuals with chronic spinal cord injury (SCI).

Methods

Seventeen individuals with chronic SCI and 20 healthy controls participated in this prospective, randomized, within-subject crossover study. Spinal motor neuron excitability was assessed using the soleus H-reflex normalized to the maximal M-wave (Hsubmax/Mmax ratio). For each vibration modality, measurements were obtained immediately before and immediately after the intervention. Within- and between-group analyses were conducted to evaluate changes in spinal motor neuron excitability following each vibration modality.

Results

Baseline Hsubmax/Mmax ratios were significantly higher in the SCI group than in healthy controls (both p < 0.01). WBV produced a significant reduction in the Hsubmax/Mmax ratio in both groups (SCI, p = 0.012; controls, p < 0.001), with a larger decrease in controls. Focal Achilles tendon vibration did not significantly alter the Hsubmax/Mmax ratio in the SCI group (p = 0.868) but resulted in a significant increase in healthy controls (p = 0.007). Between-group comparison of percentage change demonstrated a significant difference after WBV (p < 0.001), whereas the difference after tendon vibration did not reach statistical significance (p = 0.074).

Conclusion

WBV was associated with an acute inhibitory modulation of spinal motor neuron excitability in individuals with chronic SCI, whereas focal Achilles tendon vibration did not produce a significant reduction in the Hsubmax/Mmax ratio in this group. Further studies are needed to determine the clinical relevance and durability of these effects.

Keywords

spinal cord injury spasticity whole-body vibration tendon vibration H-reflex spinal motor neuron excitability

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