Spasticity changes in SCI following a dynamic standing program using the Segway

Abstract

Study design: A pilot prospective pre- and post-intervention study.

Objectives: To determine whether a dynamic standing program using the Segway Personal Transporter results in any measurable physiological effects in individuals with spinal cord injury (SCI) using both qualitative and quantitative measures of spasticity, pain and fatigue.

Setting: International Collaboration of Repair Discoveries (ICORD) Research Centre, Vancouver, BC, Canada.

Methods: Eight individuals with SCI ASIA (American Spinal Injury Association) A-D, who could stand with or without the assistance of bracing or supports, participated in a 4-week dynamic standing program using a Segway (3 per week, 30-min sessions). The main outcome was spasticity as measured by the Modified Ashworth Scale (MAS). Secondary measures included the SCI-Spasticity Evaluation Tool, Pain Outcomes Questionnaire, and Fatigue Severity Scale.

Results: The dynamic standing sessions were associated with immediate improvements in spasticity (MAS) (P<0.001) and self-reported pain (P<0.05). Fatigue levels decreased, however this was not significant. There is little evidence to suggest that these beneficial outcomes may have lasting effects.

Conclusions: Dynamic standing on the Segway may be effective for short-term spasticity reduction and decreased pain and fatigue. Future work should examine a larger sample size and help to propose mechanisms for potential reductions in spasticity.