Effect of Vibration Exercise on Upper Limb Strength, Function, and Pain

Not Applicable

Completed

Brief Summary: The primary purpose of this study is to explore the benefits of vibration dumbbell resistance training over standard dumbbell resistance training for improving upper limb strength, function and pain among manual wheelchair users with paraplegia.

Detailed Description: Objectives: The primary purpose of this study is to explore the benefits of vibration dumbbell resistance training over standard dumbbell resistance training for improving upper limb strength, function and pain among manual wheelchair users with paraplegia.

Experimental Design: Design: Randomized Control Trial

Methods: Twenty subjects with paraplegia will be recruited and randomized into two groups, a vibration dumbbell training (V-DT) group and a standard dumbbell training group (S-DT). Both groups will participate in a supervised 12-week (3 sessions per week) dumbbell (free-weight) strength training program consisting of nine exercises specifically designed to improve upper limb muscle function to support propulsion and transfer activities and protect the shoulders from developing pain. For each of the nine exercises the vibration group will hold a high-frequency (40 Hz) vibrating dumbbell in a static arm posture (isometric training) while the control group will move a non-vibrating dumbbell through the full range of motion for a given exercise (isotonic training). Both groups will follow a standardized protocol for assessing and progressing the amount of weight that is added to the dumbbell to achieve optimal training effects.

All participants will participate in laboratory testing for various outcome measures at baseline, 6 weeks and 12 weeks .

Recruitment & Eligibility

Inclusion Criteria

have a neurological impairment secondary to spinal cord injury (SCI) or disease at T2 or lower
greater than 6 months post injury
use a manual wheelchair as primary means of mobility (at least 30 hrs. per week)
18 to 65 years of age
provide signed medical release by primary care physician to engage in a high-intensity resistance training exercise program
live within 60 minutes driving time (1 hour) from the research center
able to perform a transfer independently to and from a wheelchair
have normal range of motion in the upper limbs.

Exclusion Criteria

history of fractures or dislocations in the shoulder, elbow and wrist from which the subject has not fully recovered or joint replacement of any of the joints in the upper extremities
upper limb pain that interferes with the ability to propel or transfer
recent hospitalization for any reason (within the past three months)
pregnant women
history of coronary artery disease, coronary bypass surgery or other cardio-respiratory events

Arm && Interventions

Group	Intervention	Description
Resistance Training - Vibrating Dumbbell	Vibrating Dumbbell	Study participants who are randomized into the vibration exercise group will complete an in-home exercise program using a vibrating dumbbell.
Resistance Training - Standard Dumbbell	Standard Dumbbell	Study participants who are randomized into the control exercise group will complete an in-home exercise program using standard dumbbells.

Primary Outcome Measures

Name	Time	Method
Changes in Functional Shoulder Pain	Baseline and 12 weeks	Score generated by the Wheelchair Users Shoulder Pain Index. Participants self report shoulder pain over the past week while performing activities of daily living. Scores range from 1 to 150 where higher scores represent higher levels of pain.
Change in Strength	Baseline and 12 weeks	Measurement of peak torque (Nm/kg) for Shoulder Adduction. Measurement was done using the Biodex System.
Change in Upper Extremity Pain	Baseline and 12 weeks	Score generated by the Numerical Rating Scale for shoulder pain. Participants self report upper extremity pain over the last 24 hours with scores on a 0 to 10 scale. Higher scores represent higher levels of pain.
Change in General Health Measures	Baseline and 12 weeks	Score generated by the Short Form 36 walk-wheel. Participants self report on health questions within 8 domains each of which are scored from 0 to 100. The scores from each of the subscales are then averaged together to obtain an overall total score. A score of 0 represents the worst possible health state and a score of 100 represents the best possible health state.

Secondary Outcome Measures

Name	Time	Method
Change in Acceleration	Baseline and 12 weeks	Change in acceleration (seconds) during the 250 foot level propulsion task.
Change in Peak Force	Baseline and 12 weeks	Change in peak force (N) during the 250 foot level propulsion task. Measurement was done using the SmartWheel.
Change in Mechanical Effective Force	Baseline and 12 weeks	Change in mechanical effective force during 250 foot level propulsion task (no unit) Measurement will be done using the SmartWheel.
Wheelchair Transfer Ability	Baseline and 12 weeks	Measurement of relative transfer range. Measured as the change in relative uphill (maximum) transfer height (inches).
Power Output	Baseline and 12 weeks	Measurement of peak power output (watts/kg) using the Load Arm Ergometer.
Change in Peak Speed	Baseline and 12 weeks	Change in peak speed (m/s) measured on a 3 degree incline. Measurement will be done using the SmartWheel.