Category Archives: Spinal Cord Injury

Spinal Cord Injury

Galileo side-alternating vibration is a powerful tool after neural injury that promotes early mobilization from a laying to vertical position.  It is an easy-to-use tool that compliments standard therapies with the goal of optimizing muscle recovery and plasticity without overground training.  Galileo-Training prior to walking in many people improves their waking results.

Galileo works by putting muscles through thousands of reflexive muscle contractions in minutes DIRECTLY through the afferent & efferent nervous system engaging both small and large antagonistic muscles.  The high repetition rate provides efficient therapy with little stress on the cardiovascular system in 12-15 minutes resulting in an unparalleled rapid change in the tone of the muscles being utilized and neuromuscular function.

Results are often visibly evident after 2-3 weeks of training in therapy three times a week or, at home for more intense training twice-a-day morning and evening.     

Condition Effects:

  • Stimulation of muscles
  • Reduction of spasticity and management due to neuronal fatigue
  • Stimulation of the neurological system (both afferent and efferent nerves)
  • Stimulation of large muscle chains in a physiological pattern due to Galileo’s “side-alternating” movement pattern similar to the human gait
  • Improvement of intramuscular coordination
  • Improvement of balance, muscle function, force and power
  • Improvement in blood circulation and the lymphatic system
  • Improvement of blood flow
  • Higher bone mass and osteoporosis prevention
  • Back pain treatment and prevention
  • Combination of vibration and muscle training in a laying, sitting, and standing position

Motor Complete SCI 32% Lower Muscle Area & 43% Lower Muscle Density

Lower-extremity muscle atrophy and fat infiltration after chronic spinal cord injury.

J Musculoskelet Neuronal Interact, 2015; 15(1): 32-41, PMID: 25730650
Moore CD, Craven BC, Thabane L, Laing AC, Frank-Wilson AW, Kontulainen SA, Papaioannou A, Adachi JD, Giangregorio LM

Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network.


BACKGROUND: Atrophy and fatty-infiltration of lower-extremity muscle after spinal cord injury (SCI) predisposes individuals to metabolic disease and related mortality.

OBJECTIVES: To determine the magnitude of atrophy and fatty-infiltration of lower-extremity muscles and related factors in a group of individuals with chronic SCI and diverse impairment.

METHODS: Muscle cross-sectional area and density were calculated from peripheral quantitative computed tomography scans of the 66% site of the calf of 70 participants with chronic SCI [50 male, mean age 49 (standard deviation 12) years, C2-T12, AIS A-D] and matched controls. Regression models for muscle area and density were formed using 16 potential correlates selected a priori.

An illustration of watershed-guided muscle segmentation of the 66% site of the calf of a male with complete paraplegia (A) and corresponding able-bodied control (B).

An illustration of watershed-guided muscle segmentation of the 66% site of the calf of a male with complete paraplegia (A) and corresponding able-bodied control (B).

RESULTS: Participants with motor-complete SCI had approximately 32% lower muscle area, and approximately 43% lower muscle density values relative to controls. Participants with motor-incomplete SCI had muscle area and density values that were both approximately 14% lower than controls. Body mass (+), tetraplegia (+), motor function (+), spasticity (+), vigorous physical activity (+), wheelchair use (-), age (-), and waist circumference (-) were associated with muscle size and/or density in best-fit regression models.

CONCLUSIONS: There are modifiable factors related to muscle size, body composition, and activity level that may offer therapeutic targets for preserving metabolic health after chronic SCI.

Effect of WBV on Spinal Loads.

Eur Spine J. 2014 Mar;23(3):666-72. doi: 10.1007/s00586-013-3087-8. Epub 2013 Nov 8.

In vivo measurements of the effect of whole body vibration on spinal loads

Rohlmann A1, Schmidt H, Gast U, Kutzner I, Damm P, Bergmann G.


PURPOSE:  It is assumed that whole body vibration (WBV) improves muscle strength, bone density, blood flow and mobility and is therefore used in wide ranges such as to improve fitness and prevent osteoporosis and back pain. It is expected that WBV produces large forces on the spine, which poses a potential risk factor for the health of the spine. Therefore, the aim of the study was to measure the effect of various vibration frequencies, amplitudes, device types and body positions on the loads acting on a lumbar vertebral body replacement (VBR).

METHODS:  Three patients suffering from a fractured lumbar vertebral body were treated using a telemeterized VBR. The implant loads were measured during WBV while the patients stood on devices with vertically and seesaw-induced vibration. Frequencies between 5 and 50 Hz and amplitudes of 1, 2 and 4 mm were tested. The patients stood with their knees straight, slightly bent, or bent at 60°. In addition, they stood on their forefeet.

RESULTS:  The peak resultant forces on the implant increased due to vibration by an average of 24% relative to the forces induced without vibration. The average increase of the peak implant force was 27% for vertically induced vibration and 15% for seesaw vibration. The forces were higher when the legs were straight than when the knees were bent. Both the vibration frequency and the amplitude had only a minor effect on the measured forces.CompareForcesPPvsG

CONCLUSIONS:  The force increase due to WBV is caused by an activation of the trunk muscles and by the acceleration forces. The forces produced during WBV are usually lower than those produced during walking. Therefore, the absolute magnitude of the forces produced during WBV should not be harmful, even for people with osteoporosis.

PMID: 24201510 [PubMed – in process]
PMCID: PMC3940795




Increase Blood Flow & Muscle Mass

Spinal Cord. 2011 Apr;49(4):554-9. Epub 2010 Nov 2.

Effects of whole-body vibration on blood flow and neuromuscular activity in spinal cord injury.

Herrero AJ, Menéndez H, Gil L, Martín J, Martín T, García-López D, Gil-Agudo A, Marín PJ.

Source:  Research Center on Physical Disability, ASPAYM Castilla y León, Valladolid, Spain.



Abstract STUDY DESIGN:  Crossover trial

OBJECTIVES:  To investigate the effects of whole-body vibration (WBV) on muscular activity and blood flow velocity after different vibration treatments in patients with spinal cord injury (SCI). METHODS:  Eight individuals with SCI received six 3-min WBV treatments depending on a combination of frequency (10, 20 or 30 Hz) and protocol (constant, that is, three consecutive minutes of WBV, or fragmented, that is, three sets of 1 min of WBV with 1 min of rest between the sets). Femoral artery blood flow velocity was registered at minutes 1, 2 and 3 of WBV, and at minutes 1 and 2 after the end of the stimulus. Electromyography activity (EMG) of vastus lateralis (VL) and vastus medialis (VM) was registered at baseline and during WBV.

RESULTS:  Peak blood velocity (PBV) increased after 1, 2 and 3 min of WBV. The 10 Hz frequency did not alter blood flow, whereas the 20 Hz frequency increased PBV after 2 and 3 min of WBV, and the 30 Hz frequency increased PBV after 1, 2 and 3 min of WBV and during the first minute after the end of the stimulus. No protocol effect was observed for blood parameters. EMG activity of VL and VM increased independently of the applied frequency or protocol.

CONCLUSION:  WBV is an effective method to increase leg blood flow and to activate muscle mass in SCI patients, and could be considered to be incorporated in their rehabilitation programs. PMID: 21042329

SCI Rats Recover with WBV

J Neurotrauma. 2013 Mar 15;30(6):453-68. doi: 10.1089/neu.2012.2653. Epub 2013 Apr 3.

Whole-body vibration improves functional recovery in spinal cord injured rats

Wirth F, Schempf G, Stein G, Wellmann K, Manthou M, Scholl C, Sidorenko M, Semler O, Eisel L, Harrach R, Angelova S, Jaminet P, Ankerne J, Ashrafi M,Ozsoy O, Ozsoy U, Schubert H, Abdulla D, Dunlop SA, Angelov DN, Irintchev A, Schönau E.

Source: Department of Anatomy I, University of Cologne, Köln, Germany.


Purpose:  Whole-body vibration (WBV) is a relatively novel form of exercise used to improve neuromuscular performance in healthy individuals. Its usefulness as a therapy for patients with neurological disorders, in particular spinal cord injury (SCI), has received little attention in clinical settings and, surprisingly, even less in animal SCI models.

Method:  We performed severe compression SCI at a low-thoracic level in Wistar rats followed by daily WBV starting 7 (10 rats) or 14 (10 rats) days after injury (WBV7 and WBV14, respectively) and continued over a 12-week post-injury period. Rats with SCI but no WBV training (sham, 10 rats) and intact animals (10 rats) served as controls.


  • Compared to sham-treated rats, WBV did not improve BBB score, plantar stepping, or ladder stepping during the 12-week period.
  • Accordingly, WBV did not significantly alter plantar H-reflex, lesion volume, serotonergic input to the lumbar spinal cord, nor cholinergic or glutamatergic inputs to lumbar motoneurons at 12 weeks after SCI.
  • However, compared to sham, WBV14, but not WBV7, significantly improved body weight support (rump-height index) during overground locomotion and overall recovery between 6-12 weeks and also restored the density of synaptic terminals in the lumbar spinal cord at 12 weeks.
  • Most remarkably, WBV14 led to a significant improvement of bladder function at 6-12 weeks after injury.

Conclusion:  These findings provide the first evidence for functional benefits of WBV in an animal SCI model and warrant further preclinical investigations to determine mechanisms underpinning this noninvasive, inexpensive, and easily delivered potential rehabilitation therapy for SCI.

Galileo Neuromuscular Responses

Eur J Appl Physiol. 2013 Jan;113(1):1-11. doi: 10.1007/s00421-012-2402-0.

The influence of vibration type, frequency, body position and additional load on the neuromuscular activity during whole body vibration

Ritzmann R, Gollhofer A, Kramer A.


Institute of Sport and Sport Science, University of Freiburg, Schwarzwaldstraße 175, 79117 Freiburg, Germany.


This study aimed to assess the influence of different whole body vibration (WBV) determinants on the electromyographic (EMG) activity during WBV in order to identify those training conditions that cause highest neuromuscular responses and therefore provide optimal training conditions. In a randomized cross-over study, the EMG activity of six leg muscles was analyzed in 18 subjects with respect to the following determinants:

  1. Vibration type: side-alternating vibration (SV) Galileo vs. synchronous vibration (SyV) Power Plate
  2. Frequencies (5-10, 15-20, 25-30 Hz)
  3. Knee flexion angle (10°, 30°, 60°)
  4. Stance condition (forefoot vs. normal stance)
  5. Load variation (no extra load vs. additional load equal to one-third of the body weight)

The results are:

  1. Neuromuscular activity during SV (Galileo) was enhanced compared to SyV (Power Plate)   (P < 0.05)
  2. A progressive increase in frequency caused a progressive increase in EMG activity (P < 0.05)
  3. The EMG activity was highest for the knee extensors when the knee joint was 60° flexed (P < 0.05)
  4. The plantar flexors in the forefoot stance condition was best (P < 0.05)
  5. Additional load caused an increase in neuromuscular activation (P < 0.05)

In conclusion, large variations of the EMG activation could be observed across conditions. However, with an appropriate adjustment of specific WBV determinants, high EMG activations and therefore high activation intensities could be achieved in the selected muscles.

The combination of high vibration frequencies with additional load on the SV platform (Galileo) led to highest EMG activities. Regarding the body position, a knee flexion of 60° and forefoot stance appear to be beneficial for the knee extensors and the plantar flexors, respectively.

EMG Activity Galileo (black) vs Power Plate (white)

EMG Activity Galileo (black) vs Power Plate(white)

EMG Activity Galileo (black) vs Power Plate(white)


SCI Bone Mineral Density First Year

Bone. 2015 Jan 14;74C:69-75. doi: 10.1016/j.bone.2015.01.005.

Decreases in bone mineral density at cortical and trabecular sites in the tibia and femur during the first year of spinal cord injury.

Coupaud S1, McLean AN2, Purcell M2, Fraser MH2, Allan DB2.

BACKGROUND:  Disuse osteoporosis occurs in response to long-term immobilization. Spinal cord injury (SCI) leads to a form of disuse osteoporosis that only affects the paralyzed limbs. High rates of bone resorption after injury are evident from decreases in bone mineral content (BMC), which in the past have been attributed in the main to loss of trabecular bone in the epiphyses and cortical thinning in the shaft through endocortical resorption.

METHODS:  Patients with motor-complete SCI recruited from the Queen Elizabeth National Spinal Injuries Unit (Glasgow, UK) were scanned within 5weeks of injury (baseline) using peripheral Quantitative Computed Tomography (pQCT). Unilateral scans of the tibia, femur and radius provided separate estimates of trabecular and cortical bone parameters in the epiphyses and diaphyses, respectively. Using repeat pQCT scans at 4, 8 and 12months post-injury, changes in BMC, bone mineral density (BMD) and cross-sectional area (CSA) of the bone were quantified.

RESULTS:  Twenty-six subjects (5 female, 21 male) with SCI (12 paraplegic, 14 tetraplegic), ranging from 16 to 76years old, were enrolled onto the study. Repeated-measures analyses showed a significant effect of time since injury on key bone parameters at the epiphyses of the tibia and femur (BMC, total BMD, trabecular BMD) and their diaphyses (BMC, cortical BMD, cortical CSA). There was no significant effect of gender or age on key outcome measures, but there was a tendency for the female subjects to experience greater decreases in cortical BMD. The decreases in cortical BMD in the tibia and femur were found to be statistically significant in both men and women.


CONCLUSIONS:  By carrying out repeat pQCT scans at four-monthly intervals, this study provides a uniquely detailed description of the cortical bone changes that occur alongside trabecular bone changes in the first year of complete SCI. Significant decreases in BMD were recorded in both the cortical and trabecular bone compartments of the tibia and femur throughout the first year of injury. This study provides evidence for the need for targeted early intervention to preserve bone mass within this patient group.

Copyright © 2015 Elsevier Inc. All rights reserved.

Bone Mineral Density Improvements

Adapt Phys Activ Q. 2010 Jan;27(1):60-72.

The effects of whole body vibration on bone mineral density for a person with a spinal cord injury: a case study.

Davis R, Sanborn C, Nichols D, Bazett-Jones DM, Dugan EL.


Source: Kinesiology Department at Texas Woman’s University in Denton, TX, USA.


Introduction:  Bone mineral density (BMD) loss is a medical concern for individuals with spinal cord injury (SCI). Concerns related to osteoporosis have lead researchers to use various interventions to address BMD loss within this population. Whole body vibration (WBV) has been reported to improve BMD for postmenopausal women and suggested for SCI.

Purpose: The purpose of this case study was to identify the effects of WBV on BMD for an individual with SCI.

Method:  There were three progressive phases (standing only, partial standing, and combined stand with vibration), each lasting 10 weeks.

Results:  Using the least significant change calculation, significant positive changes in BMD were reported at the trunk (0.46 g/cm(2)) and spine (.093 g/cm(2)) for phase 3 only. Increases in leg lean tissue mass and reduction in total body fat were noted in all three phases.


Reduce Quadricep Spasticity

Restor Neurol Neurosci. 2009;27(6):621-31. University of Miami, Miami, FL, USA.

Effect of WBV on quadriceps spasticity in individuals with spastic hypertonia due to Spinal Injury

Introduction:  Individuals with spinal cord injury (SCI) often have involuntary, reflex-evoked muscle activity resulting in spasticity. Vibration may modulate reflex activity thereby decreasing spasticity. This study suggests feasibility of using whole-body vibration (WBV) to decrease quadriceps spasticity in individuals with SCI.

Methods:  Participants were individuals (n=16) with spastic quadriceps hypertonia due to chronic SCI (> 1 year). Quadriceps spasticity was measured by gravity-provoked stretch (Pendulum Test) before (initial) and after (final) a 3 day/week, 12-session WBV intervention. In addition, differences between immediate (immediate post-WBV) and delayed (delayed post-WBV) within-session effects were quantified. Finally, we assessed response differences between subjects who did and those who did not use antispastic agents.

Results:  There was a significant reduction in quadriceps spasticity after participation in a WBV intervention that persisted for at least eight days. Within a WBV session, spasticity was reduced in the delayed post-WBV test compared to the immediate post-WBV test. The WBV intervention was associated with similar changes in quadriceps spasticity in subjects who did and those who did not use antispastic agents.

Conclusions:  Vibration may be a useful adjunct to training in those with spasticity. Future studies should directly compare the antispastic effects of vibration to those of antispastic agents.*


Passive Standing on Soleus H-reflex

Neurosci Lett. 2010 Sep 20;482(1):66-70. doi: 10.1016/j.neulet.2010.07.009. Epub 2010 Jul 13.

Acute effects of whole body vibration during passive standing on soleus H-reflex in subjects with and without spinal cord injury

Sayenko DG, Masani K, Alizadeh-Meghrazi M, Popovic MR, Craven BC.

Source Toronto Rehabilitation Institute, Toronto, Canada.


Objective: Whole-body vibration (WBV) is being used to enhance neuromuscular performance including muscle strength, power, and endurance in many settings among diverse patient groups including elite athletes. However, the mechanisms underlying the observed neuromuscular effects of WBV have not been established. The extent to which WBV will produce similar neuromuscular effects among patients with neurological impairments unable to voluntarily contract their lower extremity muscles is unknown. We hypothesized that modulation of spinal motorneuronal excitability during WBV may be achieved without voluntary contraction.

Study overview: The purpose of our study was to describe and compare the acute effects of WBV during passive standing in a standing frame on the soleus H-reflex among men with and without spinal cord injury (SCI). In spinal cord intact participants, WBV caused significant inhibition of the H-reflex as early as 6s after vibration onset (9.0+/-3.9%) (p<0.001).

Main outcome measure: The magnitude of the H-reflex gradually recovered after WBV, but remained significantly below initial values until 36s post-WBV (57.5+/-22.0%) (p=0.01). Among participants with SCI, H-reflex inhibition was less pronounced with onset 24 s following WBV (54.2+/-18.7%) (p=0.03). The magnitude of the H-reflex fully recovered after 60s of WBV exposure.

Results: These results concur with prior reports of inhibitory effects of local vibration application on the H-reflex. Our results suggest that acute modulation of spinal motoneuronal excitability during WBV can be achieved in the absence of voluntary leg muscle contractions.

Summary: Nonetheless, WBV has implications for rehabilitation service delivery through modulation of spinal motoneuronal excitability in individuals with SCI.

Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

PMID: 20633603

Induce Reflex Standing

American Academy of Physical Medicine and Rehabilitation, 2001;

Motor rehabilitation of spinal cord dysfunction by means of whole body vibration

Gianutsos JG, Oakes LC, Siasoco V, Appelblatt S, Hamel J, Gold JT


Objective:   To explore (1) the efficacy of whole body vibration (WBV) in inducing reflex standing and, specifically, (2) the progress of persons with spinal cord dysfunction of 3 differing etiologies.

Design:   Case series. Setting: Rehabilitation center in a metropolitan area. Patients: Persons with spinal paralysis of various etiologies who were otherwise unable to stand without the use of long-leg braces locked at the knee.

  • Case 1: a 21-year- old man who underwent laminectomy at T2–9 for resection of an intramedullary tumor.
  • Case 2: a 12-year-old boy presented with quadriplegia secondary to transverse myelitis.
  • Case 3: a 24-year old man with C5 American Spinal Injury Association class A tetraplegia for 5 years secondary to a fall.

Interventions:  WBV to produce rapid, mechanically delivered repetitive stretches to the lower extremities, thereby resulting in involuntary muscle contraction.

Main Outcome Measures:  Standing time with and without WBV, degree of volitional movement, trunk, and body control, ability to transfer, and carry over to voluntary standing and walking.

Results:  All 3 patients were able to stand with minimal assistance and to increase progressively the length of standing time. Eventually, 2 were able to walk independently using various ambulatory aids.

Conclusions:  WBV represents a promising modality for use in the rehabilitation of persons with motor dysfunction of spinal origin. In our sample, WBV successfully induced reflex standing in all 3 patients and standing was followed by ambulation in 2 cases.

Reduce Chronic Functional Constipation

Colorectal Dis. 2012 Nov;14(11):e779-85. doi: 10.1111/codi.12021.

Whole-body vibration for functional constipation: a single-centre, single-blinded, randomized controlled trial.

Wu TJ, Wei TS, Chou YH, Yang CP, Wu CL, Chen YC, Liu SY.

Source: Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.


AIM: The aim of this trial was to determine whether whole-body vibration (WBV) induced via a noninvasive oscillation platform could improve symptoms and health-related quality of life (HRQOL) in patients with chronic functional constipation.

METHOD: A single-blinded, randomized controlled trial was performed in a single hospital in Taiwan. Patients diagnosed with chronic functional constipation, as per the Rome III diagnostic criteria, were included and randomized to either the WBV treatment or no treatment (control) group. The treatment group received six 15-min sessions of WBV therapy over a 2-week period. Patients received vibrations of 2 mm in amplitude at a frequency of 12 Hz. The primary outcome was whether constipation symptoms improved, assessed by the constipation severity instrument (CSI) and the secondary outcome measure was whether there was an improvement in HRQOL.

RESULTS: Whole-body vibration therapy over a 2-week period in patients with chronic functional constipation (n = 14) significantly reduced the total CSI and obstructive defaecation subscale scores compared with control (n = 13). However, WBV did not improve the pain and chronic inertia subscale scores of the CSI or HRQOL.

CONCLUSION: These findings suggest that low-intensity WBV induced via a noninvasive oscillation platform may be an effective therapy for reducing symptom severity in patients with chronic functional constipation.

© 2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.