Positive effects of Galileo side-alternating vibration in Cerebral Palsy
- Reduction of spasticity
- Improvement of muscle force and power
- Improved gait speed
- Improvement of mGMFM (modified gross motor function measure)
- Higher bone mass
Cologne Children’s Hospital, Jan 2013
E. Schoenau, C. Stark, O. Semler – Children’s Hospital, University of Cologne, Germany
Background: Rehabilitation of children with Cerebral Palsy (CP) aims to reduce sequelae and enhance function. Physiotherapy is a rehabilitative strategy for the treatment of patients with CP, but with little supporting evidence for the different treatment concepts. The Cologne Concept “Auf die Beine” combines Interval-Rehabilitation consisting of short and intensive in-patient stays with 6 months home-based whole body vibration training. “Auf die Beine” is a routine procedure supported by the German health care system. We are presenting the gross motor function results after 6 months of training and additional 6 months follow-up.
Design: Retrospective analysis of 356 children and adolescents
Participants and Setting: 356 children and adolescents diagnosed with CP were included in the retrospective analysis. Mean age was 8.9 years (SD 4.4) and GMFCS levels were 7.3% level I, 14.9% level II, 30.3% level III, 31.2% level IV and 7.6% level V. All patients completed 6 months of home based whole body vibration training, two blocks of intensive physiotherapy and the 12 month visit (6 months follow-up).
Methods: Gross motor function was assessed with the Gross Motor Function Measure (GMFM-66) total score after 6 and 12 (Follow-up) months and the GMFM-88-Goal-Dimensions after 6 months.
Results: GMFM-66-Totalscore improved by 2.9 points (Mean 3.35; p<0.001) after 6 months and by 0.2 points (Mean 0.63; p=0.033) after 6 months follow-up. Goal dimension A (lying) improved by 2.0% (Mean 3.8; p=0.001), B (sitting) by 3.3% (Mean 5.9; p<0.001), C (crawling) by 4.8% (Mean 6.7; p<0.001), D (standing) by 5.1% (Mean 8.0; p<0.001) and E (walking) by 2.8% (Median 4.6; p<0.001).
Conclusion: The Interval-Rehabilitation combined with home-based training shows a significant positive effect on gross motor function in patients with CP. The results could be sustained after 6 months follow-up. To our knowledge this is the first retrospective evaluation of a routine health care concept for children with mobility problems.
Clinical Rehabilitation February 14, 2013
Objective: To evaluate ambulatory function and leg muscle thickness after whole body vibration training in children with cerebral palsy.
Design: A block randomized controlled trial with two groups.
Setting: Physical therapy department laboratory.
Subjects: A total of 30 (15 experimental, mean (SD) age 10.0 (2.26) years and 15 control, 9.6 (2.58)) children with cerebral palsy, 15 males and 15 females.
Interventions: The experimental group underwent whole body vibration training combined with conventional physical therapy training; the control group underwent conventional physical therapy training three days a week for eight weeks respectively.
Main outcome measures: Three-dimensional gait analyses and ultrasonographic imaging of the leg muscles were measured at pre- and post-test of intervention for eight weeks.
Results: Whole body vibration training resulted in significantly better gait speed (P = 0.001, from 0.37 (0.04) m/s to 0.48 (0.06)), stride length (P = 0.001, from 0.38 (0.18) m to 0.48 (0.18)) and cycle time (P = 0.001, from 0.85 (0.48) s to 0.58 (0.38)) in the experimental group compared with that in the control group. The ankle angle (P = 0.019, from 7.30 (4.02) degree to 13.58 (8.79)) also showed a remarkable increase in the experimental group, but not the hip (P = 0.321) and knee angle (P = 0.102). The thicknesses of the tibialis anterior (P = 0.001, 0.48 (0.08) mm to 0.63 (0.10)) and soleus (P = 0.001, 0.45 (0.04) mm to 0.63 (0.12)) muscles were significantly higher in the experimental group than in the control group. However, no significant effect was observed in the thickness of the gastrocnemius muscle (P = 0.645).
Exercise, Health and Performance, Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia.
To examine the effects of whole body vibration (WBV) exposure on muscle function in children with Cystic Fibrosis (CF). Non-randomised controlled cross-over trial.
The setting was home-based WBV exposure. The participants were children (8 – 15 years) with CF (n = 7).
participants served as their own controls for the first four weeks (usual care), then underwent four weeks of parentally-supervised home-based WBV exposure followed by four weeks washout (usual care). The WBV exposure consisted of 20 – 30 minutes of intermittent (1 min vibration:1 min rest) exposure on a Galileo platform (20 – 22Hz, 1 mm amplitude) 3 days/week. The primary outcome measures of absolute and relative lower body (leg extension (LE), leg press (LP)), upper body (chess press (CP)) strength and power, and power were measured at baseline, and weeks 4, 8 and 12. Secondary exploratory outcomes were cardiorespiratory fitness, pulmonary function and health-related quality of life.
Six participants completed the training without adverse events. Muscle function changes following WBV exposure were not statistically significant. However, moderate-to-large relative effect sizes (ES) favouring WBV were evident for leg extension strength (ES = 0.66 (-0.50, 1.82)), LP relative strength (ES = 0.92 (-0.27, 2.11)), leg press peak power (ES = 0.78 (-0.50, 2.07)) and CMJ height (ES = 0.60 (-0.56 to 1.76)).
The results from this first controlled trial indicate that WBV may be a potentially effective exercise modality to safely increase leg strength and explosive power in children with CF. Potentially clinically relevant changes support continued investigation of the efficacy, mechanism and feasibility of this intervention in future large-scale studies.
Children, Cystic Fibrosis, Muscle function, Muscle power, Vibration
J Musculoskelet Neuronal Interact. 2013 Mar;13(1):13-8.
Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden. firstname.lastname@example.org
To study the tolerability of whole body vibration (WBV) exercise in patients with Duchenne muscular dystrophy (DMD) and its effects on muscle and bone.
WBV was performed two to three times a week for three months. Motor function, muscle strength, bone mass and biochemical markers of bone and mineral metabolism were analyzed before and after the WBV period at 0, 3, 6 and 12 months.
Six ambulatory patients with DMD aged 5.7-12.5 years completed the study. No changes in creatine kinase activity were found, indicating that the WBV exercise did not further damage the skeletal muscle. No significant changes in bone mass, muscle strength or bone markers were found. However, there was a non-significant trend for the bone formation marker, bone-specific alkaline phosphate, to increase from a mean of 59 U/L to 73 U/L after three months of WBV. The bone formation marker levels returned to baseline three months after discontinuing WBV and were still at that level after nine months.
WBV therapy appears to be safe and well tolerated among ambulatory DMD patients. The potential benefits of WBV on bone and muscle in DMD remain to be elucidated.
Phys Rehab Kur Med, 2003; 13: 286-290
Crevenna R, Fialka-Moser V, Rödler S, Keilani M, Zöch C, Nuhr M, Quittan M, Wolzt M
Department of Physical Medicine and Rehabilitation, Department of Cardiothoracic Surgery, Department of Clinical Pharmacology, Department of Cardiology, Vienna University, Vienna, Austria
Purpose: The benefits of whole-body vibration exercise (WBV) have not yet been recognized in heart transplant recipients although these patients often show a severe loss in skeletal muscle strength and bone mineral density over time. At present, WBV is not generally recommended for rehabilitation of transplant patients. The purpose of this study was to document the safety, cardiovascular responses and metabolic changes to WBV in heart transplant patients.
Material and Methods: 14 male clinically stable heart transplant recipients were included in this study. The subjects were exposed to one set of whole-body vibration using the Galileo 2000 device. Heart rate, systolic and diastolic blood pressure, blood lactate concentration and the Borg scale were used to determine objective and subjective exertion during WBV.
Results: In every patient WBV was terminated due to muscular fatigue. The mean duration of exercise was 248 seconds (range, 51 – 607 seconds). Heart rate, systolic and diastolic blood pressure, lactate concentrations and the Borg score increased during WBV to levels achieved during aerobic exercise. No patient experienced adverse events.
Conclusion: The results of this pilot study indicate that WBV is feasible and safe in heart transplant recipients. The cardiovascular and metabolic response of an acute bout of WBV is similar to that of standard aerobic exercise.
Institute of Sport Sciences, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. email@example.com
We investigated spontaneous effects of random whole-body vibration (rWBV) on postural control in Parkinsonian subjects. Effects were examined in biomechanical tests from a total of 52 patients divided equally into one experimental and one control group. Postural control was tested pre- and post-treatment in two standardized conditions (narrow standing and tandem standing).
The intervention was based on rWBV (ŷ: 3 mm, f: 6 Hz/sec) consisting of 5 series lasting 60 seconds each.
The main findings from this study were that: