Author Archives: Marilyn Hamilton

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.

Abstract

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.

PMID:22966839

Improve Dynamic Balance

Arthritis Care Res (Hoboken). 2010 Aug;62(8):1072-8. doi: 10.1002/acr.20180.

Tilt vibratory exercise and the dynamic balance in fibromyalgia: A randomized controlled trial.

Gusi N, Parraca JA, Olivares PR, Leal A, Adsuar JC.

Source

University of Extremadura, Cáceres, Spain. ngusi@unex.es

Abstract

OBJECTIVE: To evaluate the feasibility and efficacy of tilt whole-body vibration (WBV) for improving dynamic balance in women with fibromyalgia (FM).

METHODS: Forty-one women (ages 41-65 years) were randomly assigned to either a vibration (n = 21) or control (n = 20) group. The vibration intervention consisted of a 30-minute session of instruction plus 3 sessions of WBV per week over a period of 12 weeks. Each vibration session consisted of 6 repetitions of a 45-60-second 12.5-Hz vibration. The posture of the patient was lateral. Dynamic balance was assessed with a balance platform, and the level of stability could be controlled. We performed intent-to-treat (ITT) analysis and efficacy analysis in participants who completed the study (vibration, n = 18; control, n = 18).

RESULTS: Based on ITT analysis, the dynamic balance of the vibration group improved by 36% as compared with baseline, whereas that of the control group was unchanged. Differences in the dynamic balance index were predicted (61%; P < 0.001) by the following linear model: (0.027 x body weight) – (0.800 x dynamic balance at baseline) – (0.632 x group).

CONCLUSION: The vibration program was useful and feasible for improving dynamic balance in women with FM. These novel results support further research aimed at the development of physical therapy programs that utilize controlled vibration.

PMID: 20235191

Prevent Bone Fractures & Osteoporosis

Sports Med. 2012 Apr 1;42(4):301-25. doi: 10.2165/11597670-000000000-00000.

Effects of training on bone mass in older adults: a systematic review.

Gómez-Cabello A, Ara I, González-Agüero A, Casajús JA, Vicente-Rodríguez G.

Source: GENUD-Growth, Exercise, NUtrition and Development Research Group, Universidad de Zaragoza, Huesca, Spain.

Abstract:

Purpose: It is widely recognized that the risk of fractures is closely related to the typical decline in bone mass during the aging process in both women and men. Exercise has been reported as one of the best non-pharmacological ways to improve bone mass throughout life. However, not all exercise regimens have the same positive effects on bone mass, and the studies that have evaluated the role of exercise programmes on bone-related variables in elderly people have obtained inconclusive results.

Method: This systematic review aims to summarize and update present knowledge about the effects of different types of training programmes on bone mass in older adults and elderly people as a starting point for developing future interventions that maintain a healthy bone mass and higher quality of life in people throughout their lifetime. A literature search using MEDLINE and the Cochrane Central Register of Controlled Trials databases was conducted and bibliographies for studies discussing the effect of exercise interventions in older adults published up to August 2011 were examined.

Results:

Inclusion criteria were met by 59 controlled trials, 7 meta-analyses and 8 reviews.
The studies included in this review indicate that bone-related variables can be increased, or at least the common decline in bone mass during ageing attenuated, through following specific training programmes.
Walking provides a modest increase in the loads on the skeleton above gravity and, therefore, this type of exercise has proved to be less effective in osteoporosis prevention.
Strength exercise seems to be a powerful stimulus to improve and maintain bone mass during the ageing process.
Multi-component exercise programmes of strength, aerobic, high impact and/or weight-bearing training, as well as whole-body vibration (WBV) alone or in combination with exercise, may help to increase or at least prevent decline in bone mass with ageing, especially in postmenopausal women.
This review provides, therefore, an overview of intervention studies involving training and bone measurements among older adults, especially postmenopausal women.

Conclusion: Some novelties are that WBV training is a promising alternative to prevent bone fractures and osteoporosis. Because this type of exercise under prescription is potentially safe, it may be considered as a low impact alternative to current methods combating bone deterioration. In other respects, the ability of peripheral quantitative computed tomography (pQCT) to assess bone strength and geometric properties may prove advantageous in evaluating the effects of training on bone health. As a result of changes in bone mass becoming evident by pQCT even when dual energy X-ray absortiometry (DXA) measurements were unremarkable, pQCT may provide new knowledge about the effects of exercise on bone that could not be elucidated by DXA. Future research is recommended including longest-term exercise training programmes, the addition of pQCT measurements to DXA scanners and more trials among men, including older participants.

PMID: 22376192

Osteopenic Women

Int J Sports Med. 2013 Apr 2. [Epub ahead of print]

Vibration or Balance Training on Neuromuscular Performance in Osteopenic Women

Stolzenberg N, Belavý DL, Rawer R, Felsenberg D.

Source

Centre for Muscle and Bone Research, Charité Berlin, Berlin, Germany

Abstract

Maintaining neuromuscular function in older age is an important topic for aging societies, especially for older women with low bone density who may be at risk of falls and bone fracture. This randomized controlled trial investigated the effect of resistive exercise with either whole-body vibration training (VIB) or coordination/balance training (BAL) on neuromuscular function (countermovement jump, multiple 1-leg hopping, sit-to-stand test). 68 postmenopausal women with osteopenia or osteoporosis were recruited for the study. 57 subjects completed the 9-month, twice weekly, intervention period. All subjects conducted 30 min of resistance exercise each training day. The VIB-group performed additional training on the Galileo vibration exercise device. The BAL-group performed balance training. An “intent-to-treat” analysis showed greater improvement in the VIB-group for peak countermovement power (p=0.004). The mean [95% confidence interval] effect size for this parameter was a + 0.9[0.3 to 1.5] W/kg greater change in VIB than BAL after 9 months. In multiple 1-leg hopping, a significantly better performance in the VIB-group after the intervention period was seen on a “per-protocol” analysis only. Both groups improved in the sit-to-stand test.

Results

The current study provides evidence that short-duration whole-body vibration exercise can have a greater impact on some aspects of neuromuscular function in post-menopausal women with low bone density than proprioceptive training.

PMID: 23549694

Duchenne Muscular Dystrophy and Spinal Muscular Atrophy.

Eur J Paediatr Neurol, 2014; 18(2): 140-9

Whole-body vibration training in children with Duchenne muscular dystrophy and spinal muscular atrophy.

Vry J, Schubert IJ, Semler O, Haug V, Schonau E, Kirschner J

Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstrasse 1, 79106 Freiburg, Germany. Electronic address: Julia.vry@uniklinik-freiburg.de.

Abstract

INTRODUCTION: Whole-body-vibration training is used to improve muscle strength and function and might therefore constitute a potential supportive therapy for neuromuscular diseases.

OBJECTIVE: To evaluate safety of whole-body vibration training in ambulatory children with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA). METHODS: 14 children with DMD and 8 with SMA underwent an 8-week vibration training programme on a Galileo MedM(R) at home (3 x 3 min twice a day, 5 days a week). Primary outcome was safety of the training, assessed clinically and by measuring serum creatine kinase levels. Secondary outcome was efficacy as measured by changes in time function tests, muscle strength and angular degree of dorsiflexion of the ankles.

RESULTS: All children showed good clinical tolerance. In boys with DMD, creatine kinase increased by 56% after the first day of training and returned to baseline after 8 weeks of continuous whole-body vibration training. No changes in laboratory parameters were observed in children with SMA. Secondary outcomes showed mild, but not significant, improvements with the exception of the distance walked in the 6-min walking test in children with SMA, which rose from 371.3 m to 402.8 m (p < 0.01).

INTERPRETATION: Whole-body vibration training is clinically well tolerated in children with DMD and SMA. The relevance of the temporary increase in creatine kinase in DMD during the first days of training is unclear, but it is not related to clinical symptoms or deterioration.

PMID: 24157400

Cerebral Palsy Cologne Concept

Cologne Children’s Hospital, Jan 2013

Intensive Physiotherapy and Home Based Vibration Training for Children with Cerebral Palsy:

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.

Cerebral Palsy Children Improve

Clinical Rehabilitation February 14, 2013

Effect of whole body vibration training on mobility in children with cerebral palsy: a randomized controlled experimenter-blinded study

Byoung-Kwon Lee, Seung-Chul Chon Department of Physical Therapy, Konyang University, Daejeon, Republic of Korea
Seung-Chul Chon, Department of Physical Therapy, College of Medical Science, Konyang University, Gasuwon-Dong, Seo-Gu, Daejeon 302-718, Republic of Korea.

Abstract

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).

Conclusions: These findings suggest that whole body vibration may improve mobility in children with cerebral palsy, probably through a positive effect on the leg muscles

Increase Blood Flow and Activate Muscle Mass

Whole-body vibration alters blood flow velocity and neuromuscular activity in Friedreich’s ataxia

Clin. Physiol Funct Imaging. 2010 Nov 15

Research Center on Physical Disability, ASPAYM Castilla y León, Valladolid, Spain Laboratory of Physiology, Faculty of Health Sciences, Miguel de Cervantes European University, Valladolid, Spain Institute of Biomedicine, University of León, León, Spain

Purpose: The purpose of this study was to investigate the effects of whole-body vibration (WBV) on blood flow velocity and muscular activity after different vibration protocols in Friedreich’s ataxia (FA) patients.

Method: After two familiarization sessions ten patients received six 3 min WBV treatments depending on a combination of frequency (10, 20 or 30 Hz) and protocol (constant or fragmented). Femoral artery blood flow velocity, vastus lateralis (VL) and vastus medialis (VM) electromyography (EMG), and rate of perceived exertion were registered.

Results: Peak blood velocity was increased with respect to basal values after 1, 2 and 3 min of WBV (14·8%, 18·8% and 19·7%, respectively, P < 0·001).

Likewise, mean blood velocity was increased with respect to basal values after 1, 2 and 3 min of WBV (17·3%, 19·4% and 16·6%, respectively, P < 0·001).

EMG amplitude of VL and VM was increased (39% and 23%, respectively, P < 0·05) and EMG frequencies decreased during the application of WBV.

The results of this study suggest that higher frequencies (30 Hz) produce a greater increase in blood flow velocity and rate of perceived exertion.

Conclusion: WBV is an effective method to increase blood flow and to activate muscle mass in patients with Friedreich’s ataxia, and could therefore be considered to be incorporated in rehabilitation programs of this collective.

*From Pubmed.org

Children with Cystic Fibrosis

J Clin Med Res. 2013 Jun;5(3):205-16. doi: 10.4021/jocmr1137w. Epub 2013 Apr 23.

The effect of whole body vibration exposure on muscle function in children with cystic fibrosis: a pilot efficacy trial

O’Keefe K, Orr R, Huang P, Selvadurai H, Cooper P, Munns CF, Singh MA.

Source

Exercise, Health and Performance, Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia.

Abstract

BACKGROUND:

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.

METHODS:

The setting was home-based WBV exposure. The participants were children (8 – 15 years) with CF (n = 7).

INTERVENTION:

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.

RESULTS:

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)).

CONCLUSIONS:

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.

KEYWORDS:

Children, Cystic Fibrosis, Muscle function, Muscle power, Vibration

Cologne Congenital Disorder

Cologne Reduced Mobility

Cologne MMC

Muscle Function in Children with Cystic Fibrosis

J Clin Med Res. 2013 Jun;5(3):205-16. doi: 10.4021/jocmr1137w. Epub 2013 Apr 23.

The effect of whole body vibration exposure on muscle function in children with cystic fibrosis: a pilot efficacy trial.

O’Keefe K, Orr R, Huang P, Selvadurai H, Cooper P, Munns CF, Singh MA.

Source: Exercise, Health and Performance, Faculty Research Group, Faculty of Health Sciences, University of Sydney, Australia.

Abstract

BACKGROUND: 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.

METHODS: The setting was home-based WBV exposure. The participants were children (8 – 15 years) with CF (n = 7).

INTERVENTION: 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.

RESULTS:

CONCLUSIONS:

KEYWORDS: Children, Cystic Fibrosis, Muscle function, Muscle power, Vibration

PMID: 23671546

Improve Muscle Function in Cystic Fibrosis

Int J Rehabil Res., 2008; 31(3): 253-6,

Whole body vibration: a new therapeutic approach to improve muscle function in cystic fibrosis

Rietschel E, van Koningsbruggen S, Fricke O, Semler O, Schoenau E
CF-Center, Children”s Hospital, University of Cologne, Cologne, Germany. Ernst.Rietschel@uk-koeln.de

Abstract

OBJECTIVE: Disease progression in cystic fibrosis (CF) leads to muscle wasting and loss of muscle function. The aim of this prospective pilot study was to evaluate the effects of whole body vibration (WBV) on muscle function in adult patients with CF.

PARTICIPANTS: Ten patients (three males; seven females) of the CF Center Cologne, Germany, have completed the 3-month study (age: 24-47 years; forced expiratory volume in 1 s (FEV1) 17-109% predicted (49+/-29) and body mass index (BMI) 16.6-24.4 kg/m2 (19.3+/-2.5). WBV was provided by a vibration platform (Galileo 2000).

METHOD: The patients were standing in an upright position receiving vertical vibration of frequencies between 20 and 25 Hz. The vibration exercise evokes muscle contractions via stretch reflexes improving muscular activity. The training schedule consisted of three 3-min sessions twice a day, 5 days per week for 3 months. Every 4 weeks the following tests were carried out: FEV1, forced vital capacity (FVC), BMI, chair-rising test (CRT), one-leg and two-leg jump test as well as maximal isometric grip force.

RESULTS: The study has been approved by the local ethics committee. After 3 months of WBV all parameters in the CRT significantly improved: chair-rising time (P=0.03), maximal force (P=0.02), maximal power (P=0.01) as well as velocity (P=0.02). The peak jump force (P=0.02) and velocity (P=0.01) of the two-leg jump significantly improved. Parameters in the one-leg jump as well as maximal isometric grip force showed no significant improvement. Weight and BMI showed a slightly positive trend whereas FEV1 and FVC did not significantly change. Any change in mechanographic parameters did not correlate with FEV1 or FVC in this study.

CONCLUSION: These results demonstrate that WBV can improve muscle function in CF patients.

Product groups: Galileo^® Therapy Systems
Topics: Paediatrics, Neuronal Diseases, Medical Faculties, Physiotherapy & Rehabilitation, Therapy & Prevention with Galileo^®
PMID: 18708849

Duchene Muscular Dystrophy

J Musculoskelet Neuronal Interact. 2013 Mar;13(1):13-8.

Whole body vibration therapy in patients with Duchenne muscular dystrophy – a prospective observational study.

Söderpalm AC, Kroksmark AK, Magnusson P, Karlsson J, Tulinius M, Swolin-Eide D.

Source

Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska University Hospital/Östra, Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden. ann-charlott.soderpalm@vgregion.se

Abstract

OBJECTIVES:

To study the tolerability of whole body vibration (WBV) exercise in patients with Duchenne muscular dystrophy (DMD) and its effects on muscle and bone.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID: 23445910

Friedreich’s Ataxia

Clin Physiol Funct Imaging, 2011; 31(2): 139-44

Whole-body vibration alters blood flow velocity and neuromuscular activity in Friedreich’s ataxia.

Herrero AJ, Martin J, Martin T, Garcia-Lopez D, Garatachea N, Jimenez B, Marin PJ
Research Center on Physical Disability, ASPAYM Castilla y Leon, Valladolid, Spain. jaherrero@oficinas.aspaymcyl.org

Abstract

Results: Peak blood velocity was increased with respect to basal values after 1, 2 and 3 min of WBV (14.8%, 18.8% and 19.7%, respectively, P<0.001). Likewise, mean blood velocity was increased with respect to basal values after 1, 2 and 3 min of WBV (17.3%, 19.4% and 16.6%, respectively, P<0.001). EMG amplitude of VL and VM was increased (39% and 23%, respectively, P<0.05) and EMG frequencies decreased during the application of WBV.

Conclusion: The results of this study suggest that higher frequencies (30 Hz) produce a greater increase in blood flow velocity and rate of perceived exertion. WBV is an effective method to increase blood flow and to activate muscle mass in patients with Friedreich”s ataxia, and could therefore be considered to be incorporated in rehabilitation programs of this collective.

PMID: 21078065

Galileo Well Tolerated with Duchenne Muscular Dystrophy

Vibration therapy tolerated in children with Duchenne muscular dystrophy: a pilot study.
Pediatr Neurol. 2014 Jul;51(1):126-9
Myers KA1, Ramage B2, Khan A3, Mah JK4.

Abstract

BACKGROUND:
Duchenne muscular dystrophy is an X-linked recessive muscular dystrophy. Clinical management primarily involves rehabilitation strategies aimed at preserving functional mobility as long as possible. Side-alternating vibration therapy is a rehabilitation intervention that has shown promise in a number of different neuromuscular disorders, and has the potential to preserve strength, functional mobility, and bone mass. There has been little research regarding the tolerance to side-alternating vibration therapy in muscle diseases such as Duchenne muscular dystrophy.

METHODS:
Four patients were recruited for a pilot study assessing the safety and tolerance of side-alternating vibration therapy in individuals with Duchenne muscular dystrophy. All patients participated in a 4-week training period involving side-alternating vibration therapy sessions three times per week. Serum creatine kinase was measured, and adverse effects reviewed at each session with functional mobility assessed before and after the training period.

RESULTS:
All patients tolerated the training protocol well, and there were no major changes in functional mobility. One patient had a transient increase in creatine kinase during the study; however, levels of this enzyme were stable overall when comparing the pretraining and posttraining values. Some patients reported subjective improvement during the training period.

CONCLUSIONS:
Side-alternating vibration therapy is well tolerated in children with Duchenne muscular dystrophy and may have potential to improve or maintain functional mobility and strength in these patients.

Copyright © 2014 Elsevier Inc. All rights reserved.
KEYWORDS:
Duchenne muscular dystrophy; rehabilitation; safety; side-alternating vibration therapy; whole-body vibration therapy
PMID: 24830767 [PubMed – indexed for MEDLINE]

Improve Pain & Fatigue

J Altern Complement Med. 2008 Oct;14(8):975-81. doi: 10.1089/acm.2008.0050.

Six weeks of whole-body vibration exercise improves pain and fatigue in women with fibromyalgia.

Alentorn-Geli E, Padilla J, Moras G, Lázaro Haro C, Fernández-Solà J.

Source Laboratory of Biomechanics, INEF-Exercise and Sport Sciences School, University of Barcelona, Spain. ealentorngelifm@yahoo.es

Abstract

OBJECTIVE: The aim of this study was to investigate the effectiveness of a 6-week traditional exercise program with supplementary whole-body vibration (WBV) in improving health status, physical functioning, and main symptoms of fibromyalgia (FM) in women with FM.

METHODS: Thirty-six (36) women with FM (mean +/- standard error of the mean age 55.97 +/- 1.55) were randomized into 3 treatment groups: exercise and vibration (EVG), exercise (EG), and control (CG). Exercise therapy, consisting of aerobic activities, stretching, and relaxation techniques, was performed twice a week (90 min/day). Following each exercise session, the EVG underwent a protocol with WBV, whereas the EG performed the same protocol without vibratory stimulus. The Fibromyalgia Impact Questionnaire (FIQ) was administered at baseline and 6 weeks following the initiation of the treatments. Estimates of pain, fatigue, stiffness, and depression were also reported using the visual analogue scale.

RESULTS: A significant 3 x 2 (group x time)-repeated measures analysis of variance interaction was found for pain (p = 0.018) and fatigue (p = 0.002) but not for FIQ (p = 0.069), stiffness (p = 0.142), or depression (p = 0.654). Pain and fatigue scores were significantly reduced from baseline in the EVG, but not in the EG or CG. In addition, the EVG showed significantly lower pain and fatigue scores at week 6 compared to the CG, whereas no significant differences were found between the EG and CG (p > 0.05).

CONCLUSION: Results suggest that a 6-week traditional exercise program with supplementary WBV safely reduces pain and fatigue, whereas exercise alone fails to induce improvements.

PMID: 18990045

Galileo Prevents Bone Loss

Bone, 2010; 46(1): 137-47,

Prevention of bone loss during 56 days of strict bed rest by side-alternating resistive vibration exercise

Rittweger J, Beller G, Armbrecht G, Mulder E, Buehring B, Gast U, Dimeo F, Schubert H, de Haan A, Stegeman DF, Schiessl H, Felsenberg D

Institute for Biomedical Research into Human Movement and Health, Manchester Metropolitan University, Manchester, UK. j.rittweger@mmu.ac.uk

Abstract

Purpose: Bed rest is a recognized model for muscle atrophy and bone loss in space flight and in clinical medicine. We hypothesized that whole body vibration in combination with resistive exercise (RVE) would be an effective countermeasure.

Method: Twenty healthy male volunteers underwent horizontal bed rest for 56 days and were randomly assigned either to a group that performed RVE 11 times per week or to a group that underwent bed rest only (Ctrl). Bone mineral content (BMC) was assessed by peripheral quantitative computed tomography (pQCT) in the tibia and the radius and by dual x-ray absorptiometry (DXA) in the hip and lumbar spine at baseline and at regular intervals during bed rest and a 12-month follow-up.

Results: RVE appeared to protect muscle size and function, and it also prevented bone loss (p-values between <0.001 and 0.01). Bone losses were largest in the distal tibia epiphysis, where BMC declined from 421.8 mg/mm (SD 51.3) to 406.6 mg/mm (SD 52.7) in Ctrl, but only from 411.1 mg/mm (SD 56.6) to 409.6 mg/mm (SD 66.7) in RVE. Most of the BMC losses were recovered by 12-month follow-up. Analyses showed that the epiphyseal cortex, rather than spongiosa, depicted the most pronounced changes during bed rest and recovery.

Conclusion: These results suggest that the combined counter measure applied in this study is effective to prevent bone losses from the tibia. This underlines the importance of mechanical usage for the maintenance of the human skeleton.

Heart Transplant Recipients Found Galileo Safe

Phys Rehab Kur Med, 2003; 13: 286-290

Safety of Whole-Body Vibration Exercise for Heart Transplant Recipients

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

Abstract

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.

COPD

Side-alternating vibration has minimal effect on cardiovascular response while doing intense, high-repetition muscle training

Whole body vibration training is a new and complimentary exercise modality for endurance and strength training in patients with chronic obstructive pulmonary heart disease (COPD) and provides safe exercise to improve muscle power, exercise tolerance, reduce symptoms of dyspnea, and increase HRQL.

Galileo’s side-alternating stimulation is a fast and efficient muscle tool for people with neurological diseases to improve postural control and for patients with osteoporosis to enhance bone mineral density. ^1,2
In healthy subjects it has been shown that performing resistance training on Galileo induces greater neuromuscular and hormonal responses than resistance training alone by providing a more intense stimulus. ³

Major effects from peer reviewed studies are:

An increase in muscle power, force, and performance.
Improvements in exercise capacity after Galileo training may be related to an increase in neuromuscular activation.
One possibility of Galileo’s effect is through the vibratory stretch reflex in which the mechanical vibration elicits a myostatic stretch reflex mediated by the muscle spindle and Ia-afferents.⁴
Other possible mechanisms of benefits include enhancing postural control and improving quality of inter-muscular coordination like the complex interplay of agonists and antagonists which are often disabled in patients with COPD. ^5,6

1. Zha DS, Zhu QA, Pei WW, Zheng JC, Wu SH, Xu ZX, et al. Does whole-body vibration with alternative tilting increase bone mineral density and change bone metabolism in senior people? Aging Clin Exp Res 2011.

2. Merkert J, Butz S, Nieczaj R, Steinhagen-Thiessen E, Eckardt R. Combined whole body vibration and balance training using vibrosphere(R): improvement of trunk stability, muscle tone, and postural control in stroke patients during early geriatric rehabilitation. Z Gerontol Geriatr 2011.

3. Ronnestad BR. Comparing the performance-enhancing effects of squats on a vibration platform with conventional squats in recreationally resistance-trained men. J Strength Cond Res 2004;18(4):839e45.

4. Nishihira Y, Iwasaki TAH. Effects of whole body vibration stimulus and voluntary contraction on motorneuron pool. Adv Exerc Sports Physiol 2002;8(4):83e6.

5. Bosco C, Colli R, Introini E, Cardinale M, Tsarpela O, Madella A, et al. Adaptive responses of human skeletal muscle to vibration exposure. Clin Physiol 1999;19(2):183e7.

6. Butcher SJ, Meshke JM, Sheppard MS. Reductions in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease. J Cardiopulm Rehabil 2004;24(4):274e80.

Improved Muscle Strength and Significantly Increased BMD of the Hip

J Bone Miner Res. 2004 Mar;19(3):352-9. Epub 2003 Dec 22.

Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study.

Verschueren SM¹, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S.

Abstract

High-frequency mechanical strain seems to stimulate bone strength in animals. In this randomized controlled trial, hip BMD was measured in postmenopausal women after a 24-week whole body vibration (WBV) training program. Vibration training significantly increased BMD of the hip. These findings suggest that WBV training might be useful in the prevention of osteoporosis.

INTRODUCTION:

High-frequency mechanical strain has been shown to stimulate bone strength in different animal models. However, the effects of vibration exercise on the human skeleton have rarely been studied. Particularly in postmenopausal women-who are most at risk of developing osteoporosis-randomized controlled data on the safety and efficacy of vibration loading are lacking. The aim of this randomized controlled trial was to assess the musculoskeletal effects of high-frequency loading by means of whole body vibration (WBV) in postmenopausal women.

MATERIALS AND METHODS:

Seventy volunteers (age, 58-74 years) were randomly assigned to a whole body vibration training group (WBV, n = 25), a resistance training group (RES, n = 22), or a control group (CON, n = 23). The WBV group and the RES group trained three times weekly for 24 weeks. The WBV group performed static and dynamic knee-extensor exercises on a vibration platform (35-40 Hz, 2.28-5.09g), which mechanically loaded the bone and evoked reflexive muscle contractions. The RES group trained knee extensors by dynamic leg press and leg extension exercises, increasing from low (20 RM) to high (8 RM) resistance. The CON group did not participate in any training. Hip bone density was measured using DXA at baseline and after the 6-month intervention. Isometric and dynamic strength were measured by means of a motor-driven dynamometer. Data were analyzed by means of repeated measures ANOVA.

RESULTS:

No vibration-related side effects were observed. Vibration training improved isometric and dynamic muscle strength (+15% and + 16%, respectively; p < 0.01) and also significantly increased BMD of the hip (+0.93%, p < 0.05). No changes in hip BMD were observed in women participating in resistance training or age-matched controls (-0.60% and -0.62%, respectively; not significant). Serum markers of bone turnover did not change in any of the groups.

CONCLUSION:

These findings suggest that WBV training may be a feasible and effective way to modify well-recognized risk factors for falls and fractures in older women and support the need for further human studies.

Women Improve Knee-Extension Strength

J Am Geriatr Soc. 2004 Jun;52(6):901-8.

Whole-body-vibration training increases knee-extension strength and speed of movement in older women.

Roelants M, Delecluse C, Verschueren SM.

Source: Exercise Physiology and Biomechanics Laboratory, Faculty of Physical Education and Physiotherapy, Department of Kinesiology, Katholieke Universiteit Leuven, Leuven, Belgium.

ABSTRACT:

OBJECTIVES: To investigate the effects of 24 weeks of whole-body-vibration (WBV) training on knee-extension strength and speed of movement and on counter-movement jump performance in older women.

DESIGN: A randomized, controlled trial.

SETTING: Exercise Physiology and Biomechanics Laboratory, Leuven, Belgium.

PARTICIPANTS: Eighty-nine postmenopausal women, off hormone replacement therapy, aged 58 to 74, were randomly assigned to a WBV group (n=30), a resistance-training group (RES, n=30), or a control group (n=29).

INTERVENTION: The WBV group and the RES group trained three times a week for 24 weeks. The WBV group performed unloaded static and dynamic knee-extensor exercises on a vibration platform, which provokes reflexive muscle activity. The RES group trained knee-extensors by performing dynamic leg-press and leg-extension exercises increasing from low (20 repetitions maximum (RM)) to high (8RM) resistance. The control group did not participate in any training.

MEASUREMENTS: Pre-, mid- (12 weeks), and post- (24 weeks) isometric strength and dynamic strength of knee extensors were measured using a motor-driven dynamometer. Speed of movement of knee extension was assessed using an external resistance equivalent to 1%, 20%, 40%, and 60% of isometric maximum. Counter-movement jump performance was determined using a contact mat.

RESULTS: Isometric and dynamic knee extensor strength increased significantly (P<.001) in the WBV group (mean+/-standard error 15.0+/-2.1% and 16.1+/-3.1%, respectively) and the RES group (18.4+/-2.8% and 13.9+/-2.7%, respectively) after 24 weeks of training, with the training effects not significantly different between the groups (P=.558). Speed of movement of knee extension significantly increased at low resistance (1% or 20% of isometric maximum) in the WBV group only (7.4+/-1.8% and 6.3+/-2.0%, respectively) after 24 weeks of training, with no significant differences in training effect between the WBV and the RES groups (P=.391; P=.142). Counter-movement jump height enhanced significantly (P<.001) in the WBV group (19.4+/-2.8%) and the RES group (12.9+/-2.9%) after 24 weeks of training. Most of the gain in knee-extension strength and speed of movement and in counter-movement jump performance had been realized after 12 weeks of training.

CONCLUSION: WBV is a suitable training method and is as efficient as conventional RES training to improve knee-extension strength and speed of movement and counter-movement jump performance in older women. As previously shown in young women, it is suggested that the strength gain in older women is mainly due to the vibration stimulus and not only to the unloaded exercises performed on the WBV platform.

PMID: 15161453

Improved Muscle Power

Arch Phys Med Rehabil 2003;84:1854–7

High-frequency vibration training increases muscle power in postmenopausal women

Russo CR, Lauretani F, Bandinelli S, Bartali B, Cavazzini C, Guralnik JM, Ferrucci L.

Abstract

Objective: To test whether training on a high-frequency (28Hz) vibrating platform improves muscle power and bone characteristics in postmenopausal women.

Design: Randomized controlled trial with 6-month follow-up.

Setting: Outpatient clinic in a general hospital in Italy.

Participants: Twenty-nine postmenopausal women (intervention group, n=14; matched controls, n=15).

Intervention: Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session, twice weekly for 6 months. The controls did not receive any training. Both groups were evaluated at baseline and after 6 months.

Main outcome measure: Muscle power, calculated from ground reaction forces produced by landing after jumping as high as possible on a forceplate, cortical bone density, and biomarkers of bone turnover.

Results: Over 6 months, muscle power improved by about 5% in women who received the intervention, and it remained unchanged in controls (P=.004). Muscle force remained stable in both the intervention and control groups. No significant changes were observed in bone characteristics.

Conclusion: Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women.

Keywords: Bone density, Exercise, Muscles, Postmenopause, Rehabilitation, Vibration, Women

Improvement in aBMD & BMC

Osteoporos Int. 2013 May;24(5):1623-36. doi: 10.1007/s00198-012-2144-1. Epub 2012 Sep 26.

Effect of whole body vibration (WBV) therapy on bone density and bone quality in osteopenic girls with adolescent idiopathic scoliosis: a randomized, controlled trial.

Lam TP, Ng BK, Cheung LW, Lee KM, Qin L, Cheng JC.

Source: Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. tplam@ort.cuhk.edu.hk

Abstract

PURPOSE: The aim of this randomized controlled trial was to determine whether whole body vibration (WBV) therapy was effective for treating osteopenia in adolescent idiopathic scoliosis (AIS) patients. Results showed that WBV was effective for improving areal bone mineral density (aBMD) at the femoral neck of the dominant side and lumbar spine BMC in AIS subjects.

INTRODUCTION: AIS is associated with osteopenia. Although WBV was shown to have skeletal anabolic effects in animal studies, its effect on AIS subjects remained unknown. The objective of this study was to determine whether WBV could improve bone mineral density (BMD) and bone quality for osteopenia in AIS subjects.

METHODS: This was a randomized, controlled trial recruiting 149 AIS girls between 15 and 25 years old and with bone mineral density (BMD) Z-scores <-1. They were randomly assigned to the Treatment or Control groups. The Treatment group (n = 61) stood on a low-magnitude high-frequency WBV platform 20 min/day, 5 days/week for 12 months. The Control group (n = 63) received observation alone. Bone measurement was done at baseline and at 12 months: (1) aBMD and BMC at femoral necks and lumbar spine using dual-energy X-ray absorptiometry (DXA) and (2) bone quality including bone morphometry, volumetric BMD (vBMD), and trabecular bone microarchitecture using high-resolution peripheral quantitative computed tomography (HR-pQCT) for nondominant distal radius and bilateral distal tibiae.

RESULTS: The Treatment group had numerically greater increases in all DXA parameters with a statistically significant difference being detected for the absolute and percentage increases in femoral neck aBMD at the dominant leg (0.015 (SD = 0.031)g/cm(2), 2.15 (SD = 4.32)%) and the absolute increase in lumbar spine BMC (1.17 (SD = 2.05)g) in the Treatment group as compared with the Control group (0.00084 (SD = 0.026)g/cm(2), 0.13 (SD = 3.62)% and 0.47 (SD = 1.88)g, respectively). WBV had no significant effect for other bone quality parameters.

CONCLUSIONS: WBV was effective for improving aBMD at the femoral neck of the dominant side and lumbar spine BMC in AIS subjects.

PMID: 23011683

Muscle Temperature Increase

Eur J Appl Physiol. 2008 Jul;103(4):441-8. doi: 10.1007/s00421-008-0736-4.

The rate of muscle temperature increase during acute whole-body vibration exercise.

Cochrane DJ, Stannard SR, Sargeant AJ, Rittweger J.

Source: Sport Management and Coaching, Department of Management, Massey University, Private Bag 11 222, Palmerston North, New Zealand. D.Cochrane@massey.ac.nz

Abstract

Purpose: This study compared the rate of muscle temperature (Tm) increase during acute whole-body vibration (WBV), to that of stationary cycling and passive warm-up. Additionally we wanted to determine if the purported increase in counter-movement jump and peak power cycling from acute WBV could be explained by changes in muscle temperature.

Method: Eight active participants volunteered for the study, which involved a rest period of 30 min to collect baseline measures of muscle, core, skin temperature, heart rate (HR), and thermal leg sensation (TLS), which was followed by three vertical jumps and 5 s maximal cycle performance test. A second rest period of 40 min was enforced followed by the intervention and performance tests. The change in Tm elicited during cycling was matched in the hot bath and WBV interventions. Therefore cycling was performed first, proceeded by, in a random order of hot bath and acute WBV.

Results: The rate of Tm was significantly greater (P < 0.001) during acute WBV (0.30 degree C min(-1)) compared to cycle (0.15 degree C min(-1)) and hot bath (0.09 degree C min(-1)) however there was no difference between the cycle and hot bath, and the metabolic rate was the same in cycling and WBV (19 mL kg(-1) min(-1)). All three interventions showed a significant (P < 0.001) increase in counter movement jump peak power and height. For the 5 s maximal cycle test (MIC) there were no significant differences in peak power between the three interventions.

Conclusion: In conclusion, acute WBV elevates Tm more quickly than traditional forms of cycling and passive warm-up. Given that all three warm-up methods yielded the same increase in peak power output, we propose that the main effect is caused by the increase in Tm.

Prolonged Bed-Rest Inactivity

J Endocrinol Invest. 2012 Jan;35(1):54-62. doi: 10.3275/7606. Epub 2011 Mar 21.

The effects of bed-rest and countermeasure exercise on the endocrine system in male adults: evidence for immobilization-induced reduction in sex hormone-binding globulin levels.

Belavý DL, Seibel MJ, Roth HJ, Armbrecht G, Rittweger J, Felsenberg D.

Source: Charité University Medical School, Center for Muscle and Bone Research, Berlin, Germany. belavy@gmail.com

Abstract

BACKGROUND AND AIM: There is limited data on the effects of inactivity (prolonged bed-rest) on parameters of endocrine and metabolic function; we therefore aimed to examine changes in these systems during and after prolonged (56- day) bed-rest in male adults.

SUBJECTS AND METHODS: Twenty healthy male subjects underwent 8 weeks of strict bed-rest and 12 months of follow-up as part of the Berlin Bed Rest Study. Subjects were randomized to an inactive group or a group that performed resistive vibration exercise (RVE) during bed-rest. All outcome parameters were measured before, during and after bed-rest. These included body composition (by whole body dual X-ray absorptiometry), SHBG, testosterone (T), estradiol (E2), PRL, cortisol (C), TSH and free T3 (FT3).

RESULTS: Serum SHBG levels decreased in inactive subjects but remained unchanged in the RVE group (p<0.001). Serum T concentrations increased during the first 3 weeks of bed-rest in both groups (p<0.0001), while E2 levels sharply rose with re-mobilization (p<0.0001). Serum PRL decreased in the control group but increased in the RVE group (p=0.021). C levels did not change over time (p≥0.10). TSH increased whilst FT3 decreased during bed-rest (p all ≤0.0013).

CONCLUSIONS: Prolonged bed-rest has significant effects on parameters of endocrine and metabolic function, some of which are related to, or counteracted by physical activity.

PMID: 21422800

Balance Training & Exercise

J Musculoskelet Neuronal Interact. 2000 Sep;1(1):61-5.

Balance training and exercise in geriatric patients.

Runge M, Rehfeld G, Resnicek E.

Source: Aerpah-Klinik Esslingen, Germany. RungeEsslingen@t-online.de

Abstract

Purpose: Objective measures of gait and balance which meet the criteria of reliability and validity are required as a basis for exercise regimens. We established reference values of clinically relevant locomotor and balance performances for geriatric patients. We are using these data for evaluating the effects of different therapeutic approaches to locomotor and balance disorders.

Reference values for chair rising.

We administered a battery of five tests concerning neuromuscular function, locomotion and balance to a sample of 212 participants without apparent locomotor deficits (139 women, 73 men, mean age 70,5 years, SD 6,78 , median 70 years, range 60 to 90 years, recruited by public announcements).
The test battery comprised the ‘chair rising test’ for measuring lower extremity neuromuscular function (five repetitions of rising from a chair as quickly as possible with arms crossed over the chest). The test has been proven reliable, valid, sensible and predictive for falls and future locomotor status and ADL-status.
Chair rising [sec/5x], Range: 5.4-19.4, Mean: 9.1 (women:9.2, men:9.0), SD: 1.97, Median: 8.9.

Training of balance and muscle power with Galileo 2000 – preliminary results. Galileo is a device for whole body vibration/oscillatory muscle stimulation. The subject stands with bended knees and hips on a rocking platform with a sagittal axle, which thrusts alternatively the right and left leg 7-14 mm upwards with a frequency of 27 Hz, thereby lengthening the extensor muscles of the lower extremities.

The reflexive reaction of the neuromuscular system is a chain of rapid muscle contractions. We conducted a randomized controlled trial, n=34 (age: mean 67y, range 61-85, 11 female), cross-over design, intervention group 2 months training program three times a week (each session 3×2 minutes), performance tests of all participants every two weeks).
The first 19 subjects have finished the intervention period. They reached mean performance gains in chair rising of 18%, strikingly different to the constant values of the controls!

Conclusion: We interpret the findings as improvements in muscle power by the oscillative muscle stimulation.

PMID: 15758528

Adult CP Improvements in Gait and Mobility

J Musculoskelet Neuronal Interact 2013

The acute effects of whole-body vibration on gait parameters in adults with cerebral palsy

D.C. Dickin, K.A. Faust, H. Wang, J. Frame

Abstract

Objectives: As adults with cerebral palsy (CP) are surviving longer, interventions are needed to reduce spasticity and increase strength to improve mobility and life quality. Adults with CP are lacking a form of independent exercise that allows them to maintain or improve their ambulation skills. A new approach to increase muscle strength and flexibility called whole-body vibration (WBV) was assessed.

Methods: Using an individualized frequency (I-Freq) approach to WBV therapy the acute effects on gait in adults with CP was measured. In this study, eight adults with CP (age 20-51 years, two female) participated in two testing sessions: session one determined each individual’s I-Freq; and session two included a 3D gait analysis before and after a WBV treatment. The WBV was administered in five, one minute bouts of vibration followed by one minute of rest.

Results: Following WBV exposure subjects experienced a significant increase in walking speed (P=0.047), stride length (P=0.017) and dynamic ankle range of motion (P=0.042).

Conclusions: These data show that acute WBV treatments at I-Freq can improve measures of gait and mobility in adults with CP, however, future should assess potential long-term improvements.

BSCP have BMD, Muscle Force, GMF improve

J Musculoskelet Neuronal Interact. 2010 Jun;10(2):151-8.

Effect of a new physiotherapy concept on bone mineral density, muscle force and gross motor function in children with bilateral cerebral palsy.

Stark C1, Nikopoulou-Smyrni P, Stabrey A, Semler O, Schoenau E.

Abstract

OBJECTIVE: The purpose of this study was to determine the effect of a new physiotherapy concept on bone density, muscle force and motor function in bilateral spastic cerebral palsy children.

METHODS: In a retrospective data analysis 78 children were analyzed. The concept included whole body vibration, physiotherapy, resistance training and treadmill training. The concept is structured in two in-patient stays and two periods of three months home-based vibration training. Outcome measures were dual-energy x-ray absorption (DXA), Leonardo Tilt Table and a modified Gross Motor Function Measure before and after six months of training.

RESULTS: Percent changes were highly significant for bone mineral density, -content, muscle mass and significant for angle of verticalisation, muscle force and modified Gross Motor Function Measure after six months training.

CONCLUSIONS: The new physiotherapy concept had a significant effect on bone mineral density, muscle force and gross motor function in bilateral spastic cerebral palsy children. This implicates an amelioration in all International Classification of Functioning, Disability and Health levels. The study serves as a basis for future research on evidence based pediatric physiotherapy taking into account developmental implications.

Link

J Musculoskelet Neuronal Interact. 2007 Jan-Mar;7(1):77-81.

Preliminary results on the mobility after whole body vibration in immobilized children and adolescents.

Semler O¹, Fricke O, Vezyroglou K, Stark C, Schoenau E.

Abstract

Objective: The present article is a preliminary report on the effect of Whole Body Vibration (WBV) on the mobility in long-term immobilized children and adolescents.

Participants: WBV was applied to 6 children and adolescents (diagnoses: osteogenesis imperfecta, N=4; cerebral palsy, N=1; dysraphic defect of the lumbar spine, N=1) over a time period of 6 months.

Method: WBV was applied by a vibrating platform constructed on a tilt-table. The treatment effect was measured by alternations of the tilt-angle of the table and with the “Brief assessment of motor function” (BAMF). All 6 individuals were characterized by an improved mobility, which was documented by an increased tilt-angle or an improved BAMF-score.

Results: The authors concluded WBV might be a promising approach to improve mobility in severely motor-impaired children and adolescents. Therefore, the Cologne Standing-and-Walking- Trainer powered by Galileo is a suitable therapeutic device to apply WBV in immobilized children and adolescents.

STUDY SUMMARY: Children with different chronic diseases (osteogenesis imperfecta, cerebral palsy and dysraphic defect) were treated with side alternating whole body vibration for 6 months. Muscle force and mobility improved in all subjects. In a child with cerebral palsy spasticity was reduced and muscle tone reduced. As a result the treatment with botulinum toxin could be postponed. A child with a dysraphic defect showed a reduced lordosis and decreased contractions. Knee joint angle improved from 40° to 10° in the right and 0°in the left knee. An already planned surgery could be cancelled.

Botox for CP kids? Good or Bad!

J Pediatr Orthop. 2013 Jul-Aug;33(5):494-500. doi: 10.1097/BPO.0b013e318288b42a.

Conflict of interest in the assessment of botulinum toxin A injections in patients with cerebral palsy: a systematic review.

Sung KH1, Chung CY, Lee KM, Lee YK, Lee SY, Lee J, Choi IH, Cho TJ, Yoo WJ, Park MS.

Abstract

BACKGROUND:

The efficacy of using botulinum toxin A injections in cerebral palsy (CP) is controversial. The financial conflict of interest related to medical research can affect the conclusion of an evidence-based review. This study was performed to determine as to what proportion of studies on botulinum toxin A injections in patients with CP was sponsored by the industry and whether the assessments of botulinum toxin injection in CP were associated with industry support.

METHODS:

Studies were identified with a search of the PubMed database (January 1991 to November 2011). All prospective, comparative, English language studies on the use of botulinum toxin A injections in patients with CP were included. A total of 374 articles were screened, 128 potentially eligible full articles were retrieved, and 66 studies met our inclusion criteria. The funding sources of the articles were reviewed, and qualitative conclusions regarding the effect of botulinum toxin A injection were classified as being either favorable, neutral, or unfavorable.

RESULTS:

Of 66 eligible articles, 28 were funded by the industry, and 25 were not. The other 13 studies did not include information on the funding source. A significant association was observed between the funding source and qualitative conclusions (P=0.042). Fifteen (53.6%) of the 28 industry-sponsored studies had favorable conclusions, whereas only 5 (20%) of the 25 non-industry-sponsored studies had favorable conclusions.

CONCLUSIONS:

About half of studies on the effect of botulinum toxin A in CP were sponsored by the industry. This systematic review revealed that the qualitative conclusions in those studies are more favorable to the use of the botulinum toxin A than the non-industry-sponsored studies. Clinicians should be aware of an industry-related conflict of interest regarding reports on the efficacy of botulinum toxin A injections in patients with CP.