Category Archives: Muscular Dystrophy

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

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

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.

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]