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Effect of a trunk-targeted intervention using vibration on posture and gait in children with spastic type cerebral
Marianne Unger1, Jennifer Jelsma, Christina Stark
1Division of Physiotherapy, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa. munger@sun.ac.za
Insights
Vibration therapy significantly improved posture and walking in children with spastic-type cerebral palsy (STCP). These gains in trunk strength and gait were maintained four weeks after the intervention.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Pediatrics
Background:
- Spastic-type cerebral palsy (STCP) often involves impaired trunk muscle function, affecting posture and gait.
- Targeted strengthening of trunk muscles is crucial for improving motor function in children with STCP.
Purpose of the Study:
- To investigate the efficacy of vibration-enhanced trunk muscle strengthening on posture and gait in children with STCP.
- To assess the impact on abdominal muscle thickness and functional strength.
Main Methods:
- A single-blinded, pre-post crossover trial involving 27 children (6-13 years) with STCP.
- Evaluations included the 1-Minute Walk Test, 2D-posturography, ultrasound imaging, and a one-minute sit-up test.
- Measurements assessed gait, posture, abdominal muscle thickness, and functional strength.
Main Results:
- Significant improvements were observed in walking distance (p<0.001) and posture.
- A notable increase in the number of sit-ups completed (p<0.001) indicated enhanced functional strength.
- Ultrasound confirmed increased resting thickness in all four abdominal muscles (transversus abdominis, obliquus internus, obliquus externus, rectus abdominis) with statistical significance.
Conclusions:
- Vibration-based trunk strengthening is an effective intervention for improving posture and gait in children with STCP.
- The observed benefits, including increased muscle thickness and functional strength, were sustained for at least four weeks post-intervention.
- This approach is recommended for rehabilitation programs, though further research on vibration's effects on force generation and spasticity is warranted.
Aim:
This study aimed to determine whether strengthening trunk muscles using vibration can improve posture and gait in children with spastic-type cerebral palsy (STCP).
Methods:
A total of 27 children (6-13 years) participated in a single-blinded pre-post crossover experimental trial. The 1-Minute Walk Test, 2D-posturography, ultrasound imaging and sit-ups in one minute were used to assess effect on gait, posture, resting abdominal muscle thickness and functional strength.
Results:
Significant increase in distance walked (p < 0.001), more upright posture, an increase in sit-ups executed (p < 0.001) and an increase in resting thicknesses of all the four abdominal muscles--transversus abdominis (p = 0.047), obliquus internus (p = 0.003), obliquus externus (p = 0.023) and the rectus abdominis (p = 0.001) was recorded. Strength and posture were maintained at 4-weeks post-intervention.
Conclusion:
A trunk-targeted intervention using vibration can improve posture and gait in children with STCP without any known side effects. It is recommended that vibration and specific trunk strengthening is included in training or rehabilitation programmes. Effects of vibration on force generation and spasticity need further investigation.