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Whole-body vibration training in children with Duchenne muscular dystrophy and spinal muscular atrophy
Julia Vry1, Isabel J Schubert1, Oliver Semler2
1Department of Paediatrics and Adolescent Medicine, University Medical Centre Freiburg, Mathildenstraße 1, 79106 Freiburg, Germany.
Insights
Whole-body vibration training is safe for children with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA). While creatine kinase levels temporarily rose in DMD patients, no clinical deterioration was observed, indicating good tolerance.
Area of Science:
- Neuromuscular physiology
- Rehabilitation medicine
- Pediatric physical therapy
Background:
- Whole-body vibration (WBV) training enhances muscle strength and function.
- WBV may serve as a supportive therapy for neuromuscular diseases.
Purpose of the Study:
- To assess the safety and potential efficacy of WBV training in ambulatory children diagnosed with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA).
Main Methods:
- An 8-week WBV program was administered to 14 children with DMD and 8 with SMA.
- Safety was evaluated through clinical assessment and serum creatine kinase (CK) levels.
- Efficacy was measured using functional tests, muscle strength, and ankle dorsiflexion.
Main Results:
- All participants demonstrated good clinical tolerance to WBV.
- Children with DMD experienced a transient increase in CK levels, which normalized after 8 weeks.
- No significant laboratory changes were noted in children with SMA; however, a statistically significant improvement in the 6-minute walking test was observed.
Conclusions:
- WBV training is clinically well-tolerated in pediatric patients with DMD and SMA.
- The temporary rise in CK in DMD patients did not correlate with clinical symptoms or disease progression.
- WBV shows potential as a safe intervention for improving function in these pediatric populations.
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 at home (3 × 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.
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