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Vibration therapy in young children with mild to moderate cerebral palsy: does frequency and treatment duration
Alena Adaikina1, José G B Derraik2,3,4, Paul L Hofman2
1Liggins Institute, University of Auckland, Auckland, New Zealand. a.adaikina@auckland.ac.nz.
Insights
Side-alternating vibration therapy (VT) improved mobility and motor function in children with cerebral palsy (CP). Longer treatment durations (20 weeks) showed greater benefits than shorter ones (12 weeks), regardless of frequency.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Neurology
Background:
- Vibration therapy (VT) is increasingly studied for children with cerebral palsy (CP).
- Optimal therapeutic VT protocols for CP require further investigation.
- This study examined side-alternating VT protocols with varying frequencies and durations in children with mild-to-moderate CP.
Purpose of the Study:
- To compare the effects of side-alternating VT protocols with different frequencies and durations on the health of young children with CP.
- To determine optimal VT parameters for improving health outcomes in pediatric CP.
Main Methods:
- Thirty-four children with CP (aged 6.0-12.6 years) participated as their own controls.
- Intervention involved 20 weeks of side-alternating VT (9 min/session, 4 days/week) at 20 Hz or 25 Hz.
- Assessments included the 6-minute walk test (6MWT), body composition, gross motor function, muscle function, and quality of life (CP QOL).
Main Results:
- Side-alternating VT was well-tolerated and showed high compliance (99%).
- Significant improvements were observed in 6MWT, gross motor function (standing, walking, running, jumping), spine bone mineral density, and muscle function.
- The health module of the CP QOL also improved significantly.
- No differences in outcomes were found between 20 Hz and 25 Hz frequencies.
Conclusions:
- Side-alternating VT positively impacts mobility, gross motor function, body composition, muscle function, and quality of life in children with CP.
- Longer treatment duration (20 weeks) was more effective than shorter duration (12 weeks).
- VT frequency did not influence the observed health benefits.
Background:
Vibration therapy (VT) has been increasingly studied in children with cerebral palsy (CP) over the last years, however, optimal therapeutic VT protocols are yet to be determined. The present study compared the effects of side-alternating VT protocols varying in frequency and treatment duration on the health of young children with mild-to-moderate CP.
Methods:
Thirty-four participants aged 6.0 to 12.6 years with CP acted as their own controls and underwent two consecutive study periods: a 12-week lead-in (control) period prior to the intervention period of 20-week side-alternating VT (9 min/session, 4 days/week), with the frequency either 20 Hz or 25 Hz, determined by randomisation. Participants had 4 assessment visits: baseline, after the control period, after 12-week VT (12VT), and after further 8 weeks of VT (20VT). Assessments included 6-minute walk test (6MWT); dual-energy x-ray absorptiometry; gross motor function; muscle function testing on the Leonardo mechanography plate and by hand-held dynamometry, and a quality-of-life questionnaire (CP QOL). Analysis was carried out using linear mixed models based on repeated measures.
Results:
Side-alternating VT was well-tolerated, with occasional mild itchiness reported. The median compliance level was 99%. VT led to improvements in 6MWT (+ 23 m; p = 0.007 after 20VT), gross motor function in standing skills (+ 0.8 points; p = 0.008 after 12VT; and + 1.3 points; p = 0.001 after 20VT) and in walking, running and jumping skills (+ 2.5 points; p < 0.0001 after 12VT; and + 3.7 points; p < 0.0001 after 20VT), spine bone mineral density z-score (+ 0.14; p = 0.015 after 20VT), velocity rise maximum of the chair rising test (+ 0.14 m/s; p = 0.021 after 20VT), force maximum of the single two-leg jump test (+ 0.30 N/kg; p = 0.0005 after 12VT; and + 0.46 N/kg; p = 0.022 after 20VT) and in the health module of CP QOL (+ 7 points; p = 0.0095 after 20VT). There were no observed differences between the two VT frequencies (i.e., 20 Hz vs 25 Hz) on study outcomes.
Conclusions:
The study confirms that side-alternating VT has positive effects on mobility, gross motor function, body composition, muscle function, and quality of life, independent of VT frequencies tested. Long-term, 20VT appears to be a more efficient treatment duration than a short-term, 12VT.
Trial Registration:
Australian New Zealand Clinical Trials Registry ACTRN12618002026202 ; 18/12/2018.
