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The effect of whole-body vibration on lower extremity function in children with cerebral palsy: A meta-analysis
Xiaoye Cai1, Guoping Qian2, Siyuan Cai3
1Shanghai Normal University Tianhua College, Shanghai, P. R. China.
Insights
Whole-body vibration (WBV) training significantly improves lower limb motor function in children with cerebral palsy, including gross motor function and balance. However, it did not show significant improvements in walking speed.
Area of Science:
- Rehabilitation Medicine
- Pediatric Neurology
- Biomechanics
Background:
- Cerebral palsy (CP) is a group of disorders affecting movement and posture, significantly impacting children's motor function.
- Lower limb motor deficits are a primary challenge for children with CP, affecting mobility and independence.
- Whole-body vibration (WBV) training is an emerging intervention explored for its potential therapeutic benefits.
Purpose of the Study:
- To systematically evaluate the efficacy of whole-body vibration (WBV) training on improving lower limb motor function in children with cerebral palsy.
- To synthesize evidence from randomized-controlled trials (RCTs) to determine the effectiveness of WBV compared to conventional therapies.
- To provide evidence-based recommendations for clinical practice regarding WBV in pediatric CP rehabilitation.
Main Methods:
- A comprehensive systematic search of nine databases was conducted up to December 2022.
- Risk of bias was assessed using Cochrane Collaboration tools.
- Standard meta-analyses were performed using Stata 16.0 and Revman 5.3 to calculate weighted mean differences (WMD) and 95% confidence intervals (95% CI).
Main Results:
- Thirteen RCTs with 451 participants were included.
- WBV training significantly improved Gross Motor Function Measure (GMFM-88) dimensions D and E, Timed Up and Go (TUG) test results, and Berg Balance Scale (BBS) scores.
- Significant improvements were also observed in ankle joint range of motion and ankle joint angle during muscle reaction.
- WBV training did not significantly enhance 6-minute walk test (6MWT) walking speed.
Conclusions:
- Whole-body vibration (WBV) training demonstrates superior effectiveness compared to conventional physical therapy in enhancing lower limb motor function for children with cerebral palsy.
- The findings support the integration of WBV training into clinical practice for the rehabilitation of pediatric CP.
- This meta-analysis reinforces previous findings and aids in decision-making for WBV interventions in children with CP.
Objective:
The aim of this meta-analysis was to evaluate the effect of whole-body vibration training on lower limb motor function in children with cerebral palsy in randomized-controlled trials (RCTs).
Methods:
Two independent reviewers systematically searched the records of nine databases (PubMed, Cochrane, Web of Science, EMBASE, CNKI, etc.) from inception to December 2022. Tools from the Cochrane Collaboration were used to assess risk of bias. Standard meta-analyses were performed using Stata 16.0 and Revman 5.3. For continuous variables, the arms difference was calculated as the weighted mean difference (WMD) between the values before and after the intervention and its 95% confidence interval (95% CI).
Results:
Of the 472 studies identified, 13 (total sample size 451 participants) met the inclusion criteria. Meta-analysis showed that WBV training could effectively improve GMFM88-D [WMD = 2.46, 95% CI (1.26, 3.67), P<0.01] and GMFM88-E [WMD = 3.44, 95% CI (1.21, 5.68), P = 0.003], TUG [WMD = -3.17, 95% CI (-5.11, -1.24), P = 0.001], BBS [WMD = 4.00,95% CI (3.29, 4.71), P<0. 01] and the range of motion of ankle joint and the angle of ankle joint during muscle reaction in children with cerebral palsy. The effect of WBV training on 6MWT walking speed [WMD = 47.64, 95% CI (-25.57, 120.85), p = 0.20] in children with cerebral palsy was not significantly improved.
Conclusion:
WBV training is more effective than other types of conventional physical therapy in improving the lower limb motor function of children with cerebral palsy. The results of this meta-analysis strengthen the evidence of previous individual studies, which can be applied to the clinical practice and decision-making of WBV training and rehabilitation in children with cerebral palsy.
