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Published on: October 17, 2018
The Effect of Additional Whole-Body Vibration on Musculoskeletal System in Children with Cerebral Palsy: A Systematic
Márk Ágoston Pulay1,2,3, Rita Nagy1,4,5, Tamás Kói1,6
1Centre for Translational Medicine, Semmelweis University, 1085 Budapest, Hungary.
Insights
Whole-body vibration (WBV) therapy shows promising results for children with cerebral palsy (CP), significantly improving walking performance. Further research is needed to establish optimal WBV protocols for musculoskeletal benefits.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Whole-body vibration (WBV) is increasingly used as an adjunct therapy for cerebral palsy (CP).
- The efficacy of WBV in improving musculoskeletal outcomes in children with CP is debated.
Purpose of the Study:
- To systematically review and meta-analyze the effects of WBV combined with physiotherapy on the musculoskeletal system in children with CP.
- To evaluate the impact of WBV on walking performance, muscle strength, spasticity, motor function, and stability.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searched major databases for studies comparing WBV plus physiotherapy versus physiotherapy alone.
- Analyzed data using weighted mean differences and a random-effects model.
Main Results:
- Statistically significant improvements in walking speed and step length (p < 0.05) were observed.
- A positive trend towards enhanced muscle strength, reduced spasticity, improved gross motor function, and better overall stability was noted.
- No significant differences were found in other measured outcomes.
Conclusions:
- WBV shows potential as an adjunctive therapy for children with CP, particularly for gait parameters.
- Further high-quality RCTs are recommended to establish definitive evidence and optimal WBV parameters.
- Development of clinical guidelines for WBV application in CP is suggested.
Abstract:
Nowadays, whole-body vibration (WBV) has become increasingly popular as an additional therapy in the intervention of patients with cerebral palsy (CP). However, the impact of WBV remains a subject of debate. Consequently, a systematic review and meta-analysis were undertaken to evaluate the effects of WBV on the musculoskeletal system in children with CP. Randomized controlled trials (RCTs) were sought in the most frequent databases. The intervention studied was WBV combined with conventional physiotherapy (PT) compared with conventional PT as the control; the main outcomes were changes in the musculoskeletal system. Weighted mean differences with 95%CIs were calculated. A random-effects model was applied, and the publication bias was checked using funnel plots. On the basis of the inclusion and exclusion criteria, 16 articles, including 414 patients, were considered in the final analysis. The improvement in walking performance (speed and step length) was statistically significant (p < 0.05), and although there were no significant differences in the further outcomes, a clear positive tendency was visible in the case of improved muscle strength, decreased spasticity, enhanced gross motor functions, and overall stability. Based on the findings, a clear assessment of the usefulness of this intervention cannot be made; nonetheless, due to the promising results, it would be worthwhile to conduct additional RCTs to enhance the available evidence in this field. Due to the wide range of vibration configurations, including varying durations and intensities, it is suggested to establish guidelines and a strategy for the incorporation of this additional treatment.
