Preliminary inconclusive results of a randomised double blinded cross-over pilot trial in long-term-care dwelling elderly assessing the feasibility of stochastic resonance whole-body vibration

Effects of stochastic resonance whole-body vibration on sensorimotor function in elderly individuals-A systematic review

Introduction

Due to demographic changes, falls are increasingly becoming a focus of health care. It is known that within six months after a fall, two thirds of fallers will fall again. Therefore, therapeutic procedures to improve balance that are simple and can be performed in a short time are needed. Stochastic resonance whole-body vibration (SR-WBV) may be such a procedure.

Method

An electronic search to assess the effectiveness of SR-WBV on balance in the elderly was conducted using databases that included CINAHL Cochrane, PEDro, and PubMed. Included studies were assessed using the Collaboration Risk of Bias Tool by two independent reviewers.

Results

Nine studies showing moderate methodological quality were included. Treatment parameters were heterogeneous. Vibration frequency ranged from 1 to 12 Hz. Six studies found statistically significant improvements of balance from baseline to post measurement after SR-WBV interventions. One article found clinical relevance of the improvement in total time of the "Expanded Time to Get Up and Go Test".

Discussion

Physiological adaptations after balance training are specific and may explain some of the observed heterogeneity. Two out of nine studies assessed reactive balance and both indicated statistically significant improvements after SR-WBV. Therefore, SR-WBV represents a reactive balance training.

Feasibility of a blended therapy approach in the treatment of patients with inflammatory myopathies

Background

Inflammatory myopathies (IMs) are a group of rare conditions characterized by proximal and often symmetrical muscle weakness and reduced muscle endurance. The recommended medical treatment is based on corticosteroids in combination with immunosuppressants. This anti-inflammatory therapy serves to inhibit and prevent inflammation but does not influence impaired muscle strength. Exercise, particularly progressive resistance training, plays therefore an important role in IMs management. Blended therapy, a combination of face-to-face treatment and telerehabilitation, may be a powerful therapy option in improving exercise program adherence in these patients.

Methods

The feasibility of a 12-week interactive tablet-based home exercise program combined with face-to-face therapy sessions – a ‘blended therapy’ approach - was evaluated using a quasi-experimental one-group pre-post comparison design. Primary outcomes were recruitment, attrition and adherence rates, plus measures of acceptance (Technology Acceptance Model Questionnaire (TAM)) and satisfaction (satisfaction questionnaire). Secondary outcomes comprised potential effects of the intervention on muscle strength and function, activity limitation, disability and health-related quality of life.

Results

Thirteen of the included 14 participants completed the study without any related adverse events. Mean adherence to exercise program was 84% (range: 25–100%) and participants indicated high acceptance of the intervention with mean TAM scores between 6.1 and 6.5 points. Overall satisfaction with the therapy sessions, the home program, and the technology was good. Approximately half the participants wished for longer training periods and more training sessions per week. There were inconsistent effects on muscle strength, muscle function, activity limitation, disability, and health-related quality of life.

Conclusion

Blended therapy combining the use of an interactive tablet-based resistance training program with face-to-face therapy sessions is feasible and safe and participants` acceptance with this approach was high. Furthermore, results were obtained that might be useful in selecting appropriate assessments and sample sizes in future trials.

Trial registration

NCT03713151.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40945-021-00108-z.

Effect of finding-oriented manual therapy techniques on muscle activity and postural control in patients with chronic ankle instability - A randomized controlled feasibility study

INTRODUCTION

Previous studies have analyzed the effects of manual therapy techniques (MTT) in patients with chronic ankle instability (CAI). Clinicians treat patients according the finding-oriented MTT approach. This approach is seldom pursued in research. The purpose of this study was to evaluate the feasibility and efficacy of finding-oriented MTT applications in patients with CAI.

METHOD

In this randomized controlled, blinded assessor crossover feasibility trial, participants were randomized to receive nine finding-oriented MTT treatments or no treatment during a three-week period, followed by a six-day washout period after which participants were crossed-over. Criteria under evaluation were adherence and attrition rates, safety (adverse events (AEs)) and acceptability and preliminary effects of finding-oriented MTT on muscular activity (measured by surface Electromyography (sEMG)) and on dynamic balance (measured by time to stabilization (TTS) and the modified Star Excursion Balance Test (modified STBT)).

RESULTS

Seven women and two men (mean age: 26 ± 6.1 years) with CAI enrolled in this feasibility study. Success criteria showed a high adherence (90%) and low attrition rate (10%). All data could be used for analysis. AEs such as tingling in the foot during a short time frame were reported after four finding-oriented MTT interventions. Preliminary effect sizes showed divergence and few statistically significant results for sEMG.

CONCLUSION

The participants were adherent to the finding-oriented MTT intervention. The acceptability of data recording and data analysis was good. In addition, the study protocol should be adapted by adding a 10-min warm up period, a participant familiarization to TTS and modified STBT, and test repetitions.

Effects of Stochastic Resonance Whole-Body Vibration in Individuals with Unilateral Brain Lesion: A Single-Blind Randomized Controlled Trial: Whole-Body Vibration and Neuromuscular Function

Introduction

Stochastic resonance whole-body vibration (SR-WBV) devices are promising sensorimotor interventions to address muscle weakness and to improve balance and mobility particularly in the elderly. However, it remains inconclusive whether individuals with stroke or traumatic brain injury (TBI) can profit from this method. The aim of this prospective single-blind randomized controlled trial was to investigate the effects of SR-WBV on muscle strength as well as gait and balance performance in this population.

Methods

Forty-eight individuals with stroke or TBI were randomly allocated to an experimental and a sham group. Participants were exposed daily to 5 consecutives 1-minute SR-WBV sessions, whereas the experimental group trained in a standing position with 5 Hz and the sham group in a seated position with 1 Hz. Isometric muscle strength properties of the paretic knee extensor muscles as well as balance and gait performance were measured at baseline, after the first session and after two weeks of SR-WBV.

Results

Both groups showed short- and long-term effects in gait performance. However, no between-group effects could be found at the three measurement points.

Discussion

Complementary SR-WBV showed no beneficial effects immediately after the intervention and after two weeks of conventional rehabilitation therapy. Future research is needed to identify the potential efficacy of SR-WBV in individuals with stroke and TBI using shorter and less exhausting test procedures and a generally prolonged intervention time.

[Acute Effects on TH4 Thoracic Spine Mobilisation Techniques on the Sympathetic Nervous System - a Cross-Over Feasibility Study]

Acute Effects on TH4 Thoracic Spine Mobilisation Techniques on the Sympathetic Nervous System - a Cross-Over Feasibility Study Abstract. Up to date, empiric evidence about effects of thoracic spine mobilisation (TH4) on the sympathetic nervous system is lacking. The primary goal of this feasibility study was to determine adherence rate, side effects and the protocol as well as the implementation of the study design. The secondary goal was to analyse and interpret acute effects on the sympathetic nervous system after thoracic mobilisation in anterior thrust and posterior thrust on six healthy participants on two following days. The feasibility of this study was adequate. The spine mobilisations did not produce any adverse effects. The anterior thrust spine mobilisations showed a tendency in reducing the heart rate activity.

Effects of whole-body vibration on postural control in elderly: An update of a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to offer an updated overview of the current studies on all types of whole-body vibration (WBV), to determine the effects of WBV on balance in Go-Go (active, independent), Slow-Go (some physical activity limitations) and No-Go (in need of care) elderly and to provide recommendations on available evidence on WBV for clinicians and researchers. An electronic literature search was conducted in PubMed, Cochrane Register of Controlled Trials, Physiotherapy Evidence Database (PEDro) and CINAHL (Ebsco Host) to identify studies on WBV therapy in Go-Goes, Slow-Goes and No-Goes. Outcomes were static, dynamic and functional balance. Thirty-tree studies were included in this systematic review. Pooling was possible for static balance and dynamic balance. Effect size (SMD) of WBV on static balance was 0.34 (95% CI 0.18, 0.49) in Go-Goes. Effect size (SMD) of WBV on dynamic balance was -0.15 (95% CI -0.44, 0.15) in Slow-Go and -0.90 (95% CI -1.63, -0.17) in No-Go elderly people respectively. The results of this current meta-analysis suggest that WBV can be used for improving static balance in Go-Go elderly and that it has the potential to positively influence dynamic balance in Slow-Go and No-Go elderly.

Sensory-motor training targeting motor dysfunction and muscle weakness in long-term care elderly combined with motivational strategies: a single blind randomized controlled study

BACKGROUND

This study evaluated the effects of a combined innovative training regime consisting of stochastic resonance whole-body vibration (SR-WBV) and a dance video game (DVG) on physical performance and muscle strength in long-term-care dwelling elderly.

METHODS

Thirthy long-term-care elderly were randomly allocated to an intervention group (IG; n = 16) receiving combined SR-WBV training and DVG, or a sham group (SG; n = 14). IG performed five sets one minute of SR-WBV, with one minute rest between sets (base frequency 3 Hz up to 6 Hz, Noise 4) during the first five weeks on three days per week. From week five to eight a DVG was added to SR-WBV for IG on three days per week. SG performed a five-set SR-WBV program (1 Hz, Noise 1) lasting five times one minute, with one minute rest in between, three days a week. From week five to eight stepping exercises on a trampoline were added on three days per week.

PRIMARY OUTCOME

Short physical performance battery (SPPB). Secondary outcome: isometric maximal voluntary contraction (IMVC), and sub phases of IMVC (Fsub), isometric rate of force development (IRFD) and sub time phases of IRFD (IRFDsub) were measured at baseline, after four and eight weeks. ANOVA with repeated measures was used for analyses of time and interaction effects and MANOVA determined between group intervention effects.

RESULTS

Between group effects revealed significant effects on the SPPB primary outcome after four weeks F(1, 27) = 6.17; p = 0.02) and after eight weeks F(1,27) = 11.8; p = 0.002). Secondary muscle function related outcome showed significant between group effects in IG on IRFD, Fsub 30 ms, 100 ms, 200 ms and IRFDsub 0-30 ms, 0-50 ms, 0-100 ms and 100-200 ms compared to SG (all p < 0.05).

CONCLUSIONS

Eight weeks SR-WBV and DVG intervention improved lower extremity physical function and muscle strength compared to a sham intervention in long-term-care elderly. SR-WBV and DVG seems to be effective as a training regime for skilling up in long-term-care elderly.