The immediate influence of various whole-body vibration frequency on balance and walking ability in children with cerebral palsy: a pilot study

Effects of Whole-Body Vibration Therapy in Weight-Bearing and Non-Weight Bearing Positions for Upper and Lower Extremities on Balance and Cervical Joint Position Sense in Children With Cerebral Palsy

INTRODUCTION

Cerebral palsy (CP) is a complex pathological entity that affects muscular control, coordination, proprioception, fine and gross motor abilities, position, stability, and, in some cases, cognition. This study aimed to compare the effects of whole-body vibration therapy (WBVT) in weight bearing and non-weight bearing positions for the upper and lower extremities on balance and cervical joint position sense in children with spastic CP.

METHODS

A randomized controlled trial was carried out on 60 hemiplegic children with spastic CP aged 5-15 years. Following randomization, all participants were allocated into six equal-sized groups based on the application of WBVT for upper extremities, lower extremities, or both simultaneously in either weight-bearing or non-weight-bearing positions. Pediatric balance scale (PBS) and laser tracker system were used to assess functional balance and cervical joint position sense.

RESULTS

One-way analysis of variance for Inter-group analysis showed a statistically significant difference among all groups in PBS and cervical joint position sense (p<0.05).

CONCLUSION

WBVT was found to be beneficial in improving balance and cervical joint position sense in both weight-bearing and non-weight-bearing positions for the upper and lower extremities in children with cerebral palsy. However, the simultaneous application of WBVT in weight-bearing positions for both upper and lower extremities showed the most significant improvements in improving both balance and cervical joint position sense, indicating the most efficacious position of this treatment approach in children with cerebral palsy.

Immediate effects of a vibrating foam roller on dorsiflexion rom, balance, and gait in stroke patients: a randomized controlled trial

The purpose of this study was to investigate the immediate effects of vibration foam rolling on dorsiflexion range of motion (ROM), balance, and gait in stroke patients. Thirty stroke patients volunteered to participate and were randomly assigned to the vibrating foam roller group (n=15) and the foam roller group (n=15). The vibrating foam roller group performed a 30-min foam roller exercise program, with participants subjected to vibration at 28 Hz. The foam roller group performed the same exercise program as the vibrating foam roller group, but without vibration. Dorsiflexion lunge test, limits of stability, and Timed Up and Go were used to evaluate dorsiflexion ROM, balance, and gait before and after each intervention. The results revealed that the vibration foam roller group showed significant differences in dorsiflexion ROM and gait after the intervention, while the foam roller group exhibited a significant difference only in dorsiflexion ROM (P<0.05). In comparisons between the vibration foam roller group and the foam roller group, significant differences were observed in dorsiflexion ROM and gait (P<0.05). However, there were no significant differences in balance, both before and after the intervention, as well as in the comparisons between the two groups (P>0.05). This study confirmed that a single-session vibrating foam roller exercise program improves dorsiflexion ROM and gait in stroke patients. Further studies with extended exercise program durations are needed to address limitations and explore long-term effects.

Effectiveness of whole-body vibration in patients with cerebral palsy: A systematic review and meta-analysis

BACKGROUND

This study examined the effects of systemic vibration exercises on cerebral palsy patients.

METHODS

Literature published in Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane library, Embase, Physiotherapy Evidence Database (PEDro), and PubMed was reviewed. A total of 2978 studies were initially retrieved. After further reading of the full texts 17 articles were finally included. A quality assessment of the included studies was conducted using the risk of bias (RoB) 2.0, and the Funnel plot and the Egger test were conducted to confirm the publication bias. Subgroup analysis was carried out according to the dependent variables, the international classification of functioning, disability, and health (ICF), frequency, treatment period and age.

RESULTS

The overall effect size of homogeneity was 0.474 (CI = 0.148-0.801). The analysis of the dependent variables showed the following order of the effect size: balance, muscle strength, spasticity, bone density, range of motion of the joint, gait function, and motor function. In the ICF classification, the effect size was observed to follow the order of body structure and function, activity, and participation. The effect size in the intervention according to the treatment period showed the following order: 7 to 12 weeks, 1 to 6 weeks, and 14 to 24 weeks. The age-dependent classification showed the following order in the effect size: school age, adolescent and adult, and infant and school age.

CONCLUSIONS

Systemic vibration is the most effective intervention to improve the balance and gait in patients with cerebral palsy and improve the body structure and function according to the ICF.

Therapeutic Approach of Whole-Body Vibration Exercise on Wound Healing in Animal Models: A Systematic Review

Human skin wounds pose a gathering threat to the public health, carrying an immense epidemiologic and financial burden. Pharmacological and non-pharmacological (NP) treatments have been proposed to the management of wound healing. Physical exercise is a strong NP intervention considered for patients in wound healing. Particularly, a type of exercise intervention known as whole-body vibration (WBV) exercise has gained increasing interest. WBV exercise is generated due to the transmission of mechanical vibrations, produced by a vibrating platform, to the body. The aim of this review was to summarize studies in experimental animal models using WBV exercise in wound healing. Searches were performed in EMBASE, PubMed, Scopus and Web of Science including publications on 21 November 2022 using the string "whole body vibration" AND "wound healing" (animal or mice or mouse or rat or rodent). The SYRCLE tool was used to assess the risk of bias (RoB). From 48 studies, five studies met the inclusion criteria. RoB indicated that none of the studies fulfilled all methodological analyzed criteria, resulting in possible biases. The studies were homogeneous, and results suggest beneficial effects of WBV exercise in wound healing, mainly related to enhancing angiogenesis, granulation tissue formation, reducing the blood glucose level and enhancing blood microcirculation, by increasing myofiber growth and rapid re-epithelialization. In conclusion, the various biological effects of the response to the WBV exercise indicate the relevance of this intervention in wound healing in animals. Moreover, considering the translation approach, it is possible to speculate that the beneficial effects of this non-pharmacological therapy might justify clinical trials for wound healing also in humans, after criterion evaluation.

Different Protocols for Low Whole-Body Vibration Frequency for Spasticity and Physical Performance in Children with Spastic Cerebral Palsy

Background: Whole-body vibration (WBV) is a therapeutic exercise tool that can be used in children with cerebral palsy (CP). A low vibration frequency with different protocols has been suggested, but no optimal dose has been explicitly indicated. We aimed to determine the superiority of a gradually increased 7–18 Hz WBV protocol over a static 11 Hz WBV and the immediate and short-term effects of WBV training on improving spasticity, functional strength, balance, and walking ability in children with spastic CP. Methods: Twenty-four participants with CP (mean age: 11.5 ± 2.9 years) were randomly allocated into protocols of a static 11 Hz vibration frequency group (SVF) or one that increased from a 7 to an 18 Hz vibration frequency (IVF) (n = 12/group). The WBV programmes were completed for 30 min/session/day to identify immediate effects, and the short-term programme then continued for four days/week for eight weeks. Results: Modified Ashworth Scale scores significantly and immediately improved in the IVF group (hip adductor and knee extensor, p < 0.05), and after eight weeks showed significant improvement in the SVF group (ankle plantar flexor, p < 0.05). Within groups, the Five Times Sit to Stand Test (FTSTS), the Time Up and Go Test and the Functional Reach Test significantly improved in the SVF group, whereas only the FTSTS improved in the IVF group (p < 0.05). There were no significant between-group differences at the eight-week postintervention, except reduced spasticity. Conclusions: A protocol of 7–18 Hz WBV seems to offer superior immediate results in terms of improved spasticity; however, a static 11 Hz protocol appears to offer superior results after eight weeks, although the two protocols did not differ significantly in effects on physical performance. This finding may facilitate preparations to normalise muscle tone before functional mobility therapy. The study results may support future studies about the dose-response of WBV frequency.

Beneficial effects of whole-body vibration exercise for brain disorders in experimental studies with animal models: a systematic review

Brain disorders have been a health challenge and is increasing over the years. Early diagnosis and interventions are considered essential strategies to treat patients at risk of brain disease. Physical exercise has shown to be beneficial for patients with brain diseases. A type of exercise intervention known as whole-body vibration (WBV) exercise gained increasing interest. During WBV, mechanical vibrations, produced by a vibrating platform are transmitted, to the body. The purpose of the current review was to summarize the effects of WBV exercise on brain function and behavior in experimental studies with animal models. Searches were performed in EMBASE, PubMed, Scopus and Web of Science including publications from 1960 to July 2021, using the keywords "whole body vibration" AND (animal or mice or mouse or rat or rodent). From 1284 hits, 20 papers were selected. Rats were the main animal model used (75%) followed by mice (20%) and porcine model (5%), 16 studies used males species and 4 females. The risk of bias, accessed with the SYRCLE Risk of Bias tool, indicated that none of the studies fulfilled all methodological criteria, resulting in possible bias. Despite heterogeneity, the results suggest beneficial effects of WBV exercise on brain functioning, mainly related to motor performance, coordination, behavioral control, neuronal plasticity and synapse function. In conclusion, the findings observed in animal studies justifies continued clinical research regarding the effectiveness and potential of WBV for the treatment of various types of brain disorders such as trauma, developmental disorders, neurogenetic diseases and other neurological diseases.

The effects of sling exercise program on balance and body activities in children with spastic cerebral palsy

The purpose of this study was to investigate the static and dynamic balance and body activities after administering a trunk stability exercise program using a sling for children with spastic cerebral palsy of Gross Motor Function Classification System (GMFCS) levels III–IV. This study was conducted based on a quasi-experimental study design. Six of the study participants were assigned to the control group and six were assigned to the experimental group using simple random sampling. Both groups underwent a double-blind clinical trial study in which exercise therapy was performed for 40 min twice a week for 8 weeks. The experimental group underwent the sling exercise program and the control group underwent neuro-developmental treatment. The results showed that static and dynamic balance were significantly different before and after intervention in both the experimental and control groups (P<0.05), and there was also a statistically significant difference between the two groups (P<0.05). Gross motor function and activities of daily life showed significant improvement before and after intervention in the experimental group (P<0.05), but there was no statistically significant difference in the control group (P<0.05). There was a statistically significant difference between the two groups (P<0.05). Therefore, the sling exercise program can be used as an effective treatment for improving balance and physical activity in children with cerebral palsy of GMFCS levels III–IV who have difficulty walking. In addition, such exercise will have a positive impact on the independence of such children and help them to participate in social activities.

An overview of the effects of whole-body vibration on individuals with cerebral palsy

The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.

Whole-body vibration therapy does not improve the peripheral nerve regeneration in experimental model

OBJECTIVES

Whole-body vibration (WBV) is commonly used to improve motor function, balance and functional performance, but its effects on the body are not fully understood. The main objective was to evaluate the morphometric and functional effects of WBV in an experimental nerve regeneration model.

METHODS

Wistar rats were submitted to unilateral sciatic nerve crush and treated with WBV (4-5 weeks), started at 3 or 10 days after injury. Functional performances were weekly assessed by sciatic functional index, horizontal ladder rung walking and narrow beam tests. Nerve histomorphometry analysis was assessed at the end of the protocol.

RESULTS

Injured groups, sedentary and WBV started at 3 days, had similar functional deficits. WBV, regardless of the start time, did not alter the histomorphometry parameters in the regeneration process.

CONCLUSIONS

The earlier therapy did not change the expected and natural recovery after the nerve lesion, but when the WBV starts later it seems to impair function parameter of recovery.

Effects of whole-body vibration combined with action observation on gross motor function, balance, and gait in children with spastic cerebral palsy: a preliminary study

This study evaluated the effects of whole-body vibration (WBV) com-bined with action observation on gross motor function, balance, and gait in children with spastic cerebral palsy. The participants were randomized into the WBV combined with action observation (WBVAO) group (n=7) and the WBV group (n=7). The WBVAO group received WBV combined with action observation training, and the WBV group received WBV training for 4 weeks. Both groups received 30 min of training a day, 3 times a week. All participants completed the 5 times sit to stand (FTSTS) test, Timed Up and Go (TUG) test, pediatric reach test, 10-m walk test, 6-min walk test (6MWT), and timed up and down stair (TUDS) test before and after the training intervention. Moreover, the participant’s Gross Motor Function Measure (GMFM) and Pediatric Balance Scale (PBS) scores were assessed. Both the WBVAO and WBV groups demonstrated significant increases in the scores of FTSTS test, GMFM (D and E dimensions), PBS, TUG test, 6MWT, and TUDS test. The WBVAO group improved more significantly compared to the WBV group based on the scores of the FTSTS test, GMFM (D dimension), PBS, 6MWT, and TUDS test. WBV combined with action observation improved lower extremity functional strength, gross motor function, and balance and gait in children with cerebral palsy. These results suggest that WBV combined with action observation is both feasible and suitable for individuals with cerebral palsy.