The effect of whole-body vibration on lower extremity function in children with cerebral palsy: A meta-analysis

Abstract

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.

Whole Body Vibration Therapy for Children with Disabilities: A Survey of Potential Risks and Benefits

“… 12 - Ritzman et al 13 Ahberg (2006) 31 25-40 4 6 25.7 “ Cheng (2015) 32 20 2 5 3.2 “ Eklund (1969) 33 100-200 1.5 1-2 241.2 (?) Li et al 18 El-Bagalaty (2021) 34 5-25 0-3.9 20 9.8 “ Duran (2020) 35 8-20 1-2 15 3.2 “ Gusso (2016) 36 15-20 1 9 1.6 Cai et al 25 Yin (2019) 37 12 4 6-15 2.3 “ TeKin (2021) 38 15 4 15 3.6 “ Hegazy (2021) 39 10-25 2 10 5.0 …”

“…No study has established the safety and efficacy of WBV, and precise indications for WBV have not been agreed upon. 13 , 17 , 18 , 24 , 25 Long term effects remain unknown. 7 , 13 , 17 , 18 , 19 , 20 , 21 , 24 , 25 We were unable to confirm that WBV researchers systematically searched for adverse events.…”

“…It is well established that mechanical vibration can have beneficial as well as harmful effects in humans. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 The principal component of vibration is its intensity. 20 Vibrational intensity is complex and will be discussed later.…”

“… 10 , 24 , 27 Numerous studies confirmed that mechanical vibrations stimulate reflexive muscular contractions with beneficial effects such as improved strength and motor control, increased bone mineral density, improved gait speed, decreased spasticity, and increased muscle mass in the short term. 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 22 , 24 , 25 , 27…”

“…In both these conditions WBVT may have some therapeutic value but the evidence is weak, potential risks are significant, and more research is needed. 10 , 24 , 25 …”