Whole-Body Vibration Combined with Treadmill Training Improves Walking Performance in Post-Stroke Patients: A Randomized Controlled Trial

Abstract

BackgroundStroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels. The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training (WBV-TT) on walking performance in patients with chronic stroke.Material/MethodsThirty ambulatory chronic stroke patients were randomly allocated to the WBV-TT group or the treadmill training (TT) group. The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4.5 minutes and then walked on the treadmill for 20 minutes. The participants in the TT group conducted the same exercise on a platform without vibration and then walked on the treadmill in the same manner. The vibration lasted for 45 seconds in each exercise, and the intervention was performed 3 times weekly for 6 weeks. The treadmill walking speed was gradually increased by 5% in both groups. The outcome measures included the temporospatial parameter of gait (GAITRite®) and 6-minute walk test.ResultsThe WBV-TT group showed significant improvements in walking performance with respect to walking speed, cadence, step length, stride length, single-limb support, double-limb support, and 6-minute walk test compared with baseline (p<0.05). Significant improvements were also seen in walking speed, step length, stride length, and double-limb support compared with the TT group (p<0.05).ConclusionsThese findings indicate that WBV-TT is more effective than TT for improving walking performance of patients with chronic stroke.

Long-Term Effects of Whole-Body Vibration on Human Gait: A Systematic Review and Meta-Analysis

“…Finally, 63 full-text articles were assessed for eligibility with 17 not accepted: five because training lasted <4 weeks, six because they were not RCT, four because there were no walking outcomes, one because it combined WBV training with non-physical therapy and one for comparing WBV training combined with another intervention not provided in the control group (meaning that not only WBV effects were measured). Thus, 46 articles were ultimately included in this systematic review (9, 27–69, 71, 72). A summary of the study selection is provided in Table 1.…”

“…The sample size ranged from 14 to 159 participants, with a mean age of 60.9 ± 20.0 years, varying from 7.9 years to 83.2 years. With regard to the adult population, 16 studies evaluated the effects of WBV in the elderly ( n = 59.8 ± 35.4 subjects) (9, 30–32, 36, 40, 44, 45, 50, 53, 55, 56, 59, 62, 64, 69), four in patients with Chronic Obstructive Pulmonary Disease (COPD) ( n = 42.5 ± 16.7 subjects) (57, 61, 65, 71), seven in patients with stroke ( n = 46.1 ± 27.2 subjects) (28, 35, 38, 51, 54, 67, 72), four in patients with osteoarthritis (OA) ( n = 32.2 ± 11.9 subjects) (29, 33, 63, 68), three in postmenopausal women ( n = 40.3 ± 12.5 subjects) (48, 58, 66), two in patients with multiple sclerosis ( n = 29.5 ± 6.3 subjects) (34, 39) and one in patients with the following pathologies: incomplete cervical spinal injury (47), pulmonary arterial hypertension (42), lung transplantation (43), idiopathic Parkinson's disease (41), total knee arthroplasty (49) and cerebral palsy (27) ( n = 30.0 ± 26.4 subjects). With regard to the child population, two studies evaluated the effects of WBV in cerebral palsy (37, 60), one in patients with osteogenesis imperfect (46) and one in patients with spastic diplegia or quadriplegia forms of cerebral palsy (52) ( n = 22.5 ± 5.9 subjects).…”

Comparison of Single-Session Dose Response Effects of Whole Body Vibration on Spasticity and Walking Speed in Persons with Spinal Cord Injury

“…Beyond the neuromodulatory effects of vibration on spinal reflex excitability, there is evidence that vibration activates spinal central pattern-generating circuits that underlie the generation of locomotor output [16][17][18]. Early evidence indicates that WBV may improve walking function in persons with SCI [19] and appears to augment the effects of locomotor training in persons with stroke [20]. While WBV is being used in clinical settings to treat individuals with neurologic conditions, there is little evidence available to offer guidance regarding parameters related to frequency and duration of WBV dose.…”

Spatiotemporal gait characteristic changes with gait training using the hybrid assistive limb for chronic stroke patients

“…These results suggested that gait speed was improved by increasing stride length. In most reports aimed at improvement of gait speed, both stride length and cadence were improved together with improvement of gait speed [27][28][29][30]. However, the relationship between gait speed and stride length or cadence was rarely reported, though the relationship is important to let clinicians know how the intervention affected their patients' gait pattern.…”