Effect of rehabilitation with vibrotherapy on walking ability in children with cerebral palsy

Cerebral palsy (CP) contributes to permanent but not unchanging physical disability in childhood and adolescence. Although children with CP show some age-dependent gross motor and gait development, CP-induced muscle paresis and spasticity lead to bone deformation, loss of muscle volume, contractures, and patient dependence on care. Since there are reports that gait training can improve walking ability in children with CP, and simulation of gait training using whole-body vibration (WBV) can be also effective, German scientists decided to investigate the impact of a 6-month rehabilitation program with WBV on the gait of children with CP.

• The applied rehabilitation program, with a significant contribution of vibrotherapy, significantly improved gait in children with CP.

Prepared on the basis of:

Reference Centiles to Monitor the 6-minute-walk Test in Ambulant Children with Cerebral Palsy and Identification of Effects after Rehabilitation Utilizing Whole-body Vibration. Martakis K, Stark C, Rehberg M et al. Dev Neurorehabil. 2021 Jan;24(1):45-55.

Study population

There were analyzed the cases of 157 children with CP (GMFCS mobility level of 1 or 2), who underwent a standardized inpatient and home rehabilitation program “Auf die Beine”.

Test procedure

Retrospective data analysis was performed.

In children with CP (mobility on the GMFCS scale = 1 or 2), the impact of the 6-month “Auf die Beine” neurorehabilitation training on the results of the 6-minute walk test (6MWT) was analyzed.

“Auf die Beine” combines WBV training and conventional therapy: it begins with a two-week training session in a clinical setting and continues for 6 months at home, with a break for a week’s return to the clinic midway through this period. During “Auf die Beine” children receive WBV and 4 to 5 hours of individualized physical therapy during the first (2-week) stay at the clinic, as well as during the second (1-week) stay.

At the beginning (M0) and at the end of the 6-month rehabilitation program (M6), as well as 6 months after the M6 (M12), the results of the 6MWT were assessed.

Use of vibration in the study

A System Galileo® vibrating platform (Novotec Medical, Germany) was used. The applied vibrational stimuli induced spinal reflexes and involuntary muscle stimulation. Each WBV session lasted 3 × 3 minutes. During their stays in the clinic, the patients received three WBV sessions 3 × 3 minutes a day, and at home – ten sessions lasting 3 × 3 minutes a week.

Vibrations with a frequency of 5-12 Hz (balance and proprioceptive training), 12-20 Hz (improving muscle function) and 20-27 Hz (increasing muscle mass) were used. The amplitude, depending on the child’s body structure, ranged from 0 to 3.9 mm. WBV training was not the only element of physiotherapy, although it was its main base.

Results

The applied rehabilitation program significantly improved the results of 6MWT in M6 (p <0.001).

No statistically significant changes were observed in M12 (p = 0.550).

Comment

Conventional therapy in the “Auf die Beine” neurorehabilitation program, combined with the 6-month WBV training, the main component of this program, can significantly improve walking ability in children with CP.

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