Vibrotherapy may be an alternative or augmentation of conventional rehabilitating therapy of functional balance in patients with Parkinson’s disease.
Disturbances in gait, posture and balance found in Parkinson’s disease (PD) patients significantly reduce their mobility, activity, deprive them of independence and lower quality of life. Vibrotherapy, which in many studies improves motor functions, is often used as a non-pharmacological form of rehabilitation.
The aim of the presented research was to analyze the effect of vibrotherapy on the functional balance of patients with PD and to compare the effectiveness of vibrotherapy with conventional or combined therapy (conventional therapy + vibrotherapy).
The Berg Balance Scale (BBS), which is considered a standard in the assessment of functional balance, was used. BBS provides an overall assessment of balance when standing or walking, and also estimates the risk of falls.
- There was a significant improvement in BBS compared to baseline, both after conventional therapy, after vibrotherapy, as well as after combined therapy.
- Combined therapy gave better results than conventional therapy.
- There were no statistically significant differences in BBS improvement between conventional therapy and vibrotherapy.
Prepared on the basis of:
Comparison of the effect of whole-body vibration therapy versus conventional therapy on functional balance of patients with Parkinson’s disease: adding a mixed group. Guadarrama-Molina E, Barrón-Gámez CE, Estrada-Bellmann I, Meléndez-Flores JD, Ramírez-Castañeda P, Hernández-Suárez RMG, Menchaca-Pérez M, Salas-Fraire O. Acta Neurol Belg. 2021 Jun;121(3):721-728.
Study population
The study involved 45 patients with no age or gender limitations, with PD manifested by disturbances in gait, balance or posture.
Test procedure
Group 1 (control) received conventional therapy (thermotherapy, stretching, strengthening, coordination). Group 2 underwent vibrotherapy. Group 3 underwent a combined therapy protocol, i.e. first conventional therapy and then vibrotherapy. In total, 20 treatment sessions (3 per week) were conducted. BBS was assessed twice in each group: before the initial session and after the final session.
Use of vibration in the study
Vibrotherapy (whole body vibration, WBV) consisted of a rehabilitation therapy protocol developed specifically for this purpose, the aim of which was to stimulate the work of the lower limbs and, to a lesser extent, the upper limbs, using tolerated and favorable vibration frequencies. Vibration was provided by the Fitvibe Excel Pro Vibration Trainer. The patient was placed on a vibrating plate and the therapist monitored the entire procedure. Eight positions were used. Vibration parameters were as follows: frequency 20 Hz, amplitude 2 mm, treatment in each position lasted 20 s. Between positions, subjects rested 30-60 s. Positions were easy to perform. They included the activation of the gluteal muscles, hamstrings, quadriceps and triceps muscles – important for stability and posture.
Results
Patients who received conventional therapy showed an increase in BBS by 3.4 ± 2.4 points. Vibrotherapy increased BBS by 4.1 ± 1.5. The combined therapy increased BBS by 5.9 ± 3.1 (p = 0.022). The differences between the conventional therapy and combined therapy groups were statistically significant (p = 0.021), but not between conventional therapy and vibrotherapy (p = 0.370) or between vibrotherapy and combination therapy (p = 0.052).
Comment
Conventional rehabilitation therapy, vibrotherapy, or a combination of both, improved the functional balance in patients with PD. Combined therapy resulted in greater improvement compared to conventional therapy, while no difference was observed between conventional therapy and vibrotherapy.
This study therefore suggests that vibrotherapy may be a useful tool for enhancing the effects of conventional therapy and that a combination of both may be a significant therapeutic alternative for improving functional balance in PD patients compared to conventional therapy alone.
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