Background Cerebral palsy (CP) is the most common cause of physical disability in early childhood. Vibration therapy (VT) is a promising rehabilitation approach for children with CP with potential to impact mobility, bone and muscle health as demonstrated by extant research. However, it is still unclear how long therapy must be conducted for and what the optimal vibration frequency is in order to gain health benefits. Methods/design The study is a randomized clinical trial evaluating and comparing the effects of two vibration frequency (20 Hz vs 25 Hz) and duration protocols (12 weeks vs 20 weeks) of side-alternating VT on mobility and other health parameters in children with CP. Children aged 5–12 years old with CP and GMFCS level I-III who are able to understand instruction and safely stand are eligible for the study. Exclusion criteria include bone fracture within 12 weeks of enrolment; acute conditions; the history of significant organic disease; the history of taking anabolic agents, glucocorticoids, growth hormone, and botulinum toxin injection into lower limbs within 3 months of enrolment. All participants will act as their own control with a 12-week lead-in period prior to intervention. The intervention period will consist of 20 weeks of home- or school-based VT 9 min per day, 4 times a week. After the baseline assessment, participants will be randomized to either a 20 Hz or 25 Hz vibration-frequency group. The primary outcome is mobility measured by a 6-min walking test, with analysis performed on the principle of intention to treat. Secondary outcomes include body composition, muscle strength, physical activity level, balance, gross motor function, respiratory function, and quality of life. Participants will undergo four assessment visits over the study period: baseline, at weeks 12, 24, and 32. Discussion The results of the study will provide evidence-based insights into the health benefits of side-alternating VT as a therapeutic tool in young children with cerebral palsy. The investigation of different vibration training protocols will help define the optimal parameters of intervention protocols (duration, frequency) of side-alternating VT to maximize outcomes on the health of 5–12-year-old children with CP. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): 12618002026202 (Registration date 18/12/2018).
Congenital myopathy is a heterogeneous group of muscle disorders characterized by muscle weakness and hypotonia. This condition is associated with a range of skeletal, respiratory, and ophthalmologic complications and requires a multidisciplinary therapeutic approach aimed at maximizing the function and independence of patients. One promising direction for therapeutic intervention is physical exercise rehabilitation, given its demonstrated ability to promote muscle and bone health of patients with a variety of neuromuscular conditions. However, there are few data to assist health care professionals identify the optimal physical activity levels and exercise type, including the intensity, frequency, and duration. This lack of empirical evidence is particularly problematic given the fact that inappropriate exercise modes can potentially cause muscle damage in patients with congenital myopathy. In this article, we discuss the rationale behind the incorporation of two types of physical exercises, strength and aerobic training, into the clinical care of patients with congenital myopathy. Given the paucity of literature on the management of congenital myopathy, we review the results of published research on the treatment of both congenital myopathy and other neuromuscular diseases that could provide helpful insights into the physical rehabilitation of patients with congenital myopathy. We also discuss the potential benefits of vibration therapy, which has been studied in patients with other neuromuscular disorders over the last two decades. We conclude by proposing directions for future research on physical rehabilitation of patients with congenital myopathy.
Background Vibration therapy (VT) has been increasingly studied in children with cerebral palsy (CP) over the last years, however, optimal therapeutic VT protocols are yet to be determined. The present study compared the effects of side-alternating VT protocols varying in frequency and treatment duration on the health of young children with mild-to-moderate CP. Methods Thirty-four participants aged 6.0 to 12.6 years with CP acted as their own controls and underwent two consecutive study periods: a 12-week lead-in (control) period prior to the intervention period of 20-week side-alternating VT (9 min/session, 4 days/week), with the frequency either 20 Hz or 25 Hz, determined by randomisation. Participants had 4 assessment visits: baseline, after the control period, after 12-week VT (12VT), and after further 8 weeks of VT (20VT). Assessments included 6-minute walk test (6MWT); dual-energy x-ray absorptiometry; gross motor function; muscle function testing on the Leonardo mechanography plate and by hand-held dynamometry, and a quality-of-life questionnaire (CP QOL). Analysis was carried out using linear mixed models based on repeated measures. Results Side-alternating VT was well-tolerated, with occasional mild itchiness reported. The median compliance level was 99%. VT led to improvements in 6MWT (+ 23 m; p = 0.007 after 20VT), gross motor function in standing skills (+ 0.8 points; p = 0.008 after 12VT; and + 1.3 points; p = 0.001 after 20VT) and in walking, running and jumping skills (+ 2.5 points; p < 0.0001 after 12VT; and + 3.7 points; p < 0.0001 after 20VT), spine bone mineral density z-score (+ 0.14; p = 0.015 after 20VT), velocity rise maximum of the chair rising test (+ 0.14 m/s; p = 0.021 after 20VT), force maximum of the single two-leg jump test (+ 0.30 N/kg; p = 0.0005 after 12VT; and + 0.46 N/kg; p = 0.022 after 20VT) and in the health module of CP QOL (+ 7 points; p = 0.0095 after 20VT). There were no observed differences between the two VT frequencies (i.e., 20 Hz vs 25 Hz) on study outcomes. Conclusions The study confirms that side-alternating VT has positive effects on mobility, gross motor function, body composition, muscle function, and quality of life, independent of VT frequencies tested. Long-term, 20VT appears to be a more efficient treatment duration than a short-term, 12VT. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12618002026202; 18/12/2018.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.