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Objective To investigate the effect of age and Gross Motor Function Classification System (GMFCS) level on walking endurance after 20 weeks of vibration therapy in children and young people with cerebral palsy (CP). Design The study was a clinical trial without control group comparing baseline and postintervention outcomes within participants. Setting Vibration therapy was performed at school or at home. Assessments took place in a clinical research unit. Participants Children and young people (N=59) with CP, aged 5-20 years, GMFCS level II, III, or IV, recruited through schools, physiotherapy services, and District Health Board clinics, Auckland, New Zealand. Interventions Participants performed side-alternating whole-body vibration therapy (WBVT) at 20 Hz and 3-mm amplitude, 9 minutes per day, 4 times per week for 20 weeks. Main Outcome Measures Distance walked in the 6-minute walk test (6MWT) was recorded before and after the intervention. Results Participants baseline results for the 6MWT were lower, independent of age or GMFCS, when compared to non-CP literature. On average, participants walked 12% further in the 6MWT after the intervention ( P <.001). There was significant improvement in 6MWT distance in all age groups (5-10y: 16%, P <.001; 11-15y: 10%, P =.001; 16-20y: 13%, P <.001) and all GMFCS levels (level II: 10%, P <.001, level III: 40%, P =.013, level IV: 57%, P =.007). There was a greater percentage improvement in the distance walked in those with GMFCS level III and level IV than level II ( P =.049 and P <.001, respectively). Conclusions WBVT had a beneficial effect on walking endurance in children and young people with CP, independent of age and GMFCS.

Aims A pilot study was performed to establish the safety, feasibility and efficacy of vibration therapy (VT) on bone and muscle health in children and adolescents with a range of musculoskeletal disorders. Methods Seventeen participants (15.7 years ± 2.9 years), with conditions that impacted on their musculoskeletal health, completed 20 weeks of side‐alternating VT for 9 min/session, 4 times/week at 20 Hz. Data were collected at baseline and after 20 weeks of intervention. Assessments included whole‐body dual‐energyX‐ray absorptiometry, muscle function (force plate) and 6‐min walk test. Results Compliance with the prescribed VT training protocol was relatively high overall at 78% and there were no adverse events reported. After 20 weeks intervention, functional assessments showed time taken to perform the chair test was reduced by 15% (P = 0.018), leg balance improved with standard ellipse area decreasing by 88% (P = 0.006) and distance walked in the 6‐min walk test improved by 9% (P = 0.002). Participants displayed increased total body mass (1.94 kg; P = 0.018) with increased lean mass (1.20 kg; P = 0.019) but not fat mass (P = 0.19). There was no change in total body bone mineral density (P = 0.44) or bone mineral content (P = 0.07). Conclusions Twenty weeks of side‐alternating VT was a feasible protocol that was associated with improvements in physical function and no detrimental effects on lean mass, bone mass or density in children and adolescents with musculoskeletal disorders.

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Introduction: Morphologic features of Iliocapsularis (IC) may aid clinical decision-making in the symptomatic hip. The relationship between IC muscle size and underlying hip pathology is emerging; however, research is limited in the imaging literature. The purpose of this study was to determine the reliability and reproducibility of measurements of the IC muscle and its MRI appearances. It also looked for any association between IC dimension and axial levels, side, gender and bony features of hip instability. Methods: Retrospective study of 37 MRI scans were assessed by four observers. MRI axial T1 images were used to define the IC anatomy, measure the IC and rectus femoris at the femoral head centre (FHC) and adjacent levels and calculate the iliocapsularis-to-rectus femoris (IR) ratio. Measurements were repeated at least 2 weeks later. Radiographic assessment of the lateral centre edge angle, acetabular index and femoral neck-shaft angle were also conducted. Results:The IC was always present, but was well-defined in only 4% of cases with fair agreement. The intraclass correlation coefficient for reliability and reproducibility was the highest for IC width 0.94 (0.91-0.96). No significant correlation was identified between the IR ratio and radiographic parameters. Conclusion: Iliocapsularis is visible and reliably measured on MRI despite observers considering the muscle to be not well-defined. Despite gender differences in muscle size, the IR ratio was unchanged. There is a significant difference in the IR ratio above and below the FHC; therefore, clinicians need to be aware of how this may impact the clinical use when utilising the IR ratio.