Effects of Whole-Body Vibration-Assisted Training on Lower Limb Blood Flow in Children With Myelomeningocele

Abstract

This study investigated the effectiveness of whole-body vibration (WBV) training incorporated into a conventional physiotherapy (PT) program (WBV-assisted training) in improving blood flow in the lower limbs and range of motion in the lower limb joints of children with myelomeningocele (MMC). A total of 31 children with MMC (7–15 years old) underwent a 6 weeks treatment program consisting of 2 weeks of conventional PT followed by 4 weeks of WBV-assisted training. The assessment comprised two parts: evaluation of lower limb joint range of motion and Doppler ultrasonography of the superficial femoral, popliteal, and anterior tibial arteries and was performed three times for each of the participants (at baseline, after 10 sessions of PT but before WBV-assisted training, and after 20 sessions of WBV-assisted training). Our results showed that WBV-assisted training significantly improved lower limb circulation in patients with MMC, increasing velocity and reducing resistivity in all tested arteries. Moreover, WBV-assisted training alleviated lower-extremity contractures, especially of the knee. Thus, WBV-assisted training is effective as an adjunctive rehabilitation program for improving functional mobility in children with MMC.

Effects of Whole-Body Vibration Training on Lower Limb Blood Flow in Children with Myelomeningocele—A Randomized Trial

“…Although there is limited information on peripheral blood circulation disorders in MMC, the study of Boot et al confirmed the presence of poorer vascular properties in the common femoral artery (i.e., smaller diameter, lower flow, higher levels of wall shear stress) in the SB population compared to able-bodied controls as well as individuals with a spinal cord injury [ 6 ]. Our previous findings also revealed that children with MMC present poor arterial circulation in their legs [ 7 ]. Additionally, this study noted a statistically significant correlation between hip and knee contractures associated with altered blood flow velocity and resistivity of the lower limb arteries [ 7 ].…”

“…Our previous findings also revealed that children with MMC present poor arterial circulation in their legs [ 7 ]. Additionally, this study noted a statistically significant correlation between hip and knee contractures associated with altered blood flow velocity and resistivity of the lower limb arteries [ 7 ].…”

“…Based on examination of arteries, the following information was obtained: (1) Peak systolic velocity (PSV); (2) end-diastolic velocity (EDV); (3) Resistivity Index (RI); and the (4) Pulsatility Index (PI). The detailed Doppler test procedures were identical to those reported in our previous study [ 7 ]. Each examination was performed for each participant twice: At a baseline (Pre-WBV or Pre-PT) and the day after the 3-week intervention (Post-WBV or Post-PT).…”

“…Both the evaluation of USG Doppler as well as the ROM examination were carried out in accordance with previously developed protocols used in our previous study [ 7 ].…”

“…Because it was difficult to recruit a sufficient number of participants willing to undertake vibration training as the only form of physiotherapy (PT), our previous study investigated the effectiveness of WBV training applied in conjunction with conventional PT (WBV-PT). Although our findings showed that WBV-PT significantly improved both vascular properties in individuals with MMC and the ROM of lower limb joints, the effectiveness of WBV alone has not been determined [ 7 ]. However, the application of WBV using a tilt-table proved to be so safe, easy to perform, and well tolerated by children with MMC that it convinced the participants to take part in a three-week program using only WBV training.…”