Effects of Whole-Body Vibration on the Improvement of Balance, Gait and Activities of Daily Living in Patients with Subacute Stroke

Abstract

The purpose of this study was to investigate the effects of whole-body vibration on the improvement of functional performance in subacute stroke patients. Methods: Twenty subacute stroke patients were equally randomized to either a vibration or a control group and received 4-week conventional rehabilitation therapy and standing exercise. During the standing exercise, the vibration group received 10-minute whole-body vibration and the control group performed standing exercise without vibration. Outcome variable included the Korean version of Berg Balance Scale (BBS), the manual muscle test (MMT) of the paretic knee extensor, Modified Ashworth Scale (MAS) of the paretic ankle plantar flexor spasticity, Functional Ambulation Category (FAC), and the Korean version of Modified Barthel Index (MBI) before and after 4-week intervention. Results: After the 4-week intervention, the difference in BBS between groups was significant, which was significantly larger in the vibration group than in the control group. Significant differences in FAC and MBI were also observed between groups. The change of the FAC, total MBI, and mobility MBI were significantly higher in the vibration group than in the control group. MMT and MAS did not show significant difference after intervention between groups. Differences in BBS were strongly positively correlated with FAC and mobility MBI, and were moderately correlated with both of total MBI and self-care MBI. Conclusion: Additional whole-body vibration intervention may efficiently improve balance control and ambulation in subacute stroke patients.

Efficacy and safety of whole-body vibration therapy for post-stroke spasticity: A systematic review and meta-analysis

“…In the experimental group, the intervention was WBV or conventional treatment supplemented with WBV, whereas the control group received sham vibration or conventional treatment. For spasticity sites, nine articles ( 13 , 23 , 26 , 37 , 38 , 40 – 42 , 44 ) included patients with lower limb spasticity and two articles ( 39 , 43 ) included patients with upper limb spasticity. The fundamental features of the included research were outlined in Table 1 .…”

“…The evaluation of the potential for bias in the included studies is summarized in Supplementary Table S1 . Overall, according to the Cochrane Bias Risk Scale, four studies ( 13 , 26 , 39 , 43 ) met five low-bias risk criteria, three studies ( 23 , 37 , 41 ) met four criteria, two studies ( 38 , 42 ) met three criteria, one study ( 40 ) met two criteria, and one study ( 44 ) only met one low-bias standard. We summarized the results as follows: (1) Random sequence generation: except Sung ( 42 ) using a randomization method of high bias risk, all of the other included studies described a method of random sequence generation; (2) Allocation hidden: four studies ( 13 , 26 , 39 , 41 ) reported a clear random assignment scheme and the rest of studies did not report; (3) Implementation bias and measurement bias: eight studies and four studies, respectively, were found to have a low risk of implementation and measurement bias.…”

“…Overall, according to the Cochrane Bias Risk Scale, four studies ( 13 , 26 , 39 , 43 ) met five low-bias risk criteria, three studies ( 23 , 37 , 41 ) met four criteria, two studies ( 38 , 42 ) met three criteria, one study ( 40 ) met two criteria, and one study ( 44 ) only met one low-bias standard. We summarized the results as follows: (1) Random sequence generation: except Sung ( 42 ) using a randomization method of high bias risk, all of the other included studies described a method of random sequence generation; (2) Allocation hidden: four studies ( 13 , 26 , 39 , 41 ) reported a clear random assignment scheme and the rest of studies did not report; (3) Implementation bias and measurement bias: eight studies and four studies, respectively, were found to have a low risk of implementation and measurement bias. The studies by Wei ( 44 ), Li et al ( 40 ), and He ( 38 ) were unclear in these two respects: (4) Follow-up bias: only the studies by Wei ( 44 ) indicated missing data, which means the remaining were deemed to low risk; (5) Reporting bias and other bias: other possible sources of bias could not be found, and not all research used selective reporting ( Figures 3 , 4 ).…”

“…Regarding vibration duration, four studies ( 40 , 42 – 44 ) performed 10 min of vibration, and the effects of WBV were better than those applied 5 and 15 min of vibration to patients with spasticity (SMD = −0.41, 95% CI: −0.75 to −0.07, P = 0.02) ( Figure 10 ).…”

“…Alp et al ( 23 ) reported that ankle spasticity levels decreased gradually at the 3- and 6-month follow-ups. As for the adverse effects, in five studies, no notable serious adverse events associated with WBV were reported ( 13 , 26 , 38 , 40 , 42 ). According to one study ( 41 ), five modest side effects (fatigue, redness of the skin, mild headache, and drowsiness) and 1 out of 84 patients experienced mild knee pain following the WBV.…”