The Effect of Vibration Therapy on Walking Endurance in Children and Young People With Cerebral Palsy: Do Age and Gross Motor Function Classification System Matter?

Abstract

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.

The Use of the 6MWT for Rehabilitation in Children with Cerebral Palsy: A Narrative Review

“…The 6MWT was used in other types of intervention, such as games and virtual reality activities, orthoses and whole-body vibration [ 7 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]. The use of internet-based intervention or intensive short-duration virtual reality intervention for 4 to 20 weeks reported significant improvements in the 6MWT when the children were involved in gross motor activity games.…”

“…A total of 124 studies were initially identified; after a review of the full text, 87 were excluded, as they included neurodegenerative or genetic disorders ( n = 55), as they were case reports ( n = 15), or as they did not provide details on 6MWT ( n = 17). The remaining 37 articles [ 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ], comprising a total of 1292 children, met the inclusion criteria after a review of the full text ( Figure 1 ).…”

“…Five studies [ 7 , 44 , 45 , 46 , 47 ] investigate the efficacy of whole-body vibration in children with CP. In two different articles, Cheng and colleagues [ 44 , 46 ], evaluated the effect of an 8-week program of WBV on 16 children aged 9.2 years diagnosed with spastic diplegia or quadriplegia with two similar protocols.…”

“…In the last study, Telford and colleagues [ 47 ] investigated the effect of age and GMFCS level on improvements in walking capacity (6MWT) of 59 children aged 5–20 years, before and after a 20-week vibration therapy program. All participants significantly improved their scores after intervention, independent of age and GMFCS level.…”

Developing the Gross Motor Skills of Children by Simultaneously Training Them with Rhythmic Gymnastics

“…Motor skills development is generally connected with obesity in children, especially the gross motor skills (C Graf, 2004) that happens due to the energy intake higher than energy expenditure (Soetjingsih, 2014) and seldom performing physical activities, (Ramdani & Azizah, 2020) involving big muscles (Papalia & Feldman, 2015) like running, jumping, climbing, kicking, whereas physical activities are important factors supporting the development of academic skills of young child ( Ali et al, 2017). Other problems connected with the development of children's' gross motor skills as found by (Nisnayeni, 2012); (Telford, et al 2020), are delays on children's development like delay to stand up, less able to swing hands, and cannot follow the rhythmic gymnastic well, and as it is also influential on the development of motor skills, children face problems in reading (Overvliet, et al, 2011), and children age 5-6 years seem lazy to move their body especially arms and legs (Fuaidah, & Miftahillah, 2018). The development of children's motor is still dominated by boys (Bardid, et al, 2017).…”