Vibration therapy in patients with cerebral palsy: a systematic review

Abstract

The neurological disorder cerebral palsy (CP) is caused by unprogressive lesions of the immature brain and affects movement, posture, and the musculoskeletal system. Vibration therapy (VT) is increasingly used to reduce the signs and symptoms associated with this developmental disability. The purpose of this narrative review was systematically to appraise published research regarding acute and long-term effects of VT on functional, neuromuscular, and structural parameters. Systematic searches of three electronic databases identified 28 studies that fulfilled the inclusion criteria. Studies were analyzed to determine participant characteristics, VT-treatment protocols, effect on gross motor function (GMF), strength, gait, posture, mobility, spasticity, reflex excitability, muscle tone, mass, and bone strength within this population, and outcome measures used to evaluate effects. The results revealed that one acute session of VT reduces reflex excitability, spasticity, and coordination deficits. Subsequently, VT has a positive effect on the ability to move, manifested for GMF, strength, gait, and mobility in patients with CP. Effects persist up to 30 minutes after VT. Long-term effects of VT manifest as reduced muscle tone and spasticity occurring concomitantly with improved movement ability in regard to GMF, strength, gait, and mobility, as well as increased muscle mass and bone-mineral density. Posture control remained unaffected by VT. In conclusion, the acute and chronic application of VT as a nonpharmacological approach has the potential to ameliorate CP symptoms, achieving functional and structural adaptations associated with significant improvements in daily living. Even though further studies including adult populations validating the neuromuscular mechanisms underlying the aforementioned adaptations should be fostered, growing scientific evidence supports the effectiveness of VT in regard to supplementing conventional treatments (physiotherapy and drugs). Therefore, VT could reduce CP-associated physical disability and sensorimotor handicaps. Goals for patients and their caregivers referring to greater independence and improved safety may be achieved more easily and time efficiently.

State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy

“…Our review has shown that traditional interventions for contracture management, including neurodevelopmental therapy [3•] (red light) and passive stretching in isolation [155] (yellow light), appear ineffective and the panel assigned negative recommendations since effective substitutes exist. In contrast, we found emergent low-quality evidence suggesting ankle robotics [32], biofeedback [30], botulinum toxin plus electrical stimulation [190], and whole-body vibration [97] may help manage contracture, by eliciting antagonist muscle activity that counterbalance involuntary agonist muscle contractions (yellow light), though more research is needed in this area.…”

Vibration‐induced depression in spinal loop excitability revisited

“…These results may also allow a better understanding of plasticity in spinal circuitry of spastic patients, these patients being characterized by a spinal hyperexcitability responsible for muscle spasms and long‐lasting reflexes (Nardone & Schieppati, ; Ritzmann et al . ). Our results could reinforce interest in the use of vibration as a therapy in those patients.…”

Osteoporose/Frakturen bei Menschen mit geistiger Behinderung

“…Als sonstige oder auch zukünftige Präventionsmaßnahmen ist die Vibrationstherapie und Elektrostimulation möglicherweise hilfreich. So berichten Ritzmann et al [39] über Verbesserungen im Bereich der Kraft, Mobilität und Knochendichte durch Vibrationstherapie und Bosques et al [40] über positive Effekte der Elektrostimulation auf die Mobilität, Muskelmasse und möglicherweise auch auf die Knochendichte bei Patienten mit Zerebralparese.…”