WHOLE BODY VIBRATION EXERCISES FOR CHILDREN WITH CEREBRAL PALSY
Background: Cerebral Palsy (CP) is defined as long-lasting non-progressive damage to the foetal or developing brain which may affect the individual’s movement and posture. A new physiotherapy intervention has been introduced in order to help treat children with CP which is called Whole Body Vibration (WBV). WBV helps to improve walking, muscle strength, bone mineral density (BMD), decrease tone and improve motor function in children with CP. However, research into the effectiveness of WBV has produced inconsistent results. An up-to-date systematic review is therefore necessary to appraise and synthesise all the available evidence. Objective: The aim of this systematic review was to evaluate the effectiveness of WBV exercises in children with CP on strength, walking, function, bone mineral density (BMD) and spasticity. Search Strategy: Five databases were searched during the month of May 2018 using a pre-determined selection of key words. The databases were: Cochrane Library, PubMed, CINAHL Plus with Full Text, MEDLINE and PEDro. The reference lists of all articles selected for inclusion were also searched to identify any additional studies. Selection Criteria: All randomised controlled trials (RCTs) including randomized cross-over trials were included in this systematic review. Data Collection and Analysis: The articles were selected based on the inclusion criteria. The methodological quality of all the final selected studies was assessed using The Cochrane Risk of Bias Tool. Results: Twelve articles were selected for inclusion in this review. The results of all six studies that focused on walking indicated that WBV has a positive effect on walking in children with CP who either walk alone or with a walking aid. Similarly, improvement in strength was found in four studies out of five, improvement in BMD was found in two studies out of only three and improvement in spasticity was found in three studies only. Four studies focusing on function resulted in an equal amount of conflicting results. The methodological quality of the studies included was variable. Conclusion: Results of the selected studies suggest that WBV as an adjunct to other treatment may improve walking who can walk with or without a walking aid. It may also improve muscle strength in children with CP. WBV may also improve spasticity and BMD. However, further high quality research is recommended to validate improvement in muscle strength, spasticity and BMD. Conflicting evidence for function has been found, therefore, further high quality studies are also recommended to investigate this further.