THE EFFECTS OF WHOLE BODY VIBRATION IN CHILDREN WITH CEREBRAL PALSY: A SYSTEMATIC REVIEW
Background: Cerebral palsy is a leading cause of disability in children. Primary motor impairments often mean children must receive physiotherapeutic treatment to prevent secondary musculoskeletal problems, and maintain functional mobility and quality of life. Whole body vibration (WBV) has become increasingly used within this population for neurorehabilitation. It has been shown to have positive effects on relevant outcomes for these children: motor function, mobility, strength, balance, bone mineral density (BMD) and spasticity. Yet the evidence remains lacking; previous systematic reviews have been inconclusive as to the effects of WBV. New, recently published trials warrant consolidation of evidence. Objective: The purpose of this systematic review is to evaluate the evidence from randomized controlled trials about the effects of WBV on various outcomes in children with CP, and determine whether WBV with physiotherapy is more effective than standard physiotherapy alone. Methods: A systematic search of six online databases was performed on 15/03/18, using preselected search terms ‘cerebral palsy’ and ‘whole body vibration’. Appropriate medical subject heading (MeSH) terms were used for PubMed, MEDLINE and Cochrane Library. Unique search strings were developed for SCOPUS, CINAHL and PEDro. Trials meeting eligibility criteria were assessed by the author using the Cochrane Collaboration’s risk of bias tool for methodological quality before undergoing the data collection and analysis process. Results: Twelve randomized controlled trials encompassing 298 children were ultimately selected for inclusion. Methodological assessment revealed two moderate quality studies, five of poor quality and five of acceptable quality. Critical analysis of the studies revealed substantial heterogeneity in some aspects, yet there was moderate evidence indicating WBV improves strength and muscle mass, posture and spasticity, as well as low quality evidence suggesting WBV improves balance, BMD, gait and motor function. Conclusion: WBV can be effective in improving critical outcomes for children with CP. It should be considered an addition to physiotherapeutic neurorehabilitation, as it is more effective than physiotherapy alone. More rigorous studies with larger samples are needed to elaborate on effects in certain CP sub-populations and specific WBV settings.