Whole Body Vibration for Children and Young Adults With Moderate Severity of Cerebral Palsy
Condition: Cerebral Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Interventional

Summary: 
      Osteopenia is common in children with cerebral palsy (CP) due to poor bone growth and muscle
      disuse and the problem extends to their adulthood. These children and young adults with CP,
      especially those with moderate physical disabilities, are unable to perform the required
      amount of exercise to improve their bone health as their typically developing counterparts.
      As a result, non-traumatic fractures and bone pain are common in individuals with moderate
      severity of CP. Whole body vibration therapy (WBVT) has been recently proven to improve bone
      health and muscle function in healthy adults and post-menopausal women. Among the research of
      the WBVT for children with CP, promising results have been shown on gross motor function,
      balance and muscle strength for children with mild disability. Among these published studies,
      the vibration protocols required the study participants to perform simple exercises on the
      vibration platform. Very limited studies have been conducted on children and young adults
      with moderate CP. At present, it is unknown if the effect of WBVT would be for this
      population group when compared with those with mild CP in terms of their gross motor function
      and balance, because the moderate group is greatly compromised in their mobility and extent
      of regular exercises when compared with the normal population and those with mild CP. In
      addition, it is unknown if static standing on the vibration platform would have similar
      effects on the gross motor function as doing simple exercises on the vibration platform. This
      pilot study aims to examine the effect of WBVT on children and young adults with moderate
      severity of CP. A convenience sample of 5 pre-puberty children aged between 6 to 14 years and
      5 young adults aged between 18 to 40 years with moderate CP, i.e. Gross Motor Function
      Classification System, GMFCS level III or IV, will be recruited to systematically investigate
      the effects of WBVT on their functional abilities.
    

Detailed description: 
      Osteopenia is common in children with cerebral palsy (CP) due to poor bone growth and muscle
      disuse and the problem extends to their adulthood. These children and young adults with CP,
      especially those with moderate physical disabilities, are unable to perform the required
      amount of exercise to improve their bone health as their typically developing counterparts.
      It has been demonstrated that strong bones or good bone health are related to muscle
      contractions during normal movements and regular exercises. As a result, non-traumatic
      fractures and bone pain are common in individuals with moderate severity of CP. Whole body
      vibration therapy (WBVT) has been recently proven to improve bone health and muscle function
      in healthy adults and post-menopausal women. It has been postulated that the vibration can
      stimulate the muscle spindles and elicit consistent muscle contractions. This would be a
      great advantage to the individuals with physical disabilities, who have limited movements and
      control in their body and prevent them to perform regular exercises as the normal
      individuals. Among the research of the WBVT for children with CP, promising results have been
      shown on gross motor function, balance and muscle strength for children with mild disability.
      Among these published studies, the vibration protocols required the study participants to
      perform simple exercises on the vibration platform. Very limited studies have been conducted
      on children and young adults with moderate CP. At present, it is unknown if the effect of
      WBVT on this population group would be similar to those with mild CP in terms of their gross
      motor function and balance, because the moderate group is greatly compromised in their
      mobility and extent of regular exercises when compared with the normal population and those
      with mild CP. It is also unknown if static standing on the vibration platform would have
      similar effects on the gross motor function as doing simple exercises on the vibration
      platform.

      This pilot study aims to examine the effect of WBVT on children and young adults with
      moderate severity of CP. A convenience sample of 5 pre-puberty children aged between 6 to 14
      years and 5 young adults aged between 18 to 40 years with moderate CP, i.e. Gross Motor
      Function Classification System, GMFCS level III or IV, will be recruited to systematically
      investigate the effects of WBVT on their functional abilities. Individuals with GMFCS level
      III mobilise with hand-held mobility devices such as crutches or walking frames. Individuals
      of levels IV have very limited functional mobility and are mostly limited to an indoor
      environment.

      The children and young adults will receive the WBVT when standing still on a vibration
      platform of 20 Hertz and a peak-to-peak amplitude of 2 mm: sessions will be 18 minutes in
      length, 4 days per week for 4 weeks. Assessments will be performed at baseline and at
      completion of the intervention to examine the changes in the functional abilities of these
      children and young adults. The vibration frequency, duration and amplitude will be
      progressively increased over 2 weeks to the maximum of 3 minutes of 20 Hz with a peak-to-peak
      amplitude of 2mm and remain the same for the rest of the 2 weeks.

      The outcomes of this pilot study will show if this intervention is beneficial for children
      and young adults with moderate CP with respect to their functional abilities, and if there
      may be any related practical issues of this intervention to this population group. The
      outcomes also provide preliminary evidence to clinicians if this intervention is effective to
      improve functional abilities of children and young adults with moderate severity of CP and
      provide preliminary data to calculate sample sizes for future studies.
    

Intervention name(s): whole body vibration
Intervention type(s): Device
Intervention description(s): The children and young adults will receive the WBVT when standing still on a vibration platform of 20 Hertz and a peak-to-peak amplitude of 2 mm: sessions will be 18 minutes in length, 4 days per week for 4 weeks. Assessments will be performed at baseline and at completion of the intervention to examine the functional abilities of these children and young adults. The vibration frequency, duration and amplitude will be progressively increased over 2 weeks to the maximum of 3 minutes of 20 Hz with a peak-to-peak amplitude of 2mm.
Intervention model: Single Group Assignment
Intervention model description: The study participants would receive 4 weeks of whole body vibration therapy, 4 sessions per week for 18 minutes per session.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: whole body vibration; cerebral palsy; functional abilities; children; adults