## 4 Discussion
[11] found that hand-transmitted vibration improved grip strength and upper extremity function in subacute stroke patients. Participants sat on an armless chair, leaning forward with their hands gently resting on the vibration plate to ensure comfort. Also, Whole-Body Vibration training combined with task-related training offers greater improvements in arm function, spasticity, and grip strength compared to conventional upper limb training, with or without vibration, in individuals with poststroke hemiplegia [17]. In this study, the functionality of the upper limb was assessed using the ABILHAND scale. The results indicated significant improvements in both the intervention and control groups, but no statistically significant differences were found between them. Interestingly, children with hemiplegia demonstrated superior functionality compared to those with quadriplegia, aligning with the existing literature on differential CP impacts [18; 19]. Managing lower limb spasticity and weakness is supported by repetitive use during weight-bearing activities. In contrast, children with hemiplegia often rely on one-handed tasks, which can lead to learned nonuse of the affected upper limb, making rehabilitation after focal treatments more challenging. However, the small sample size precludes definitive conclusions, emphasizing the need for larger studies to corroborate these results. Quality of life, assessed using the CP QOL questionnaire, showed no statistically significant differences between the intervention and control groups, suggesting that the intervention did not have a major impact on improving the quality of life for either adolescents or younger children with cerebral palsy over the course of this study. However, some trends such as improvement in emotional well-being and decreased pain impact in the intervention group were observed. In contrast, [PERSON] et al. [28] reported quality-of-life improvements in adolescents with CP following a 20-week WBV program with a higher frequency of sessions. Differences in intervention duration and vibration protocols may explain these discrepancies, underscoring the importance of standardized methodologies in future research. The primary limitations of this pilot study include its small sample size, short intervention duration, and variability in baseline spasticity levels and age between the participants, which ranged widely from 5 to 18 years. This study aimed to explore the feasibility and potential effects of UEVT-WBV on upper extremity function in children with CP, rather than to draw definitive conclusions. Both groups received conventional physiotherapy alongside UEVT-WBV, making it challenging to isolate the specific effects of UEVT-WBV. Additionally, the lack of blinding in outcome assessments introduces the potential for bias, further limiting the interpretability of the findings. We acknowledge the limitation of using the Kolmogorov-Smirnov test for normality in a small sample of 10 participants. While alternative methods like histograms and Q-Qplots were also used, the small sample size may limit the robustness of these findings, warranting cautious interpretation. No significant time \(\times\) group interaction effects were observed for primary outcomes such as spasticity (MAS) and manual ability (ABILHAND), suggesting similar changes over time in both the intervention and control groups. These findings should be interpreted with caution given the exploratory nature of this study, and future investigations should prioritize methodological improvements. Future studies should employ larger, more homogenous cohorts, longer intervention periods, and robustly controlled protocols to better evaluate the standalone efficacy of UEVT-WBV. Efforts to reduce variability in baseline characteristics through stratified randomization, as well as ensuring blinding of evaluations, are essential to minimize bias.