Whole Body Vibration Versus Conventional Physiotherapy to Improve Balance and Gait in Parkinson’s Disease

Movement Disorders Clinic, Beelitz-Heilstätten, Germany.
Archives of physical medicine and rehabilitation (Impact Factor: 2.57). 04/2008; 89(3):399-403. DOI: 10.1016/j.apmr.2007.09.031
Source: PubMed


To compare the effects of whole body vibration (WBV) and conventional physiotherapy (PT) on levodopa-resistant disturbances of balance and gait in idiopathic Parkinson's disease (PD).
Randomized controlled rater-blinded trial comparing 2 active interventions, final follow-up assessment 4 weeks after termination of active intervention.
Specialized referral center, hospitalized care.
Patients with PD and dopa-resistant imbalance on stable dopamine replacement medication (N=27) were randomized (intent-to-treat population) to receive WBV (n=13) or conventional PT (controls, n=14). Twenty-one patients (per protocol population) completed follow-up (14 men, 7 women; mean age, 73.8 y; age range, 62-84 y; mean disease duration, 7.2 y; mean dopa-equivalent dose, 768 mg/d).
Subjects were randomized to receive 30 sessions (two 15-min sessions a day, 5 days a week) of either WBV on an oscillating platform or conventional balance training including exercises on a tilt board. Twenty-one subjects (10 with WBV, 11 controls) were available for follow-up 4 weeks after treatment termination.
The primary measure was Tinetti Balance Scale score. Secondary clinical ratings included stand-walk-sit test, walking velocity, Unified Parkinson's Disease Rating Scale (section III motor examination) score, performance in the pull test, and dynamic posturography.
The Tinetti score improved from 9.3 to 12.8 points in the WBV group and from 8.3 to 11.7 in the controls. All secondary measures, except posturography, likewise improved at follow-up compared with baseline in both groups. Quantitative dynamic posturography only improved in patients with WBV (1937-1467 mm) whereas there was no significant change in controls (1832-2030 mm).
Equilibrium and gait improved in patients with PD receiving conventional WBV or conventional PT in the setting of a comprehensive rehabilitation program. There was no conclusive evidence for superior efficacy of WBV compared with conventional balance training.

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    • "To reduce these motor fluctuations, new treatments based on peripheral stimulation of the sensory-motor system, called bottom-up stimulation, have been inspiring new rehabilitation approaches in PD [7] [8]. Recently, new approaches have been developed to recover the gait impairment such as the Automated Mechanical Peripheral Stimulation (AMPS) treatment [9] [10]. "
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    ABSTRACT: This study aims to evaluate the change in gait spatiotemporal parameters in subjects with Parkinson’s disease (PD) before and after Automated Mechanical Peripheral Stimulation (AMPS) treatment. Thirty-five subjects with PD and 35 healthy age-matched subjects took part in this study. A dedicated medical device (Gondola) was used to administer the AMPS. All patients with PD were treated in off levodopa phase and their gait performances were evaluated by an inertial measurement system before and after the intervention. The one-way ANOVA for repeated measures was performed to assess the differences between pre- and post-AMPS and the one-way ANOVA to assess the differences between PD patients and the control group. Spearman’s correlations assessed the associations between patients with PD clinical status (H&Y) and the percentage of improvement of the gait variables after AMPS ( α < 0.05 for all tests). The PD group had an improvement of 14.85% in the stride length; 14.77% in the gait velocity; and 29.91% in the gait propulsion. The correlation results showed that the higher the H&Y classification, the higher the stride length percentage of improvement. The treatment based on AMPS intervention seems to induce a better performance in the gait pattern of PD patients, mainly in intermediate and advanced stages of the condition.
    Full-text · Article · Sep 2015 · Parkinson's Disease
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    • "Research articles have demonstrated that WBV therapy can bring benefits for improving muscle strength [5] [22], bone remodeling [23] [30] and for Parkinson's disease [12] [14]. However WBV can also cause negative effects by decreasing the sensitivity of fast-adapting mechanoreceptors in the human skin, and affecting balance [11] [26] [27]; its effects can range from no effect to potentially harmful, depending on the variables selected [10] [13] [24]. "
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    ABSTRACT: Whole-body vibration (WBV) training has become popular in recent years. However, WBV may be harmful to the human body. The goal of this study was to determine the acceleration magnitudes at different body segments for different frequencies of WBV. Additionally, vibration sensation ratings by subjects served to create perception vibration magnitude and discomfort maps of the human body. In the first of two experiments, 65 young adults mean (± SD) age range of 23 (± 3.0) years, participated in WBV severity perception ratings, based on a Borg scale. Measurements were performed at 12 different frequencies, two intensities (3 and 5 mm amplitudes) of rotational mode WBV. On a separate day, a second experiment (n = 40) included vertical accelerometry of the head, hip and lower leg with the same WBV settings. The highest lower limb vibration magnitude perception based on the Borg scale was extremely intense for the frequencies between 21 and 25 Hz; somewhat hard for the trunk region (11-25 Hz) and fairly light for the head (13-25 Hz). The highest vertical accelerations were found at a frequency of 23 Hz at the tibia, 9 Hz at the hip and 13 Hz at the head. At 5 mm amplitude, 61.5% of the subjects reported discomfort in the foot region (21-25 Hz), 46.2% for the lower back (17, 19 and 21 Hz) and 23% for the abdominal region (9-13 Hz). The range of 3-7 Hz represents the safest frequency range with magnitudes less than 1 g(*)sec for all studied regions. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · May 2015 · Medical Engineering & Physics
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    • "Furthermore, in other neurological diseases like multiple sklerosis, positive effects could be shown with WBV [13]. On the other hand, there was no superior efficiacy of WBV training lasting several weeks in comparison to conventional balance training [14]. In this study with PD patients, steady WBV was used. "
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    ABSTRACT: Background. Random whole body vibration (WBV) training leads to beneficial short-term effects in patients with Parkinson's disease (PD). However, the effect of WBV lasting several weeks is not clear. Objectives. The aim of this study was to assess a random WBV training over 5 weeks in PD. Methods. Twenty-one participants with PD were allocated to either an experimental or a placebo group matched by age, gender, and Hoehn&Yahr stage. The WBV training consisted of 5 series, 60 s each. In the placebo group, vibration was simulated. The primary outcome was the change of performance in Functional reach test (FRT), step-walk-turn task, biomechanical Gait Analysis, Timed up and go test (TUG), and one leg stance. Findings. In most of the parameters, there was no significant interaction of "time∗group." Both groups improved significantly in Gait parameters, TUG, and one leg stance. Only in the FRT [F(1,15) = 8.397; P < 0.05] and in the TUG [F(1,15) = 4.971; P < 0.05] the experimental group performed significantly better than the placebo group. Conclusions. Random WBV training over 5 weeks seems to be less effective than reported in previous studies performing short-term training. The slight improvements in the FRT and TUG are not clinically relevant.
    Full-text · Article · Oct 2014 · Parkinson's Disease
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