Cerebral Palsy Clinical Trial
Official title:
Effect of Whole Body Vibration Therapy on Functional Abilities in Children and Young Adults With Moderate Severity of Cerebral Palsy- a Pilot Study
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.
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.
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