WHAT ARE THE FUNCTIONAL BENEFITS OF A COMPLEMENTARY TWO-WEEK STOCHASTIC RESONANCE WHOLE-BODY VIBRATION TRAINING IN PATIENTS WITH ACUTE BRAIN LESION?

Herren K.1,2, Schmid S.3, Rogan S.3, Radlinger L.3
1Bern University Hospital, Department of Physiotherapy, Bern, Switzerland, 2SRO Hospital of Langenthal, Langenthal, Switzerland, 3Bern University of Applied Sciences, Health, Bern, Switzerland

Background: Stroke is the major cause for complex disability in adults, whereas traumatic brain injury (TBI) is the most common cause for long-term-disability among young adults. Both conditions represent an enormous socio-economic and healthcare burden. Individuals after stroke or TBI suffer from reduced muscle strength, spasticity, proprioceptive deficits, contractures and impaired balance resulting in gait disorders and therefore reduced independence in everyday life.
The use of sinusoidal whole body vibration (WBV) showed promising functional effects in frail elderly, but only inconclusive effects on gait, mobility, balance, spasticity, and strength in stroke patients.
Stochastic resonance whole body vibration (SR-WBV) with random vibrations seems to be a safe alternative with low risk factors and low physical strain and therefore a promising option to treat weakness, balance, and mobility particularly in individuals with stroke or TBI.

Purpose: It remains unclear whether individuals with stroke or TBI can profit from SR-WBV. Therefore, the aim of this study was to investigate the impact of complementary SR-WBV on muscle strength, gait performance, and balance ability.

Methods: This study was designed as a single-blind prospective randomized controlled trial. The major inclusion criterion was the clinical diagnosis of an acute first-ever unilateral brain lesion by means of stroke or TBI. Forty-eight individuals were randomly allocated to a verum (VG) or a sham group (SG), which received an individual conventional neurological rehabilitation and additionally 5 series of SR-WBV lasting 60s daily. The VG trained in a standing position with 5Hz, while the SG was vibrated with 1 Hz sitting on a box. Maximum strength and rate of force development of the paretic leg (knee extension), balance (semi-tandem stance) and gait performance (10m gait test) were measured at baseline (pre), immediately after the first SR-WBV session (post 1) for short and after two weeks (post 2) for long term effects. To investigate short (pre / post 1) and long term effects (pre / post 2), the Wilcoxon signed-rank test was used. Between groups comparisons were conducted using the Mann–Whitney U test. Alpha-level was Bonferroni-corrected.

Results: No statistically significant between-group differences were found at pre, post 1 and post 2. Within-group comparisons revealed short term main effects for gait velocity, step length and stance phase on the affected and unaffected sides in both groups. Long term effects for strength parameters were found as a distinct increase in MVIC (VG) and a reduction of sway and sway velocity in the SG. Both groups improved regarding gait velocity, step length and stance phase of the affected and unaffected legs.

Conclusion(s): Individuals after stroke or TBI did not show any benefits regarding muscle strength, gait performance or balance ability from two weeks of SR-WBV treatment that was carried out in addition to conventional neurological rehabilitation. However, future studies should investigate longer intervention periods, since two weeks might not have been sufficient to cause any measurable effects.

Implications: Although complementary SR-WBV showed no effects on daily living tasks, it might be used as an additional therapeutic low-risk modality.

Funding acknowledgements: Swiss National Science Foundation (No. 13DPD6_127280)

Topic: Neurology: stroke

Ethics approval: The study protocol was approved by the local Ethics Committee of the Canton of Bern, Switzerland (Reference No. 225/08).


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