Liggins Institute, University of Auckland, Auckland, New Zealand.
Environmental - Occupational Health Sciences and Non-Communicable Diseases Research Group, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
BMC Pediatr. 2023 Jan 2;23(1):4. doi: 10.1186/s12887-022-03786-1.
Vibration therapy (VT) has been increasingly studied in children with cerebral palsy (CP) over the last years, however, optimal therapeutic VT protocols are yet to be determined. The present study compared the effects of side-alternating VT protocols varying in frequency and treatment duration on the health of young children with mild-to-moderate CP.
Thirty-four participants aged 6.0 to 12.6 years with CP acted as their own controls and underwent two consecutive study periods: a 12-week lead-in (control) period prior to the intervention period of 20-week side-alternating VT (9 min/session, 4 days/week), with the frequency either 20 Hz or 25 Hz, determined by randomisation. Participants had 4 assessment visits: baseline, after the control period, after 12-week VT (12VT), and after further 8 weeks of VT (20VT). Assessments included 6-minute walk test (6MWT); dual-energy x-ray absorptiometry; gross motor function; muscle function testing on the Leonardo mechanography plate and by hand-held dynamometry, and a quality-of-life questionnaire (CP QOL). Analysis was carried out using linear mixed models based on repeated measures.
Side-alternating VT was well-tolerated, with occasional mild itchiness reported. The median compliance level was 99%. VT led to improvements in 6MWT (+ 23 m; p = 0.007 after 20VT), gross motor function in standing skills (+ 0.8 points; p = 0.008 after 12VT; and + 1.3 points; p = 0.001 after 20VT) and in walking, running and jumping skills (+ 2.5 points; p < 0.0001 after 12VT; and + 3.7 points; p < 0.0001 after 20VT), spine bone mineral density z-score (+ 0.14; p = 0.015 after 20VT), velocity rise maximum of the chair rising test (+ 0.14 m/s; p = 0.021 after 20VT), force maximum of the single two-leg jump test (+ 0.30 N/kg; p = 0.0005 after 12VT; and + 0.46 N/kg; p = 0.022 after 20VT) and in the health module of CP QOL (+ 7 points; p = 0.0095 after 20VT). There were no observed differences between the two VT frequencies (i.e., 20 Hz vs 25 Hz) on study outcomes.
The study confirms that side-alternating VT has positive effects on mobility, gross motor function, body composition, muscle function, and quality of life, independent of VT frequencies tested. Long-term, 20VT appears to be a more efficient treatment duration than a short-term, 12VT.
Australian New Zealand Clinical Trials Registry ACTRN12618002026202 ; 18/12/2018.
近年来，振动疗法（VT）在脑瘫（CP）儿童中的研究越来越多，然而，最佳的治疗性 VT 方案仍有待确定。本研究比较了不同频率和治疗持续时间的交替侧 VT 方案对轻度至中度 CP 幼儿健康的影响。
34 名年龄在 6.0 至 12.6 岁的 CP 参与者作为自身对照，并进行了两个连续的研究期：12 周的导入期（对照组），然后是 20 周的交替侧 VT 干预期（9 分钟/次，每周 4 天），频率为 20 Hz 或 25 Hz，由随机决定。参与者有 4 次评估访问：基线、对照组结束后、12 周 VT 后（12VT）和进一步 8 周 VT 后（20VT）。评估包括 6 分钟步行测试（6MWT）；双能 X 射线吸收法；粗大运动功能；在 Leonardo 肌动描记板和手持测力计上进行肌肉功能测试，以及生活质量问卷（CP QOL）。分析采用基于重复测量的线性混合模型进行。
交替侧 VT 耐受性良好，偶尔有轻微瘙痒报告。中位依从性水平为 99%。VT 导致 6MWT 改善（增加 23 米；20VT 后 p=0.007）、站立技能的粗大运动功能改善（增加 0.8 分；12VT 后 p=0.008；20VT 后 p=0.001）和行走、跑步和跳跃技能改善（增加 2.5 分；12VT 后 p<0.0001；20VT 后 p<0.0001）、脊柱骨矿物质密度 z 评分增加（20VT 后 p=0.015）、椅子起身测试最大速度上升（增加 0.14 米/秒；20VT 后 p=0.021）、单腿跳测试最大力量增加（增加 0.30 N/kg；12VT 后 p=0.0005；20VT 后 p=0.022）和 CP QOL 健康模块增加（增加 7 分；20VT 后 p=0.0095）。两种 VT 频率（即 20 Hz 与 25 Hz）对研究结果无明显差异。
该研究证实，交替侧 VT 对移动性、粗大运动功能、身体成分、肌肉功能和生活质量有积极影响，而与测试的 VT 频率无关。长期 20VT 似乎比短期 12VT 更有效。
澳大利亚和新西兰临床试验注册中心 ACTRN12618002026202；2018 年 12 月 18 日。
