Effects of prolonged muscle stretching and whole body vibration on range of motion and walking ability in children and adolescents with cerebral palsy

Abstract

The aim of this study was to evaluate the effects of a prolonged muscle stretching (PMS) compared with the PMS and whole body vibration (WBV) on range of motion (ROM) and walking ability in children and adolescents with cerebral palsy (CP). A randomized crossover trial was assigned. Twelve children and adolescents with spastic CP aged 10.58±2.35 (range 6 to 18) years were randomly allocated into either control (CG; n=6) or experimental (EG; n=6) group. In the CG, participants were performed to stand on a tilt table for 40 minutes/session/day. Individuals in the EG was conducted the same one for 30 minutes, WBV was subsequently applied for 10 minutes. Durations of immediate and short-term effects were once a day and 5 days/wk for 6 wks, and after a 1-day and 2-week washout, all participants were crossed over to the opposite arm, respectively. ROM and one minute walk test (1MWT) were measured before and after the treatment changes. For immediate effect, degree of ROM significantly increased in the hip flexion (P = 0.012) and ankle dorsiflexion (P = 0.032) of the higher spastic leg and hip flexion (P = 0.019) of the lower spastic leg in the EG, but no change in the CG.  There was no significant difference in between groups. After a 6-week, degree of ROM significantly increased in the ankle dorsiflexion (P = 0.002) of the higher spastic leg and knee flexion (P = 0.021) of the lower spastic leg in the CG. ROM increased in the knee flexion (P = 0.002) and ankle dorsiflexion (P = 0.002) of the higher spastic leg and ankle dorsiflexion (P = 0.006) of the lower spastic leg in the EG.  Distance of the 1MWT significantly increased in the EG (P = 0.02). When comparing between groups, ROM significantly better increased as 4.31% of knee flexion (P = 0.001) and 23.61% of ankle dorsiflexion (P = 0.056) of the higher spastic leg in the EG. One-MWT did not change significantly. Conclusion, the results suggest that a 6-week intervention of combining PMS with WBV can improve ROM of knee and ankle joint and walking ability in children and adolescents with spastic CP. This intervention is appropriate due to simple, less time and non-dependent on physical therapist.  Further study should evaluate long-term effect in other outcomes.