We love to shake things up here at NAPA. If you have ever visited NAPA, you know we love to try new things, challenge our patients, and push the limits on what is possible for each and every child. But have you seen the newest thing shaking up kids and therapists alike at our Los Angeles or Boston locations? The Galileo vibration plate! This whole body vibration (WBV) plate takes “Shake It Off” to a whole new level, and here’s what the recent research has to say about it.
One research group looking at all the current literature published about whole body vibration therapy (VT) found that one session of VT decreases coordination deficits, reflex excitability, and spasticity, positively affecting gross motor skills, gait, mobility, and strength in patients with cerebral palsy, with effects lasting up to 30 minutes after VT. Long-term benefits of vibration therapy include increased muscle mass and bone-mineral density, improved gross motor function, strength, gait, and mobility, and reduced muscle tone and spasticity. This suggests VT could reduce CP-related physical disability and sensorimotor difficulty. Thus, patients and families could improve independence and safety more easily and efficiently by incorporating vibration therapy into standard therapy practices for optimal neurorehabilitation. (PMID: 29950843)
In examining the immediate effect of a single session of whole body vibration on spasticity in children with cerebral palsy, Park et al. found that spasticity decreased immediately after a single session of WBV, and this improvement lasted for one to two hours. Children with CP received 20 Hz WBV in supported standing on a vibrating platform for 20 minutes, with a one-minute break halfway through the session. This study specifically looked at spasticity of the ankle plantarflexors, the muscles of the calf that place the foot in plantarflexion, the top of the foot pointing away from the leg and the foot or toes flexing downward toward the sole. We use plantarflexion whenever we stand on our tiptoes or point our toes. In children with CP, these plantarflexor muscles can have increased spasticity, causing gait abnormalities such as toe walking and crouched gait. This study proposed that vibration therapy triggers muscle contractions by stimulating muscle spindles and motor neurons and may decrease spasticity through the muscle spindle’s slowing effect on the stretch reflex. Spasticity is increased resistance to quick muscle stretch, or involuntary muscle stiffness that affects a person’s ability to control those muscles, and it is present in about 80% of people with CP (PMC4339555).
Park’s research suggests that WBV prior to physical or occupational therapy sessions may help prepare children with spasticity to learn motor skills by temporarily decreasing spasticity in their plantarflexor muscles.
Another study by Ali et al. compared the effects of WBV and a core stability program on balance in children with spastic cerebral palsy. Over a 12-week period, a group of 30 children completed a 30-min core stability program, while another group of 30 children completed 10 minutes of WBV training, each intervention three times per week in addition to their typical 1-hour therapy program, which they received three times per week for 12 weeks. The WBV group received 30 Hz WBV for 5 minutes in a full squat, followed by 1 minute rest, then 5 minutes standing. The core stability program involved abdominals, bridging, and twisting exercises training stabilizing muscles to allow controlled leg and arm movements. The WBV group improved in stability in all directions (forward/backward, side-to-side, and overall) more than the core stability group. Ali et al. found that WBV training improves balance in children with spastic CP, as well as reducing spasticity. Another mechanism for vibration training involves activation of the proprioceptive reflex, which elicits a warm-up effect that improves muscle power and balance in those prone to falls. The WBV group’s balance improvement may be attributed to WBV strengthening trunk and leg muscles, and subsequently functional improvement in children with spastic CP. Vibration increased the g-forces acting on muscles, which improved exercise load and enhanced neuromuscular activation. In this way, vibration training affects muscle strength and increases muscle power to improve balance. (PMID: 31488967)
Cait Parr is a pediatric physical therapist at NAPA Center. Her favorite animal is snails, because they remind her to slow down and enjoy the beautiful details about life. She loves desserts almost as much as she loves long walks with her husband on the beach at sunset.
