Abstract:
Aim. The aims of the present thesis are to (1) explore the effectiveness of vibration therapy (VT) in children and adolescents aged 2-16 years with two neuromuscular disorders (NMD), cerebral palsy (CP) and congenital myopathy (CM); (2) investigate the feasibility and acceptance of home-based VT in children aged 2-4 years with CP and children and adolescents 4-16 years old with CM; (3) determine the effect of different VT protocols varied in frequency and treatment duration in young children aged 5-12 years with mild-to-moderate CP.
Methods. Three clinical studies were conducted utilising a study design where all participants (n=54) acted as their own controls and underwent two consecutive study periods: a 12-week lead-in period prior to the intervention period of side-alternating VT, which ranged from 12 weeks (Studies 2 and 3) to 20 weeks (Study 1). VT was performed on the Galileo Basic vibration platform for 9 minutes per session, four days a week, with the frequency was set for 20 Hz (Study 2 and 3) or either 20 Hz or 25 Hz, determined by the random assignment of participants into either of the two experimental groups (Study 1). Participants had 3-4 assessment visits and completed: 6-minute walk test and 10-metre walk test to assess mobility; dual-energy x-ray absorptiometry to evaluate body composition; gross motor function testing; muscle function testing on the Leonardo mechanography plate and by hand-held dynamometry, as well as disease-specific quality-of-life questionnaires.
Findings. VT was well-tolerated, with occasional mild itchiness and skin redness reported. The median compliance level with VT treatment was 75-100%. The study found VT to be associated with positive effects on gross motor function, muscle function, and quality of life in children and adolescents with CP and CM. The analysis of the VT impact on bone health did not reveal consistent patterns, with the most pronounced effect observed in children with CP younger than 5 years of age. Further, we found a long-term, 20-week VT to be a more efficient treatment duration than a short-term, 12-week VT, and that two tested frequencies (20 Hz and 25 Hz) are equally effective in young children with CP. Conclusions. The results of this thesis demonstrate the potential of home-based VT for being incorporated into rehabilitation plans for children and adolescents with NMD. Further, findings suggest promising directions for future studies seeking to improve treatment options for patients with CM and CP.