New Zealand Rehabilitation Association, Inc.

Ahlborg, L, Andersson, C, and Julin, P. Whole-body vibration training compared with resistance training: effect on spasticity, muscle strength and motor performance in adults with cerebral palsy. Journal of Rehabilitation Medicine. 2006; 38: 302-308.

This small study investigated the therapeutic benefits of whole-body vibration training (WBV) versus progressive resistance training in adults with cerebral palsy.  Fourteen people with spastic diplegia were recruited to the study and randomized to receive either WBV or resistance training.  WBV involved standing or moving while on a vibrating platform.  It is theorised that sustaining static or dynamic postures on a vibrating platform stimulates a tonic vibration reflex, encouraging synchronization of muscle contractions.  Progressive resistance training involved a gym base weights programme, focusing on strengthening of lower limb musculature.  Both groups participated in an 8-week training programme.  Outcomes measured pre- and post-intervention included the modified Ashworth scale (a measure of spasticity), isokinetic muscle strength in the lower limbs, the Six-Minute Walk Test (a measure of cardiovascular function and mobility), the Timed Up and Go test (a measure of balance and speed of movement), and the Gross Motor Function Measure.  Outcome measures were collected by a physiotherapist not involved in the interventions, but there is no indication that any person was blinded to study group allocation.

The results of this study suggested that both WBV and progressive resistance training can increase muscle strength in adults with cerebral palsy without negatively influencing spasticity.  In fact, the WBV group demonstrated a statically significant improvement in spasticity in their stronger leg following the 8-week period of treatment.  There was little carry over from the improvements in muscle strength to mobility function however, with no changes noted on the Six-Minute Walk Test or the Time Up and Go test.  This however is a little unsurprising as both interventions tested in this study focus on body functions (muscle strength) rather than activities (walking, sit-to-standing).  While, these results should be taken with a large grain of salt – the sample sizes were small, there were one or two problems with some participants completing the prescribed treatment regimes in both groups, and with the lack of blinding of assessor or participants to group allocation – it is still nice to see further empirical data supporting the use of muscle strengthening activities in groups of people with spasticity.  It’s not that long ago therapists were anxious about any suggestion of attempting strength training with people who had high tone!