Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study
Restricted accessResearch articleFirst published online July, 2016
Comparing the effects of whole-body vibration to standard exercise in ambulatory people with Multiple Sclerosis: a randomised controlled feasibility study
This study aimed firstly to investigate the feasibility of the study protocol and outcome measures, secondly to obtain data in order to inform the power calculations for a larger randomised controlled trial, and finally to investigate if whole-body vibration (WBV) is more effective than the same duration and intensity of standard exercises (EXE) in people with Multiple Sclerosis (PwMS).
Design:
Randomised controlled feasibility study.
Setting:
Outpatient MS centre.
Subjects:
Twenty seven PwMS (age mean (SD) 48.1 (11.2)) with minimal gait impairments.
Interventions:
Twelve weeks of WBV or standard EXE, three times weekly.
Main measures:
Participants were measured with isokinetic muscle strength, vibration threshold, Timed Up and Go test (TUG), Mini-BESTest (MBT), 6 Minute Walk test (6MWT), Multiple Sclerosis Impact Scale 29 (MSIS 29), Modified Fatigue Impact Scale (MFIS) and Verbal Analogue scale for sensation (VAS) pre and post 12 week intervention.
Results:
WBV intervention was found feasible with low drop-out rate (11.1%) and high compliance (90%). Data suggest that a sample of 52 in each group would be sufficient to detect a moderate effect size, with 80% power and 5% significance for 6 minute walk test. Large effect sizes in favour of standard exercise were found for vibration threshold at 5th metatarsophalangeal joint and heel (P=0.014, r= 0.5 and P=0.005, r=0.56 respectively). No between group differences were found for muscle strength, balance or gait (P>0.05).
Conclusions:
Data suggest that the protocol is feasible, there were no adverse effects. A trial including 120 people would be needed to detect an effect on walking endurance.
CameronMFinlaysonMKesselringJ. Multiple Sclerosis Basics. Multiple Sclerosis Rehabilitation. Boca Raton, FL: CRC Press and Taylor & Francis Group; 2012, pp. 9–34.
CompstonAColesA. Multiple sclerosis. The Lancet. 2008; 372: 1502–1517.
4.
MerchutMPGruenerG. Quantitative sensory threshold testing in patients with multiple sclerosis. Electromyogr Clin Neurophysiol. 1993; 33: 119–124.
5.
HeijenbrokMWAnemaJRFaesTJBertelsmannFWHeimansJJPolmanCH. Quantitative measurement of vibratory sense and temperature sense in patients with multiple sclerosis. Electromyogr Clin Neurophysiol. 1992; 32: 385–388.
WangTYLinSI. Sensitivity of plantar cutaneous sensation and postural stability. Clin Biomech. 2008; 23: 493–499.
8.
PerrySDMcIlroyWEMakiBE. The role of plantar cutaneous mechanoreceptors in the control of compensatory stepping reactions evoked by unpredictable, multi-directional perturbation. Brain Res. 2000; 877: 401–406.
9.
RollRKavounoudiasARollJP. Cutaneous afferents from human plantar sole contribute to body posture awareness. Neuroreport. 2002; 13: 1957–1961.
10.
KelleherKJSpenceWDSolomonidisSEApatsidisDP. The effect of impaired plantar sensation on gait in people with multiple sclerosis. International Journal of MS Care. 2009; 11: 25–31.
11.
BloemBRAllumJHCarpenterMGHoneggerF. Is lower leg proprioception essential for triggering human automatic postural responses?Exp Brain Res. 2000; 130: 375–391.
12.
CormiePDeaneRSTriplettNTMcBrideJM. Acute effects of whole-body vibration on muscle activity, strength, and power. Journal of strength and conditioning research/National Strength & Conditioning Association. 2006; 20: 257–261.
13.
TorvinenSKannusPSievanenH. Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: A randomized controlled study. Journal of Bone and Mineral Research. 2003; 18: 876–884.
14.
RoelantsMDelecluseCGorisMVerschuerenS. Effects of 24 weeks of whole body vibration training on body composition and muscle strength in untrained females. International Journal of Sports Medicine. 2004; 25: 1–5.
15.
CochraneDJStannardSR. Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players. British Journal of Sports Medicine. 2005; 39: 860–865.
16.
BruyereOWuidartM-ADi PalmaE. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Archives of physical medicine and rehabilitation. 2005; 86: 303–307.
17.
BautmansIVan HeesELemperJ-CMetsT. The feasibility of Whole Body Vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial [ISRCTN62535013]. BMC geriatrics. 2005Dec22; 5: 17.
18.
TorvinenSKannuPSievänenH. Effect of a vibration exposure on muscular performance and body balance. Randomized cross-over study. Clinical Physiology And Functional Imaging. 2002; 22: 145–152.
19.
TankishevaEBogaertsABoonenSFeysHVerschuerenS. Effects of intensive whole-body vibration training on muscle strength and balance in adults with chronic stroke: a randomized controlled pilot study. Arch Phys Med Rehabil. 2014; 95: 439–446.
20.
ClaerboutMGebaraBIlsbroukxS. Effects of 3 weeks’ whole body vibration training on muscle strength and functional mobility in hospitalized persons with multiple sclerosis. Multiple Sclerosis. 2012; 18: 498–505.
21.
AhlborgLAnderssonCJulinP. Whole-body vibration training compared with resistance training: effect on spasticity, muscle strength and motor performance in adults with cerebral palsy. Journal of Rehabilitation. 2006; 38: 302–308.
22.
HaasCTTurbanskiSKesslerKSchmidtbleicherD. The effects of random whole-body-vibration on motor symptoms in Parkinson’s disease. NeuroRehabilitation. 2006; 21: 29–36.
23.
SchuhfriedOMittermaierCJovanovicTPieberKPaternostro-SlugaT. Effects of whole-body vibration in patients with multiple sclerosis: a pilot study. Clinical Rehabilitation2005; 19: 834–842.
24.
CochraneDJ. The potential neural mechanisms of acute indirect vibration. Journal of Sports Science and Medicine. 2011; 10: 19–30.
25.
EklundGHagbarthKE. Normal variability of tonic vibration reflexes in man. Experimental Neurology. 1966; 16: 80–92.
26.
CardinaleMBoscoC. The use of vibration as an exercise intervention. Exercise and Sport Sciences Reviews. 2003; 31: 3–7.
27.
SchleeGReckmannDMilaniTL. Whole body vibration training reduces plantar foot sensitivity but improves balance control of healthy subjects. Neuroscience Letters. 2012; 506: 70–73.
28.
EftekhariEMostahfezianMEtemadifarMZafariA. Resistance training and vibration improve muscle strength and functional capacity in female patients with multiple sclerosis. Asian J Sports Med. 2012; 3: 279–284.
29.
HilgersCMundermannARiehleHDettmersC. Effects of whole-body vibration training on physical function in patients with multiple sclerosis. NeuroRehabilitation. 2013; 32: 655–663.
30.
BroekmansTRoelantsMAldersGFeysPThijsHEijndeBO. Exploring the effects of a 20-week whole-body vibration training programme on leg muscle performance and function in persons with multiple sclerosis. Journal Of Rehabilitation Medicine: Official Journal Of The UEMS European Board Of Physical And Rehabilitation Medicine. 2010; 42: 866–872.
31.
DiegoIMAHernandezCPRuedaFMde la CuerdaRC. Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients. A randomised clinical trial. Neurologia. 2012; 27: 143–153.
32.
SchynsFPaulLFinlayKFergusonCNobleE. Vibration therapy in multiple sclerosis: a pilot study exploring its effects on tone, muscle force, sensation and functional performance. Clinical Rehabilitation. 2009; 23: 771–781.
33.
JacksonKJMerrimanHLVanderburghPMBrahlerCJ. Acute effects of whole-body vibration on lower extremity muscle performance in persons with multiple sclerosis. Journal of neurologic physical therapy: JNPT. 2008; 32: 171–176.
34.
UszynskiMPurtillHDonnellyACooteS. The feasibility of comparing whole body vibration intervention to the same duration and dose of exercise for people with Multiple Sclerosis. Physiotherapy Practice and Research. 2014; 35: 75–86.
35.
SharrackBHughesRA. The Guy’s Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis. Multiple Sclerosis. 1999; 5: 223–233.
36.
BorgGA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982; 14: 377–381.
37.
SurakkaJRombergARuutiainenJVirtanenAAunolaSMaentakaK. Assessment of muscle strength and motor fatigue with a knee dynamometer in subjects with multiple sclerosis: a new fatigue index. Clin Rehabil. 2004; 18: 652–659.
38.
O’NeillJMcCannSMLaganKM. Tuning fork (128 Hz) versus neurothesiometer: a comparison of methods of assessing vibration sensation in patients with diabetes mellitus. International journal of clinical practice. 2006; 60: 174–178.
39.
BrilVPerkinsBA. Comparison of vibration perception thresholds obtained with the Neurothesiometer and the CASE IV and relationship to nerve conduction studies. Diabetic Medicine. 2002; 19: 661–666.
40.
UszynskiMSaundersJDonnellyACooteS. Test-retest reliability of four sensory assessment scales for people with multiple sclerosis. Multiple Sclerosis Journal. 2013; 19: 62.
41.
BoonstraAMSchiphorst PreuperHRRenemanMFPosthumusJBStewartRE. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain. International Journal of Rehabilitation Research. 2008; 31: 165–169.
42.
CattaneoDRegolaAMeottiM. Validity of six balance disorders scales in persons with multiple sclerosis. Disability and rehabilitation. 2006; 28: 789.
43.
GoldmanMDMarrieRACohenJA. Evaluation of the six-minute walk in multiple sclerosis subjects and healthy controls. Multiple sclerosis. 2008; 14: 383–390.
44.
PaltamaaJWestHSarasojaTWikströmJMälkiäE. Reliability of physical functioning measures in ambulatory subjects with MS. Physiotherapy Research International. 2005; 10: 93–109.
45.
FranchignoniFHorakFGodiMNardoneAGiordanoA. Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010; 42: 323–331.
46.
LeddyALCrownerBEEarhartGM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther. 2011; 91: 102–113.
47.
TsangCSLiaoLRChungRCPangMY. Psychometric properties of the Mini-Balance Evaluation Systems Test (Mini-BESTest) in community-dwelling individuals with chronic stroke. Phys Ther. 2013; 93: 1102–1115.
48.
HobartJLampingDFitzpatrickRRiaziAThompsonA. The Multiple Sclerosis Impact Scale (MSIS-29): a new patient-based outcome measure. Brain: a journal of neurology. 2001; 124: 962–973.
49.
McGuiganCHutchinsonM. The multiple sclerosis impact scale (MSIS-29) is a reliable and sensitive measure. Journal of neurology, neurosurgery, and psychiatry. 2004; 75: 266–269.
50.
FiskJDRitvoPGRossLHaaseDAMarrieTJSchlechWF. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 1994; 18(Suppl 1): S79–S83.
51.
KosDKerckhofsECarreaIVerzaRRamosMJansaJ. Evaluation of the Modified Fatigue Impact Scale in four different European countries. Mult Scler. 2005; 11: 76–80.
CohenJ. Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.
54.
PallantJ. SPSS Survival Manual: A step by step guide to data analysis using SPSS: Allen & Unwin Australia, 2010.
55.
HeesenCBöhmJReichCKasperJGoebelMGoldSM. Patient perception of bodily functions in multiple sclerosis: gait and visual function are the most valuable. Multiple Sclerosis. 2008; 14: 988–991.
56.
Shumway-CookAWoollacottMH. Motor Control. Translating Research into Clinical Practice. Philadelphia: Lippincott Williams & Wilkins, 2007.
57.
KingLAPriestKCSalarianAPierceDHorakFB. Comparing the Mini-BESTest with the Berg Balance Scale to Evaluate Balance Disorders in Parkinson’s Disease. Parkinson’s Disease. 2012; 2012: 7.
58.
BaertIFreemanJSmedalT. Responsiveness and Clinically Meaningful Improvement, According to Disability Level, of Five Walking Measures After Rehabilitation in Multiple Sclerosis: A European Multicenter Study. Neurorehabilitation and Neural Repair. 2014; 28: 621–631.
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