Abstract
Ebersbach G, Edler D, Kaufhold O, Wissel J. Whole body vibration versus conventional
physiotherapy to improve balance and gait in Parkinson’s disease.
Objective
To compare the effects of whole body vibration (WBV) and conventional physiotherapy
(PT) on levodopa-resistant disturbances of balance and gait in idiopathic Parkinson’s
disease (PD).
Design
Randomized controlled rater-blinded trial comparing 2 active interventions, final
follow-up assessment 4 weeks after termination of active intervention.
Setting
Specialized referral center, hospitalized care.
Participants
Patients with PD and dopa-resistant imbalance on stable dopamine replacement medication
(N=27) were randomized (intent-to-treat population) to receive WBV (n=13) or conventional
PT (controls, n=14). Twenty-one patients (per protocol population) completed follow-up
(14 men, 7 women; mean age, 73.8y; age range, 62–84y; mean disease duration, 7.2y;
mean dopa-equivalent dose, 768mg/d).
Intervention
Subjects were randomized to receive 30 sessions (two 15-min sessions a day, 5 days
a week) of either WBV on an oscillating platform or conventional balance training
including exercises on a tilt board. Twenty-one subjects (10 with WBV, 11 controls)
were available for follow-up 4 weeks after treatment termination.
Main Outcome Measures
The primary measure was Tinetti Balance Scale score. Secondary clinical ratings included
stand-walk-sit test, walking velocity, Unified Parkinson’s Disease Rating Scale (section
III motor examination) score, performance in the pull test, and dynamic posturography.
Results
The Tinetti score improved from 9.3 to 12.8 points in the WBV group and from 8.3 to
11.7 in the controls. All secondary measures, except posturography, likewise improved
at follow-up compared with baseline in both groups. Quantitative dynamic posturography
only improved in patients with WBV (1937–1467mm) whereas there was no significant
change in controls (1832–2030mm).
Conclusions
Equilibrium and gait improved in patients with PD receiving conventional WBV or conventional
PT in the setting of a comprehensive rehabilitation program. There was no conclusive
evidence for superior efficacy of WBV compared with conventional balance training.
Key Words
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Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
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Copyright
© 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
