Effect of Whole-body Vibration on Muscle Tone, Function, and Quality of Life in Children with Spastic Cerebral Palsy: A Systematic Review with Meta-analysis

Abstract

Cerebral palsy (CP) is a common nonprogressive neurological condition. One of the important signs of CP is the spasticity which can be treated by different methods. Whole-body vibration (WBV) is an example of these treatments. However, its efficacy needs to be accurately studied. This study investigates the effects of WBV on muscle tone, function, and quality of life in children with spastic CP. Systematic review and meta-analysis were performed. We searched the literature using the following electronic databases: Scopus (via Science Direct), Cumulative Index to Nursing and Allied Health Literature (CINAHL) (EBSCO), PubMed, and PEDro and included articles from the year of their inception up to September 2023. The included articles were randomized controlled trials that used WBV on patients with spastic CP in which the outcomes were spasticity, function, and quality of life. Two reviewers independently selected the included trials. The pooled mean differences (PMDs) and 95% confidence intervals (CIs) were calculated using the Rev Man software. Ten trials involving 206 CP patients were included in this meta-analysis. All trials were of fair to good methodological quality as per the PEDro scale. Five trials compared the effect of adding WBV to standard physical therapy compared to standard physical therapy alone on motor function measured by Gross Motor Function Measure (GMFM-88) with both domains D and E. The current meta-analysis showed that the standard physical therapy treatment was statistically significantly better than WBV plus standard physical therapy on both D values (z = 2.39, P = 0.02, PMD = 3.02, CI: 0.54, 5.49) and E values (z = 3.04, P = 0.002, PMD = 4.06, CI: 1.44, 6.68). Adding WBV to the standard physical therapy was not superior to standard physical therapy alone in favor of gross motor function in patients with CP. However, it remains imperative to conduct high-quality research examining the effectiveness of whole-body vibration on children diagnosed with spastic CP exhibiting motor dysfunction and evaluating its impact on their quality of life.