Effect of whole-body vibration on freezing and flexibility in Parkinson's disease-a pilot study.

BACKGROUND: Parkinson's disease is the second most common neurodegenerative disease. Symptoms are treated by medication, physio-, exercise, and occupational therapy. Alternative methods have been used in exercise therapy for a few years now. The effect of whole-body vibration as an alternative training method has been investigated for several symptoms in Parkinson's disease. Since freezing and flexibility have not yet been investigated, the aim of this study was to evaluate the efficacy of different frequencies of application for these two symptoms. METHODS: Patients were randomly assigned to a frequency (6, 12, or 18 Hz) or the control group. Before and after the treatment of 5 × 60 s with a rest of 60 s each, the Sit and Reach test (flexibility) and the 360° turn test (freezing) were performed. RESULTS: Only the Sit and Reach test showed a significant improvement at 18 Hz (improvement from - 5.75 to - 1.89 cm, F(3,30) = 5.98**). At 360° turn, no significant differences were found. Weak to high effect sizes (standardized mean differences) were determined for the different frequencies, both for the Sit and Reach (from .01 to .64) and for the 360° turn (from - .72 to - 1.25). The highest effect size is observed for 18 Hz and the lowest for 6 Hz. CONCLUSIONS: Higher frequencies seem to be more effective than lower ones. Freezing, age, and gender also seem to play a role. Therefore, this should be investigated in further studies.

Analysis of the Effects of Whole-Body Vibration in Parkinson Disease - Systematic Review and Meta-Analysis.

BACKGROUND: Because of discrepant published results, there is a need to systematically analyze the literature that has evaluated the effectiveness of harmonic whole-body vibration (WBV) and randomized WBV in patients with Parkinson disease (PD). OBJECTIVE: To evaluate the effectiveness of harmonic versus randomized WBV on motor symptoms, balance, gait, and mobility in people with PD. TYPE: Meta-analysis. LITERATURE SURVEY: Established databases PubMed, EMBASE, CINAHL, Cochrane, Trip, and PEDro; library of the Saarland University; and electronic library of journals, including publications from 1960 to November 2017, were scanned by using "Parkinson" and "vibration" as combined search terms. METHODOLOGY: First, data were extracted from the full-text version, including number of participants, severity of disease, medication status, study design, use of vibration treatment, duration of study, number of treatment sessions and trials per session, vibration frequency and amplitude, duration of trials and rest periods, and pre- and posttest data. Qualitative analysis was performed by using the PEDro score. Standardized mean differences (SMD) with 95% confidence intervals (CI) were used to verify the efficacy of harmonic versus randomized WBV on mobility, balance, gait, and motor symptoms. SYNTHESIS: From 244 publications found in online databases, 17 eligible studies fulfilled eligibility criteria and were further analyzed qualitatively. Out of those, 7 studies attained moderate to high quality (mean PEDro score 4.6 points, SD 2.9) and were then further analyzed quantitatively. A large variation, between no effects (SMD = 0.06, 95% CI = -0.78 to 0.90) and weak effects (SMD = 0.46, 95% CI = -0.51 to 1.43), was found for motor symptoms, balance, gait, and mobility. CONCLUSIONS: There is no clear evidence of a PD symptom-reducing effect (motor symptoms, balance, gait, and mobility) of WBV compared with respective control conditions. Only a few studies found significant group differences for mobility and motor symptoms. Therefore, the overall effects of vibration therapy on PD remain somewhat inconsistent. Further high-quality studies should determine the efficacy of harmonic versus randomized WBV. LEVEL OF EVIDENCE: II.