Whole-body vibration (WBV) is a therapy intended to improve muscle strength and overall fitness.
In spinal muscular atrophy (SMA), WBV is investigated as a method to improve motor function and mobility.
WBV can also be used in Duchenne muscular dystrophy (DMD) and is well-tolerated. DMD is a genetic condition that leads to progressive deterioration of muscle fibers.
How WBV therapy works
During WBV, the person sits or lies on a machine with a vibrating platform. The device sends energy to the body, which forces the muscle to contract and relax dozens of times per second.
Even though it does not involve active exercise, it can be exhausting and feel like having been to the gym.
Advocates claim that 15 minutes three times a week is sufficient to build strength and improve flexibility and fitness. It may also help reduce back pain and bone loss.
However, comprehensive research to support these claims has not been performed. It is not clear whether the therapy has comparable or additional benefits to regular physical activity; it is usually recommended that WBV be combined with exercise. This can be strength training or cardiovascular exercise.
WBV therapy studies
There are no randomized clinical trials that have assessed WBV therapy in patients with SMA. Two small studies suggested, however, that WBV in combination with physiotherapy might benefit some patients.
The first study included 38 children with SMA type 2 or type 3. They took part in a six-month physiotherapy program that included WBV and intensive inpatient training, lasting 13 days at the start of the study and six days after three months.
The inpatient training included four to five hours of physiotherapy daily. Resistance training, pool therapy, and treadmill training were added two to three times per week. WBV was applied three times per day.
The home-based training between the inpatient stays consisted of three minutes of WBV 10 times per week.
Motor abilities were evaluated at the beginning of the program, at the end of the program (after six months), and six months after the end of the study. The program took place from 2007 to 2017. In participants who took part before 2011, motor function was assessed using the gross motor function measure (GMFM). After 2011, they were determined with the Hammersmith functional motor scale for SMA (HFMSE).
Both measures objectively assess motor abilities. The HFMSE is specifically designed for children with SMA types 2 and 3. The GMFM was intended for children with cerebral palsy, but has been applied to other diseases.
In 72.7 percent of the children assessed with the HFMSE, motor function after 12 months improved more than expected based on natural improvement over time. The children who were evaluated with the GMFM showed similar improvement.
The design of the second study was similar to that of the first. Seven patients with SMA, five with SMA type 2 and two with SMA type 3 participated in a six-month program. The program started with two weeks of inpatient training that consisted of four hours of intensive physiotherapy each day, including three minutes of WBV three times. After the two weeks, patients continued the WBV at home for six months, with another week of intensive inpatient training in between.
Motor abilities were assessed at the beginning of the program and after six months with the GMFM and by measuring the maximum force that can be produced when pushing off a plate with the feet from a semi-lying position (45 degrees).
Three children showed an improvement in the GMFM and four in muscle force. In three children, the GMFM did not change, and in one child the muscle force stayed the same. One child missed the muscle force measurement. One child had a decline in GMFM and muscle force, which was likely because of severe pneumonia he had during the training period.
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