Treatment increases bone strength in adolescents with cerebral palsy

A treatment known as whole body vibration therapy significantly increases bone strength among adolescents with cerebral palsy. Postgraduate research fellow Dr Silmara Gusso presented promising preliminary results from a new clinical trial being conducted at the Liggins Institute, at The Endocrine Society’s 95th Annual Meeting in San Francisco in June. The research has been widely reported internationally.

Caused by brain damage around the time of birth, cerebral palsy affects muscle tone and movement, severely decreasing quality of life by making walking and other daily activities difficult. As movement becomes impaired, disuse weakens both the muscles and bones.

Few therapies have proved successful in increasing bone and muscle strength among people with cerebral palsy. However, one promising approach is whole body vibration therapy, or WBVT. In this method subjects stand on a machine that moves the body causing the same tilting movement of the pelvis that occurs in walking, but much more frequently. Previous research among healthy adults, including post-menopausal women, has demonstrated that WBVT can promote bone and muscle health.

To see if these beneficial effects also occur in adolescents with cerebral palsy, researchers measured bone-mineral density and muscle mass before and after a course of WBVT. They found that leg and spine bone-mineral density increased after the therapy, although total bone-mineral density did not change. Muscle mass in the legs also increased.

WBVT increased the distance that study participants could walk for six minutes by around 10%; representing an average increase from 286 to 314 metres.

“By maintaining or improving muscle and bone health during growth, WBVT can maximize mobility and bone strength into adult life, improving both mobility and quality of life,” said Dr Gusso. “These extremely encouraging initial data strongly suggest WBVT could become a mainstay of treatment in children with loco-motor disability and justify the introduction of a completely novel and innovative treatment modality into paediatric health care.”

To assess the effects of WBVT, researchers recruited 13 adolescents (average age 17 years) with moderate cerebral palsy to receive the therapy for nine minutes per day for 20 weeks. Study participants included eight girls and five boys. Bone-mineral density and muscle mass before and after the therapy were measured using special X-ray tests.

The study is on-going and awaits full assessment of the promising initial results. Funding has been provided by the Jubilee Crippled Children’s Foundation Trust, the David Levene Foundation, the Australasian Paediatric Endocrine Group and the Maurice and Phyllis Paykel Trust.