Effect of Whole Body Vibration on stroke patients: A Systematic Review

Introduction and Purpose: Stroke is one of the major medical disorders that affect patients’ daily functional mobility. From last decade, whole-body vibration therapy (WBV) has been introduced and getting more used for patients with stroke. However, up to date, about using the WBV, the following questions are still uncertain: which stage of patients with stroke can really benefit from the WBV, what WBV intervention parameters should be provided, and what assessment instruments could be applied to evaluate the WBV effectiveness. Therefore, the purpose of this review is aimed to answer these questions by analyzing relevant articles. The purpose of this study was to identify what benefits could stroke patient receive from WBV, Methods: Two researchers performed literature search by using Ovid Medline, Scopus, Medline, Cochrane and PubMed independently. Eligible studies published from 2000 through April 2014 were selected. The keywords for search were whole body vibration, stroke, cardiovascular accident, hemiplegia, hemiparalysis, hemiparesis, functional performance, posture, balance, strength, and rehabilitation. Result: Eleven articles were qualified for the purpose of this review. WBV could be used alone, or combined with therapeutic exercise. It seemed that patients with subacute and chronic stroke could benefit more from the WBV, while the acute one does not. The intervention parameters in these studies are: once per week to five times per week, duration from 3 to 12 weeks, frequency of vibration from 5 to 45 Hz, amplitude from 0.44 to 8 mm. More than ten measurements had been described for outcome assessment in these articles. It demonstrated that the WBV could improve activity of daily living (measured by Barthel’s index), and functional mobility (measured by timed up & go - TUG 10-MWT, 6-MWT, walk speed and cadence and Tinetti Gait Test). However, it is controversial if the WBV is able to improve 1) balance in term of Berg Balance Scale (1 study said yes while other two said no), 2) muscle strength and flexibility (3 said yes, while other three said no), and 3) spasticity (one with yes and two with no in term of Modified Ashworth Scale showed improvement in lower extremity). Conclusion: Whole body vibration therapy is an effective therapy that can be used independently or combined with others. It demonstrated that patients with subcase and chronic stroke can benefit more. People with strike used the WBV varies. Its main effects are on improvement of ADL and functional mobility, but its effect on balance, strength, flexibility and spasticity is uncertain, further study may be needed. Key Words: whole-body vibration, WBV, stroke, rehabilitation