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Whole body vibration versus conventional physiotherapy to improve balance and gait in Parkinson's disease
Ebersbach G, Edler D, Kaufhold O, Wissel J
Archives of Physical Medicine and Rehabilitation 2008 Mar;89(3):399-403
clinical trial
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

Whole body vibration versus conventional physiotherapy to improve balance and gait in Parkinson's disease. OBJECTIVE: To compare the effects of whole body vibration (WBV) and conventional physiotherapy (PT) on levodopa-resistant disturbances of balance and gait in idiopathic Parkinson's disease (PD). DESIGN: Randomized controlled rater-blinded trial comparing 2 active interventions, final follow-up assessment 4 weeks after termination of active intervention. SETTING: Specialized referral center, hospitalized care. PARTICIPANTS: Patients with PD and dopa-resistant imbalance on stable dopamine replacement medication (N = 27) were randomized (intent-to-treat population) to receive WBV (n = 13) or conventional PT (controls, n = 14). Twenty-one patients (per protocol population) completed follow-up (14 men, 7 women; mean age 73.8y; age range 62 to 84y; mean disease duration 7.2y; mean dopa-equivalent dose 768mg/d). INTERVENTION: Subjects were randomized to receive 30 sessions (two 15-min sessions a day, 5 days a week) of either WBV on an oscillating platform or conventional balance training including exercises on a tilt board. Twenty-one subjects (10 with WBV, 11 controls) were available for follow-up 4 weeks after treatment termination. MAIN OUTCOME MEASURES: The primary measure was Tinetti Balance Scale score. Secondary clinical ratings included stand-walk-sit test, walking velocity, Unified Parkinson's Disease Rating Scale (section III motor examination) score, performance in the pull test, and dynamic posturography. RESULTS: The Tinetti score improved from 9.3 to 12.8 points in the WBV group and from 8.3 to 11.7 in the controls. All secondary measures, except posturography, likewise improved at follow-up compared with baseline in both groups. Quantitative dynamic posturography only improved in patients with WBV (1,937 to 1,467mm) whereas there was no significant change in controls (1,832 to 2,030mm). CONCLUSIONS: Equilibrium and gait improved in patients with PD receiving conventional WBV or conventional PT in the setting of a comprehensive rehabilitation program. There was no conclusive evidence for superior efficacy of WBV compared with conventional balance training.

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