Purpose: The following paper presents a case of a young boy who was diagnosed with hypotonic quadriplegic cerebral palsy (CP) and it answers the following PICO question via an evidence-based analysis: Would whole body vibration be an effective intervention to improve spasticity, bone mineral density, muscle strength and functional abilities in a 4-year-old boy with hypotonic quadriplegic cerebral palsy? Background: Cerebral palsy is the most common childhood disability that affects the neuromuscular system. CP occurs in 2 of every 1,000 live born neonates. The motor changes seen in children with CP are caused by injury to the brain, which can be an outcome from numerous possible mechanisms, mainly hypoxic events. This neuromuscular dysfunction leads to muscle weakness and decreased functional ability because the children are unable to voluntarily control their muscles. This can make it difficult for these children to hit developmental milestones and participate in age appropriate play. Due to their motor impairments these children have an increased risk of fractures, bony malformations, contractures, joint subluxations, and other secondary impairments. They also have decreased endurance and bone mineral density (BMD), gastrointestinal problems, and reduced balance and postural control. The injury to the brain can also cause multiple other impairments including but not limited to sensory deficits, seizures and deficits in cognitive abilities. Whole body vibration (WBV) has been utilized in many patient populations and has demonstrated positive results in multiple outcome measures. There are three components that make up WBV including frequency (measured in Hertz), amplitude (measured in millimeters) and direction (vertical displacement or side to side alternating displacement). There is evidence that WBV could produce desirable outcomes in children with CP. Case Description: The patient was a 4-year-old boy who was diagnosed with hypotonic quadriplegic cerebral palsy with oral motor dysfunction. Using the Gross Motor Function Classification System (GMFCS) the patient was classified as a Level V (detailed explanation of classification system in appendix). Outcomes: A thorough review of the current available evidence demonstrates that WBV provides numerous desirable effects in children with CP. Although the evidence is limited research was found that demonstrated that WBV used in the CP population could have positive outcomes on BMD, spasticity, muscle thickness, muscle strength, and functional ability. Discussion: The goal of this evidence based data search was to determine the beneficial outcomes that WBV could have on the CP population. The research that is available and current on this intervention in children with CP is limited and hard to compare due to the heterogeneous nature of the WBV protocols and the multiple outcome measures employed in the evidence.
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Cerebral Palsy; Whole body vibration therapy
Bear, Jan. "Cerebral Palsy and Whole Body Vibration - An Evidence Based Analysis." (2016). http://digitalrepository.unm.edu/dpt/1
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