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European Journal of Physical and Rehabilitation Medicine 2020 Jan 14

DOI: 10.23736/S1973-9087.20.06099-2


lingua: Inglese

Effects of vibratory stimulation on balance and gait in Parkinson’s disease: a systematic review and meta-analysis

Silvia MARAZZI 1, Pawel KIPER 2, Katie PALMER 3, Michela AGOSTINI 2, Andrea TUROLLA 2

1 ASST Ovest Milanese, Legnano Hospital, Legnano, Milano, Italy; 2 Laboratory of Neurorehabilitation Technologies, Fondazione Ospedale San Camillo IRCCS, Venice, Italy; 3 Department of Geriatrics, Centro Medicina dell’Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy

INTRODUCTION: Among the different rehabilitative approaches to Parkinson’s disease, there is conflicting evidence about the effects of vibratory stimulation and its capability to modulate the central elaboration of proprioceptive stimuli. The hypothesis is that the vibration-induced sensorial perturbation (through Whole Body Vibration (WBV) or localized vibration) can influence the motor response in complex tasks such as postural control and gait. Thus, the objective of this review was to evaluate the effect of different modalities of vibratory stimulation treatment on balance, gait signs and symptoms, and quality of life, in patients with Parkinson’s disease.
EVIDENCE ACQUISITION: From the initial 1249 records, 10 of them which compared Whole Body Vibration (WBV) or localized vibration to conventional physiotherapy were included (i.e. randomized controlled trials, crossover trials, and quasi-experimental trials). Finally, five papers on WBV were included in quantitative synthesis (meta-analysis), while for three studies on localized vibrations a qualitative synthesis was performed. Two independent reviewers selected potentially relevant studies based on the inclusion criteria, extracted data, and evaluated the methodological quality.
EVIDENCE SYNTHESIS: Meta-analysis was performed among five studies on WBV treatment, whose effect was found to be significantly better than standard treatment for improving gait (measured by Timed Up and Go test and Stand-walk-sit test: Standardized Mean Difference= -0.51; 95% confidence interval= -1.00 to -0.01). Conversely, WBV was not significantly better than standard treatment for all the other outcomes. Due to high heterogeneity it was not possible to conduct a quantitative meta-analysis on studies of localized vibration.
CONCLUSIONS: Results of the review show that WBV can improve gait performance in patients with Parkinson’s disease.

KEY WORDS: Parkinson disease; Balance; Gait; Whole body vibration; Localized vibration

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