J Museuloskelct Neuronal Interact 2007; 7(ł):77-81
3ri Black Forest Forum
for Musculoskełctal Intcractions,
Mav 4-7, 2006

Hyionome

Preliminary results on the mobility after whole body yibration in immobilized children and adolescents
O. Semler, O. Fricke, K. Yezyroglou, C. Stark, E. Schoenau
Children's Hospital, University ot' Cologne, Cologne, Germany
Abstract
The present article is a preliminary report on the effect of Whole Body Yibration (WBV) on the mobility in long-term immobilized children and adolescents. WBV was applied to 6 children and adolescents (diagnoses: osteogenesis imperfecta, N=4; cerebral palsy, N=l; dysraphic defect of the lumbar spine, N=l) cwer a time period of 6 months. WBV was applied by a vibrat-ing platform constructed on a tilt-table. The treatment effect was measured by alternations of the tilt-angle of the table and with the "Brief assessment of motor function" (BAMF). Ali 6 individuals were characterized by an improved mobility, which was doc-umented by an increased tilt-angle or an improved BAMF-score. The authors concluded WBY might be a promising approach to improYe mobihty in severely motor-impaired children and adolescents. Therefore, the Cologne Standing-and-WaUdng-Traincr powered by Galileo is a suitable therapeutic dcvtce to apply WBV in immobilized children and adolescents.
Keywords: Osteogenesis Imperfecta, Muscle-Bone-Unit, Whole Body Yibration, Cerebral Palsy, Physiotherapy

Introduction
Whole Body Yibration (WBY) has been recently intro-duced to improve impaired biomechanical function of the musculoskeletal system in adults'. The therapeutic principle is based on the activation of proprioreceptive spinał circuits. These reflexes can be induced by upright standing on a Yibrating platform (Figurę 1). Because reflexes arę related to the timc-differcntial activation of spindles in muscles and tendons, the induction of the reflective muscular answer depends on forces (acceleration of gravity x body mass) over time applied to the muscular system by Yibration. The fre-quency of Yibration characterizes the type of activated spinał reflective answer. Therefore, lower frequencies decrease the muscular tonus in contrast to higher frequencies increasing the muscular tonus2. The application of yibrations increased
Drs. Semler and Schoenau receive iinancial support and training devices from Novotec Mcdical. Al! other authors havc no conflict of intcrest.
Correspnndmg author: Prof. Dr. mai. Eckhard Schoenau, Children 's Hospilal, Unwersit) ('/'Cologne, Kerpenerstr. 62, 5093] Caliznę. Gannany K-mail: nkliard.schnennulinuk-koeln.iii;
Accupted l(> August 200o

bonę formation and the metabolism in skeletal muscles and skin34. Interestingly, WBY is characterized to prcvcnt the loss of bonę and muscle mass in immobilized adults. Moreover, postmenopausal women might profit from WBY regarding their muscular function. In detail, WBY improves intcr- and intramuscular co-ordination over induction of high-frequent muscular contractions of agonists and antago-nists in the neuromuscular system. This effect mainly improves power in motor-impaired individuals. Ward et al applied high-frequent Yibration therapy with Iow amplitudę to improve trabecular bonę density in children affected with neuromuscular diseases\ Negative side effects were not reported after 6 months of intensive therapy. This positive experience with Yibration therapy raised the hope that vibra-tion-therapy with individually configured applied impulses on the neuromuscular system may improve the physical abil-ity in motor-impaired children. The present srudy characterizes the preliminary therapeutic effects of the Cologne Standing-and-Walking-Trainer powered by Galileo (Figurę 2) on the mobility of children and adolescents affected with dis-eases characterized by a disease-related sarcopenia due to physical immobilization. Patients of the present report were affected with osteogenesis imperfecta (Ol), infantile cerebral palsy and Meningomyelocele (MMC).

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