Whole body vibration (WBV) applications have been used in recent years to increase muscle strength, power, and postural control in healthy and various disease populations. This study aims to investigate the effects of WBV on postural control in patients with ataxia. Twenty-four patients were randomly allocated to two groups. In the first group, whole body vibration and exercise therapy (WBV + E) were applied together for the first 8 weeks; after 1 week washout, only exercise program (OE) was applied for the second 8 weeks. In the second group, the OE program was applied first followed by the WBV + E program. Outcome measures were Sensory Organization Test (SOT), Adaptation Test (ADT), Limits of Stability Test (LOS), International Classification Ataxia Ratio Scale (ICARS), Berg Balance Scale (BBS), and Timed Up and Go Test with cognitive task (TUG-C). Twenty patients (mean age ± SD, 34.00 ± 9.16 years) completed the study. The scores of SOT, ICARS, and BBS improved significantly after both OE and WBV + E program (p < 0.05). Improvements in the WBV + E program were higher (p < 0.05). The scores of ADT, TUG-C, and three parameters of LOS improved significantly after WBV + E (p < 0.05), while there was no significant change after OE (p > 0.05). This study demonstrated that exercise programs supported by WBV can play an important role in the improvement of all components of postural control in patients with ataxia. ClinicalTrial.gov Identifier: NCT02977377
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Manto M, Marmolino D. Cerebellar ataxias. Curr Opin Neurol. 2009;22(4):419–29. https://doi.org/10.1097/wco.0b013e32832b9897.
Morton SM, Bastian AJ. Cerebellar control of balance and locomotion. Neuroscientist. 2004;10(3):247–59. https://doi.org/10.1177/1073858404263517.
Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(suppl_2):ii7–ii11. https://doi.org/10.1093/ageing/afl077.
Liu XH, Li Y, Xu HL, Sikandar A, Lin WH, Li GH, et al. Quantitative assessment of postural instability in spinocerebellar ataxia type 3 patients. Ann Clin Transl Neurol. 2020;7(8):1360–70. https://doi.org/10.1002/acn3.51124.
Cameron MH, Lord S. Postural control in multiple sclerosis: implications for fall prevention. Curr Neurol Neurosci Rep. 2010;10(5):407–12. https://doi.org/10.1007/s11910-010-0128-0.
Milne SC, Corben LA, Georgiou-Karistianis N, Delatycki MB, Yiu EM. Rehabilitation for individuals with genetic degenerative ataxia: a systematic review. Neurorehabil Neural Repair. 2017;31(7):609–22. https://doi.org/10.1177/1545968317712469.
Tseng Y-T, Khosravani S, Mahnan A, Konczak J. Exercise as medicine for the treatment of brain dysfunction: evidence for cortical stroke, cerebellar ataxia, and Parkinson’s disease. Kinesiol Rev. 2017;6(1):30–41. https://doi.org/10.1123/kr.2016-0036.
Martin CL, Tan D, Bragge P, Bialocerkowski A. Effectiveness of physiotherapy for adults with cerebellar dysfunction: a systematic review. Clin Rehabil. 2009;23(1):15–26. https://doi.org/10.1177/0269215508097853.
Wunderer K, Schabrun SM, Chipchase LS. The effect of whole body vibration in common neurological conditions–a systematic review. Phys Ther Rev. 2008;13(6):434–42. https://doi.org/10.1179/174328808X373970.
Schuhfried O, Mittermaier C, Jovanovic T, Pieber K, Paternostro-Sluga T. Effects of whole-body vibration in patients with multiple sclerosis: a pilot study. Clin Rehabil. 2005;19(8):834–42. https://doi.org/10.1191/0269215505cr919oa.
Sharififar S, Coronado RA, Romero S, Azari H, Thigpen M. The effects of whole body vibration on mobility and balance in Parkinson disease: a systematic review. Iran J Med Sci. 2014;39(4):318–26.
Ahlborg L, Andersson C, Julin P. Whole-body vibration training compared with resistance training: effect on spasticity, muscle strength and motor performance in adults with cerebral palsy. J Rehabil Med. 2006;38(5):302–8. https://doi.org/10.1080/16501970600680262.
Tankisheva E, Bogaerts A, Boonen S, Feys H, Verschueren S. Effects of intensive whole-body vibration training on muscle strength and balance in adults with chronic stroke: a randomized controlled pilot study. Arch Phys Med Rehabil. 2014;95(3):439–46. https://doi.org/10.1016/j.apmr.2013.09.009.
Alashram AR, Padua E, Annino G. Effects of whole-body vibration on motor impairments in patients with neurological disorders: a systematic review. Am J Phys Med Rehabil. 2019;98(12):1084–98. https://doi.org/10.1097/phm.0000000000001252.
Molloy DW, Standish TI. A guide to the standardized mini-mental state examination. Int Psychogeriatr. 1997;9(S1):87–94. https://doi.org/10.1017/S1041610297004754.
Güngen C, Ertan T, Eker E, Yaşar R, Engin F. Reliability and validity of the standardized mini mental state examination in the diagnosis of mild dementia in Turkish population. Turk Psikiyatr Derg. 2002;13(4):273–81.
Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33(11):1444–52. https://doi.org/10.1212/WNL.33.11.1444.
Visser JE, Carpenter MG, van der Kooij H, Bloem BR. The clinical utility of posturography. Clin Neurophysiol. 2008;119(11):2424–36. https://doi.org/10.1016/j.clinph.2008.07.220.
Monsell EM, Furman JM, Herdman SJ, Konrad HR, Shepard NT. Computerized dynamic platform posturography. Otolaryngol Head Neck Surg. 1997;117(4):394–8. https://doi.org/10.1016/S0194-5998(97)70132-3.
Hebert JR, Manago MM. Reliability and validity of the computerized dynamic posturography sensory organization test in people with multiple sclerosis. Int J MS Care. 2017;19(3):151–7. https://doi.org/10.7224/1537-2073.2016-027.
Nashner L. EquiTest system operator’s manual, version 4.04. Clackamas: NeuroCom International; 1992.
Clark S, Rose DJ, Fujimoto K. Generalizability of the limits of stability test in the evaluation of dynamic balance among older adults. Arch Phys Med Rehabil. 1997;78(10):1078–84. https://doi.org/10.1016/S0003-9993(97)90131-3.
Trouillas P, Takayanagi T, Hallett M, Currier R, Subramony S, Wessel K, et al. International cooperative ataxia rating scale for pharmacological assessment of the cerebellar syndrome. J Neurol Sci. 1997;145(2):205–11. https://doi.org/10.1016/S0022-510X(96)00231-6.
Berg K, Wood-Dauphine S, Williams J, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can. 1989;41(6):304–11. https://doi.org/10.3138/ptc.41.6.304.
Sahin F, Yilmaz F, Ozmaden A, Kotevoglu N, Sahin T, Kuran B. Reliability and validity of the Turkish version of the Berg balance scale. J Geriatr Phys Ther. 2008;31(1):32–7. https://doi.org/10.1519/00139143-200831010-00006.
Podsiadlo D, Richardson S. The timed “up & go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991;39(2):142–8. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x.
Pozo-Cruz B, Adsuar JC, Parraca JA, Pozo-Cruz J, Olivares PR, Gusi N. Using whole-body vibration training in patients affected with common neurological diseases: a systematic literature review. J Altern Complement Med. 2012;18(1):29–41. https://doi.org/10.1089/acm.2010.0691.
Peterka R. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88(3):1097–118. https://doi.org/10.1152/jn.2002.88.3.1097.
Gandolfi M, Munari D, Geroin C, Gajofatto A, Benedetti MD, Midiri A, et al. Sensory integration balance training in patients with multiple sclerosis: a randomized, controlled trial. Mult Scler J. 2015;21(11):1453–62. https://doi.org/10.1177/1352458514562438.
Diego IA, Hernández CP, Rueda FM, de la Cuerda RC. Effects of vibrotherapy on postural control, functionality and fatigue in multiple sclerosis patients: a randomised clinical trial. Neurologia. 2012;27(3):143–53. https://doi.org/10.1016/j.nrleng.2012.04.008.
Hu M-H, Woollacott MH. Multisensory training of standing balance in older adults: II. Kinematic and electromyographic postural responses. J Gerontol. 1994;49(2):M62–71. https://doi.org/10.1093/geronj/49.2.M62.
Shumway-Cook A, Woollacott M. Motor control: theory and practical applications. Medicina (Kaunas). 1995;46(6):3–43.
Johansson H, Sjölander P, Sojka P. Activity in receptor afferents from the anterior cruciate ligament evokes reflex effects on fusimotor neurones. Neurosci Res. 1990;8(1):54–9. https://doi.org/10.1016/0168-0102(90)90057-L.
Cheung W-H, Mok H-W, Qin L, Sze P-C, Lee K-M, Leung K-S. High-frequency whole-body vibration improves balancing ability in elderly women. Arch Phys Med Rehabil. 2007;88(7):852–7. https://doi.org/10.1016/j.apmr.2007.03.028.
Brooks VB. The neural basis of motor control. New York: Oxford University Press; 1986.
Kaut O, Jacobi H, Coch C, Prochnicki A, Minnerop M, Klockgether T, et al. A randomized pilot study of stochastic vibration therapy in spinocerebellar ataxia. Cerebellum. 2014;13(2):237–42. https://doi.org/10.1007/s12311-013-0532-5.
Claerbout M, Gebara B, Ilsbroukx S, Verschueren S, Peers K, Van Asch P, et al. Effects of 3 weeks’ whole body vibration training on muscle strength and functional mobility in hospitalized persons with multiple sclerosis. Mult Scler J. 2012;18(4):498–505. https://doi.org/10.1177/1352458511423267.
Broekmans T, Roelants M, Alders G, Feys P, Thijs H, Eijnde BO. Exploring the effects of a 20-week whole-body vibration training programme on leg muscle performance and function in persons with multiple sclerosis. J Rehabil Med. 2010;42(9):866–72. https://doi.org/10.2340/16501977-0609.
Camicioli R, Howieson D, Lehman S, Kaye J. Talking while walking: the effect of a dual task in aging and Alzheimer’s disease. Neurology. 1997;48(4):955–8. https://doi.org/10.1212/WNL.48.4.955.
We would like to thank all ataxic patients for taking part into the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
The study was approved by the Ethics Committee of the Hacettepe University (GO 14/397) and all procedures performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
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Before starting the experiment, all participants were informed about objectives and methods of the study and asked to sign informed consent.
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Ayvat, E., Kılınç, M., Ayvat, F. et al. The Effect of Whole Body Vibration on Postural Control of Ataxic Patients: a Randomized Controlled Cross-Over Study. Cerebellum (2021). https://doi.org/10.1007/s12311-021-01233-y
- Exercise therapy
- Whole body vibration
- Postural control