Prediction of the outcome of children who had a language delay at age 2 when they are aged 4: Still a challenge

Abstract

Purpose: This study investigated the role that variables related to children and their environment play in the prediction of outcomes at 4 years of age for children with a language delay at 2 years.

Method: A longitudinal study was undertaken where 64 children (45 boys, 19 girls; mean age?=?53.3 months; SD?=?4.4) with language delay at age 2 years were re-evaluated at age 4 years. Three developmental trajectories were analysed.

Result: The early stages of grammar, as estimated by mean length of utterance at 3.5 years, are an important prognosis factor of subsequent language impairment (LI). Children who are exposed to several risk factors simultaneously are more likely to have a language delay (LD) or a LI, but the profile of LD children is more akin to that of the typically developing (TD) children. Children with LI tend to have profiles with a greater number of risk factors.

Conclusion: The results of this study encourage different intervention approaches depending on the child’s language profile at 2 years, due to differing language prognosis. The results also point to the need to assess the child’s environment. Future studies with large diverse population samples may give more precise information on potential risk factors and their cumulative effect.     

Efficiency of acidemia correction on intermittent versus continuous hemodialysis in acute methanol poisoning

Context: Acidemia is a marker of prognosis in methanol poisoning, as well as compounding formate-induced cytotoxicity. Prompt correction of acidemia is a key treatment of methanol toxicity and methods to optimize this are poorly defined.

Objective: We studied the efficiency of acidemia correction by intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT) in a mass outbreak of methanol poisoning.

Methods: The study was designed as observational cohort study. The mean time for an increase of 1?mmol/L HCO₃^–, 0.01 unit arterial blood pH, and the total time for correction of HCO₃^– were determined in IHD- and CRRT-treated patients.

Results: Data were obtained from 18 patients treated with IHD and 13 patients treated with CRRT. At baseline, CRRT group was more acidemic than IHD group (mean arterial pH 6.79?±?0.10 versus 7.05?±?0.10; p?=?0.001). No association was found between the rate of acidemia correction and age, weight, serum methanol, lactate, formate, and glucose on admission. The time to HCO₃^– correction correlated with arterial blood pH (r=??0.511; p?=?0.003) and creatinine (r?=?0.415; p?=?0.020). There was association between the time to HCO₃^– correction and dialysate/effluent and blood flow rates (r=??0.738; p?r=??0.602; p?The mean time for HCO₃^– to increase by 1?mmol/L was 12?±?2?min for IHD versus 34?±?8?min for CRRT (p?p?=?0.024). The mean increase in HCO₃^– was 5.67?±?0.90?mmol/L/h for IHD versus 2.17?±?0.74?mmol/L/h for CRRT (p?Conclusions: Our study supports the superiority of IHD over CRRT in terms of the rate of acidemia correction.     

The feasibility and appropriateness of a peer-to-peer,play-based intervention for improving pragmatic language in children with autism spectrum disorder

Abstract

Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants.

Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant’s social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach.

Result: Children demonstrated gains in pragmatic language on the POM (χ²(3)?=?11.160, p?=?0.011) and related higher-level language on the SEE (χ²(2)?=?6.686, p?=?0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved.

Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size.     

Promoting language and social communication development in babies through an early storybook reading intervention

Purpose: This study examined the effectiveness of low- and high-intensity early storybook reading (ESR) intervention workshops delivered to parents for promoting their babies language and social communication development. These workshops educated parents on how to provide a stimulating home reading environment and engage in parent–child interactions during ESR.

Method: Parent–child dyads (n?=?32); child age: 3–12 months, were assigned into two intervention conditions: low and high intensity (LI versus HI) groups. Both groups received the same ESR strategies; however, the HI group received additional intervention time, demonstrations and support. Outcome measures were assessed pre-intervention, one and three months post-intervention and when the child turned 2 years of age.

Result: A significant time–group interaction with increased performance in the HI group was observed for language scores immediately post-intervention (p?=?0.007) and at 2-years-of-age (p?=?0.022). Significantly higher broader social communication scores were associated with the HI group at each of the time points (p?=?0.018, p?=?0.001 and p?=?0.021, respectively). Simple main effect revealed that both groups demonstrated a significant improvement in language, broader social communication and home reading practices scores.

Conclusions: ESR intervention workshops may promote language and broader social communication skills. The HI ESR intervention workshop was associated with significantly higher language and broader social communication scores.     

Longitudinal changes in phonological whole-word measures in 2-year-olds

Abstract

The purpose of this investigation was to describe changes in whole-word productions in the speech of children as they aged from 24 to 36 months. Spontaneous language samples were obtained from 12 participants during parent–child interactions every 3 months, beginning with each participant's second birthday. Fifty different words from each sample were analysed to determine changes in a variety of whole-word measures including phonological mean length of utterance (PMLU) for target words and words produced, proportion of whole-word proximity (PWP), and proportion of words produced correctly (PWC). Significant changes in whole-word measures were evidenced by the participants over the course of the investigation, and those scores did not show stabilization by the age of 36 months.     

Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial

Purpose: This study aimed to determine the efficacy of the integrative group-based cognitive rehabilitation programme, REHACOP, on improving cognitive functions in multiple sclerosis (MS).

Methods: Fourty-two MS patients were randomized to the treatment programme REHACOP (n?=?21) or waiting list control condition (n?=?21). The REHACOP group received cognitive rehabilitation in group format for three months focused on attention, processing speed, learning and memory, language, executive functioning, and social cognition. Patients completed a neuropsychological assessment at baseline and follow-up, which included tests of attention, processing speed, working memory, verbal memory, verbal fluency, and executive functioning. Repeated measures multivariate analysis of covariance (MANCOVA) was used to determine the efficacy of the cognitive rehabilitation programme.

Results: Group?×?Time interactions revealed significant improvements in the REHACOP group as compared with the control group for processing speed (p?=?0.011, n_p²?=?0.16), working memory (p?=?0.014, n_p²?=?0.15), verbal memory (p?=?0.025, n_p²?=?0.13), and executive functioning (p?=?0.024, n_p²?=?0.13), showing medium–large effect sizes.

Conclusions: Patients receiving REHACOP showed improvements in several cognitive domains. This preliminary study thus provides evidence supporting the efficacy of this integrative group-based cognitive rehabilitation intervention in MS. Future research should confirm these findings, examine the impact of the treatment on everyday life functioning and explore the presence of brain changes associated with cognitive rehabilitation.

• Implications for rehabilitation

• This study provides initial evidence for integrative group-based cognitive rehabilitation efficacy in MS patients through the implementation of the REHACOP cognitive rehabilitation programme.

• Patients received cognitive rehabilitation for three months (3 one-hour-sessions per week) focused on training attention, learning and memory, language, executive functioning, and social cognition.

• Patients attending REHACOP sessions showed medium to large and statistically significant improvements in processing speed, working memory, verbal memory, and executive functioning.

     

Randomized controlled trial of a web-based multi-modal therapy program for executive functioning in children and adolescents with unilateral cerebral palsy

Purpose state: Determine the efficacy of Move-it-to-improve-it (Mitii?), a multi-modal web-based program, in improving Executive Function (EF) in children with unilateral cerebral palsy (UCP).

Method: Participants (n?=?102) were matched in pairs then randomized to: intervention (Mitii? for 20 weeks; n?=?51; 26 males; mean age?=?11 years 8 months (SD?=?2 years 4 months); Full Scale IQ?=?84.65 (SD?=?15.19); 28 left UCP; GMFCS-E&;R (I?=?20, II?=?31) or waitlist control (n?=?50; 25 males; mean age?=?11 years 10 months (SD?=?2 years 5 months); Full Scale IQ?=?80.75 (SD?=?19.81); 20 left UCP; GMFCS-E&;R (I?=?25, II?=?25). Mitii? targeted working memory (WM), visual processing (VP), upper limb co-ordination and physical activity. EF capacity was assessed: attentional control (DSB; WISC-IV); cognitive flexibility (inhibition and number-letter sequencing DKEFS); goal setting (D-KEFs Tower Test); and information processing (WISC-IV Symbol Search and Coding). EF performance was assessed via parent report (BRIEF). Groups were compared at 20 weeks using linear regression (SPSS 21).

Results: There were no significant between group differences in attentional control (DSB; p?=?0.20;CI=??0.40,1.87); cognitive flexibility (Inhibition, p?=?0.34; CI=??0.73,2.11; number/letter sequencing, p?=?0.17; CI=??0.55,2.94); problem solving (Tower; p?=?0.28; CI=??0.61,2.09), information processing (Symbol; p?=?0.08; CI=??0.16, 2.75; Coding; p?=?0.07; CI=??0.12,2.52) or EF performance (p?=?0.13; CI=??10.04,1.38).

Conclusion:In a large RCT, Mitii^TM did not lead to significant improvements on measures of EF or parent ratings of EF performance in children with UCP.

• Implications for rehabilitation

• A large RCT of the multi-modal web based training; Move It to Improve It (Mitii^TM) improves motor processing, visual perception, and physical capacity but does demonstrate statistically significant improvements or clinical significance in executive function in children with mild to moderate unilateral cerebral palsy (UCP).

• Mitii^TM training completed by an intervention group was highly variable with few children reaching the target dosage of 60?h. Technical issues including server and internet connectively problems lead to disengagement with the program.

• Web-based training delivered in the home has the potential to increase therapy dose and accessibility, however, Mitii^TM needs to be tailored to include tasks involving goal-setting, more complex problem solving using multi-dimensional strategies, mental flexibility, switching between two cognitively demanding tasks, and greater novelty in order to increase the cognitive component and challenge required to drive changes in EF.

     

Acquisition of graphic communication by a young girl without comprehension of spoken language

Purpose: To describe a graphic-mode communication intervention involving a girl with intellectual impairment and autism who did not develop comprehension of spoken language. The aim was to teach graphic-mode vocabulary that reflected her interests, preferences, and the activities and routines of her daily life, by providing sufficient cues to the meanings of the graphic representations so that she would not need to comprehend spoken instructions. Method: An individual case study design was selected, including the use of written records, participant observation, and registration of the girl's graphic vocabulary and use of graphic signs and other communicative expressions. Results: While the girl's comprehension (and hence use) of spoken language remained lacking over a 3-year period, she acquired an active use of over 80 photographs and pictograms. Conclusions: The girl was able to cope better with the cognitive and attentional requirements of graphic communication than those of spoken language and manual signs, which had been focused in earlier interventions. Her achievements demonstrate that it is possible for communication-impaired children to learn to use an augmentative and alternative communication system without speech comprehension, provided the intervention utilizes functional strategies and non-language cues to the meaning of the graphic representations that are taught.     

Use of ISTH bleeding assessment tool to predict inherited platelet dysfunction in resource constrained settings

Background: The International Society of Thrombosis &; Hemostasis (ISTH) bleeding assessment tool (ISTH-BAT) is used to record bleeding symptoms in patients with possible bleeding disorders.

Aim: To investigate the utility of the ISTH-BAT in predicting platelet dysfunction in individuals with suspected inherited platelet function disorders.

Method: Individuals with clinical evidence of bleeding and suspected inherited platelet function disorder and healthy volunteers were included in the study. The ISTH-BAT questionnaire was applied prior to light transmission aggregometry (LTA).

Results: A total of 261 participants were included (100 healthy volunteers, and 161 with suspected inherited platelet function disorders). The ISTH-BAT score in participants with suspected inherited platelet function disorders (median 2; interquartile range [IQR] 5–1) was significantly higher than in healthy volunteers (median 0; IQR 2–0). There was also a significant difference between participants with suspected inherited platelet function disorders with a platelet defect detected by LTA (median 4; IQR 8–3) and those with normal platelet function (median 2; IQR 3–1) (p?p?=?p?=?< 0.001]).

Conclusion: The ISTH-BAT is a useful tool for documenting bleeding symptoms and the score obtained is also predictive of the presence of a platelet defect on LTA in patients with suspected inherited platelet dysfunction.     

Pre-therapy Somatostatin Receptor-Based Heterogeneity Predicts Overall Survival in Pancreatic Neuroendocrine Tumor Patients Undergoing Peptide Receptor Radionuclide Therapy

Purpose

Early identification of aggressive disease could improve decision support in pancreatic neuroendocrine tumor (pNET) patients prior to peptide receptor radionuclide therapy (PRRT). The prognostic value of intratumoral textural features (TF) determined by baseline somatostatin receptor (SSTR)-positron emission tomography (PET) before PRRT was analyzed.

Procedures

Thirty-one patients with G1/G2 pNET were enrolled (G2, n?=?23/31). Prior to PRRT with [¹⁷⁷Lu]DOTATATE (mean, 3.6 cycles), baseline SSTR-PET computed tomography was performed. By segmentation of 162 (median per patient, 5) metastases, intratumoral TF were computed. The impact of conventional PET parameters (SUV_mean/max), imaging-based TF, and clinical parameters (Ki67, CgA) for prediction of both progression-free survival (PFS) and overall survival (OS) after PRRT were evaluated.

Results

Within a median follow-up of 3.7 years, tumor progression was detected in 21 patients (median, 1.5 years) and 13/31 deceased (median, 1.9 years). In ROC analysis, the TF entropy, reflecting derangement on a voxel-by-voxel level, demonstrated predictive capability for OS (cutoff?=?6.7, AUC?=?0.71, p?=?0.02). Of note, increasing entropy could predict a longer survival (>?6.7, OS?=?2.5 years, 17/31), whereas less voxel-based derangement portended inferior outcome (<?6.7, OS?=?1.9 years, 14/31). These findings were supported in a G2 subanalysis (>?6.9, OS?=?2.8 years, 9/23 vs. <?6.9, OS?=?1.9 years, 14/23). Kaplan–Meier analysis revealed a significant distinction between high- and low-risk groups using entropy (n?=?31, p?<?0.05). For those patients below the ROC-derived threshold, the relative risk of death after PRRT was 2.73 (n?=?31, p?=?0.04). Ki67 was negatively associated with PFS (p?=?0.002); however, SUV_mean/max failed in prognostication (n.s.).

Conclusions

In contrast to conventional PET parameters, assessment of intratumoral heterogeneity demonstrated superior prognostic performance in pNET patients undergoing PRRT. This novel PET-based strategy of outcome prediction prior to PRRT might be useful for patient risk stratification.

     

Spoken language samples of Australian children in conversation,narration and exposition

Abstract

Purpose: Language sample analysis is a powerful clinical tool for identifying and describing the oral language difficulties of children with language impairment. In response to a lack of existing Australian normative data, the current study collected spoken language samples from 127 children attending the first 3 years of schooling (YOS). This dataset was compared with the New Zealand (NZ) database of language samples to determine whether clinicians can use overseas databases for appraising language performance of Australian children.

Method: Children participated in several oral language tasks: conversation, personal narratives, story retelling and exposition (YOS3 only).

Result: Analyses of the spoken language samples revealed a developmental trend of increasing syntactic complexity, semantic diversity and verbal productivity. Discourse genre had a signi?cant impact on children’s language production, with the expository task yielding the syntactically most complex language from the YOS 3 children. Comparisons between the Australian and NZ datasets revealed some differences in performance, with the Australian children showing better syntactic complexity.

Conclusion: The Australian dataset of language samples provides clinicians with useful information regarding young school-age children’s performance on a range of discourse tasks deemed important for classroom participation. Care should be taken when using the NZ database for diagnostic purposes.     

An exploratory study of clinician real-time morpho-syntactic judgements with pre-school children

Abstract

The purpose of this study was to explore the feasibility of employing real-time morpho-syntactic judgements. A system of capturing real-time judgements of children's utterances was implemented using a modified talk-time sampling procedure with 13 monolingual, English-speaking US pre-school children who had standard scores above 85 on a norm-referenced measure of language ability, four of whom had histories of diagnosed language deficits and were receiving language therapy. The remaining participants (n = 9) were typically-developing. The primary research questions were whether the linguistic data from abbreviated talk-time samples were comparable to traditional 100 utterance samples, and whether utterance level judgements made in real-time were in concordance with the linguistic data available in talk-time samples. Results of this investigation revealed positive and significant correlations in linguistic data across both forms of language sampling, as well as statistically significant inverse correlation between real-time judgement of utterance errors and mean length of utterances in morphemes (MLU-m), indicating that clinician decisions about children's utterances were closely associated with morpho-syntactic accuracy. Further analyses revealed that the percentage of conversational utterances with errors was different for children with and without histories of language impairment. Implications for potential clinical application and directions for future research are discussed.     

Investigating the effect of regional native accents on sentence comprehension in children with language impairment

Purpose: Research has shown that accent variation can affect typically developing (TD) children’s understanding of language, as well as that of children with speech difficulties, neuro-typical adults and those with aphasia and dementia. This study aims to investigate the effect of regional native accents on sentence comprehension in children with language impairment (LI), an area not previously explored.

Method: Forty-three children with LI (mean age 6.04) and forty-five younger TD children (mean age 4.10), matched on a measure of sentence comprehension, completed a sentence comprehension task spoken in three regional accents. Instructions were spoken in the children’s local Irish accent, a neutral-Irish accent and an unfamiliar Northern-Irish (NI) accent. Instructions were adapted from the Token Test and were matched on syllable length and complexity.

Result: The two groups performed similarly overall on the task. Children had significantly greater difficulty understanding instructions spoken in the NI accent than in either of the other two accents. The ability to process accent variation was significantly associated with receptive language and phonological short term memory ability.

Conclusions: Variation in regional accents may be negatively impacting the performance of children on language comprehension assessments. Potential effects on diagnostic or clinical decisions will require further exploration.     

The impact of Professional Boundaries for Health Professionals (PBHP) training on knowledge,comfort, experience,and ethical decision-making: a longitudinal randomized controlled trial

Purpose: A randomized controlled trial was conducted to evaluate the impact of Professional Boundaries for Health Professionals (PBHP) training program on the knowledge, comfort, experience, and ethical decision-making of multidisciplinary practitioners facing client–practitioner boundary dilemmas.

Methods: In all, 36 rehabilitation practitioners from an Australian state-wide spinal cord injuries service were assigned to experimental and control groups. The Boundaries in Practice (BIP) Scale measured outcomes at four points: pre, post, 3 months, and 1 year. The control group received the training after 3 months. Nonparametric Friedman’s two-way analysis of variance was used to examine the trajectories over time.

Results: Analysis was conducted using the data of 10 experimental and 13 control group participants who responded at four data collection points. The experimental group showed significant improvement in knowledge (χ²?=?10.673, p?=?0.014) and comfort (χ²?=?9.727, p?=?0.021) managing professional boundaries post-training. The control group showed no significant change in knowledge or comfort. No significant change was seen in experience across either experimental (χ²?=?3.609, p?=?0.307) or control group (χ²?=?7.800, p?=?0.050). Ethical decision-making improved in the control group (χ²?=?13.188, p?=?0.004) following training, however remained unchanged in the experimental group.

Conclusions: The findings do not definitively support this training approach. Ethical decision-making may improve more substantially within the practice context and organizational culture change. Multifaceted approaches are indicated.

• Implications for Rehabilitation

• Ethical dilemmas related to boundaries between clients and practitioners are a frequent occurrence in the rehabilitation setting.

• In a relatively small sample, the current randomized trial provided inconclusive evidence on the benefit of a 1-day needs-oriented training program to improve knowledge, comfort, and ethical decision-making.

• Randomized trials of education and training for rehabilitation practitioners are fraught with challenges in the clinical environment of the rehabilitation setting.

• Multifaceted training approaches, management support and training as well as changes to policy and organizational context in the rehabilitation setting may be needed to more holistically address the issues surrounding professional boundaries in the rehabilitation setting.

     

Learning word meanings during reading: Effects of phonological and semantic cues on children with language impairment

Abstract

Phonological and semantic deficits in spoken word learning have been documented in children with language impairment (LI), and cues that address these deficits have been shown to improve their word learning performance. However, the effects of such cues on word learning during reading remain largely unexplored. This study investigated whether (a) control, (b) phonological, (c) semantic, and (d) combined phonological-semantic conditions affected semantic word learning during reading in 9- to 11-year-old children with LI (n =?12) and with typical language (TL, n =?11) from low-income backgrounds. Children were exposed to 20 novel words across these four conditions prior to reading passages containing the novel words. After reading, a dynamic semantic assessment was given, which included oral definitions, contextual clues, and multiple choices. Results indicated that the LI group performed more poorly than the TL group in phonological and combined conditions, but not in the control or semantic conditions. Also, a similar trend for both groups was suggested, with improved performance in the semantic and combined conditions relative to the control and phonological conditions. Clinical implications include a continued need for explicit instruction in semantic properties of novel words to facilitate semantic word learning during reading in children with LI.     

The encoding of word forms into memory may be challenging for college students with developmental language impairment

Purpose: To describe the word-learning problems characteristic of developmental language impairment (LI).

Method: College students with LI (n?=?39) or normal language development (ND, n?=?40) attempted to learn novel word forms. Training for half of the words was meaning-focused; training for the other half was form-focused. Form recognition and stem completion tasks administered immediately after training tapped encoding of the lexical configuration and a repetition of the stem completion task one week later tapped consolidation. A visual world paradigm tapped lexical engagement.

Result: At the immediate post-test, the LI group was poorer at recognition and completion of word forms than their ND peers, suggesting a deficit in encoding the lexical configuration. However, the gap between the LI and ND groups in stem completion did not grow over the week, suggesting intact consolidation. Form-focused training yielded better performance than meaning-focused training at immediate- and one week tests. For both groups, newly trained words slowed the recognition of familiar English words, revealing lexical engagement.

Conclusion: The encoding of word-form configurations is challenging for some, but not all, college students with LI. Training that encourages a focus on the form may be a useful part of vocabulary intervention for those affected.     

Phonological awareness development in children with and without spoken language difficulties: A 12-month longitudinal study of German-speaking pre-school children

Purpose: There is strong empirical evidence that English-speaking children with spoken language difficulties (SLD) often have phonological awareness (PA) deficits. The aim of this study was to explore longitudinally if this is also true of pre-school children speaking German, a language that makes extensive use of derivational morphemes which may impact on the acquisition of different PA levels.

Method: Thirty 4-year-old children with SLD were assessed on 11?PA subtests at three points over a 12-month period and compared with 97 four-year-old typically developing (TD) children.

Result: The TD-group had a mean percentage correct of over 50% for the majority of tasks (including phoneme tasks) and their PA skills developed significantly over time. In contrast, the SLD-group improved their PA performance over time on syllable and rhyme, but not on phoneme level tasks. Group comparisons revealed that children with SLD had weaker PA skills, particularly on phoneme level tasks.

Conclusion: The study contributes a longitudinal perspective on PA development before school entry. In line with their English-speaking peers, German-speaking children with SLD showed poorer PA skills than TD peers, indicating that the relationship between SLD and PA is similar across these two related but different languages.     

Concurrent Validity of Postural Sway Measures in Older Adults With Cognitive Impairment

Abstract

Aims: To examine concurrent validity of inertial sensor (APDM ISway) versus force plate center of pressure (COP) measures of postural sway in cognitively impaired older adults. Methods: Participants, mean age 85.6 (SD 4.8), were tested in 4 static standing conditions: (1) eyes open/normal base, (2) eyes open/narrow base, (3) eyes closed/normal base, and (4) eyes closed/narrow base. ISway and COP measures were collected. Results: Strong correlations between ISway trunk sway smoothness [ISway JERK, (m²/s⁵)] and COP path length (r?=?0.67–0.85) and COP mean velocity (r?=?0.77–0.87); also ISway total sway acceleration path length/trail duration [ISway PATH, (m²/s²)] and COP path length (r?=?0.77–0.87) and COP mean velocity (r?=?0.77–0.91). Increased sway was detected in narrow versus normal base and eyes closed versus open conditions (P = .001). Conclusions: APDM ISway demonstrated concurrent validity to force-plate COP and changes in postural sway were detected between conditions.     

The effect of whole-body vibration therapy on bone metabolism,motor function,and anthropometric parameters in women with postmenopausal osteoporosis

Purpose: To review the research literature on the effectiveness of whole-body vibration (WBV) therapy in women with postmenopausal osteoporosis.

Methods: A systematic review was conducted by two independent reviewers. Mean differences (MDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with the I² test. The Cochrane risk of bias tool was used to assess the methodological quality of the selected studies.

Results: Nine randomized controlled trials involving 625 patients met the inclusion criteria. No significant improvement was found in bone mineral density (BMD) (SMD?=??0.06, 95%CI=??0.22–0.11, p?=?0.50); bone turnover markers (MD?=??0.25, 95%CI=??0.54–0.03, p?=?0.08); anthropometric parameters, including muscle mass, fat mass, body mass index (BMI), and weight (SMD?=?0.02, 95%CI=??0.16–0.21, p?=?0.81); or maximal isotonic knee extensor strength (SMD?=?0.16, 95%CI=??0.63–0.95, p?=?0.69). However, maximal isometric knee extensor strength improved (SMD?=?0.71, 95%CI?=?0.34–1.08, p?=?0.0002).

Conclusions: WBV is beneficial for enhancing maximal isometric knee extensor strength, but it has no overall treatment effect on BMD, bone turnover markers, anthropometric parameters, or maximal isotonic knee extensor strength in women with postmenopausal osteoporosis.

• Implication of rehabilitation

• Osteoporosis is the leading underlying cause of fractures in postmenopausal women, whole body vibration (WBV) has received much attention as a potential intervention for the management of osteoporosis in recent years.

• Whole body vibration is beneficial for enhancing maximal isometric knee extensor strength in women with postmenopausal osteoporosis.

• Whole body vibration has no overall treatment effect on bone mineral density, bone turnover markers, anthropometric parameters and maximal isotonic knee extensor strength in women with postmenopausal osteoporosis.