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Whole-body vibration training in children with Duchenne muscular dystrophy and spinal muscular atrophy
Affiliation:1. Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA;2. NMR Laboratory, DRF, I2BM, MIRCen, Institute of Myology, Pitie-Salpetriere University Hospital and CEA, Paris, France;3. Functional & Applied Biomechanics Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD, USA;4. RehabTek Inc, Glenview, IL, USA;5. Office of Biostatistics, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA;1. Center for Duchenne Muscular Dystrophy, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA;2. Department of Microbiology, Immunology, and Molecular Genetics, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA;3. The Center for Gene Therapy, Nationwide Children''s Hospital, Columbus, OH, USA;4. Departments of Pediatrics, The Ohio State University, Columbus, OH, USA
Abstract:IntroductionWhole-body-vibration training is used to improve muscle strength and function and might therefore constitute a potential supportive therapy for neuromuscular diseases.ObjectiveTo evaluate safety of whole-body vibration training in ambulatory children with Duchenne muscular dystrophy (DMD) and spinal muscular atrophy (SMA).Methods14 children with DMD and 8 with SMA underwent an 8-week vibration training programme on a Galileo MedM® at home (3 × 3 min twice a day, 5 days a week). Primary outcome was safety of the training, assessed clinically and by measuring serum creatine kinase levels. Secondary outcome was efficacy as measured by changes in time function tests, muscle strength and angular degree of dorsiflexion of the ankles.ResultsAll children showed good clinical tolerance. In boys with DMD, creatine kinase increased by 56% after the first day of training and returned to baseline after 8 weeks of continuous whole-body vibration training. No changes in laboratory parameters were observed in children with SMA. Secondary outcomes showed mild, but not significant, improvements with the exception of the distance walked in the 6-min walking test in children with SMA, which rose from 371.3 m to 402.8 m (p < 0.01).InterpretationWhole-body vibration training is clinically well tolerated in children with DMD and SMA. The relevance of the temporary increase in creatine kinase in DMD during the first days of training is unclear, but it is not related to clinical symptoms or deterioration.
Keywords:Whole-body vibration training  Exercise in neuromuscular diseases  Duchenne muscular dystrophy  Spinal muscular atrophy  Creatine kinase
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