The Effect of Whole Body Vibration on Pain and Disability in Adults with Chronic Low Back Pain: A Systematic Review

Transcription

1 The Effect of Whole Body Vibration on Pain and Disability in Adults with Chronic Low Back Pain: A Systematic Review

2 Authors Travis Fahey, SPT Matthew Donaldson, SPT Charles Lewis, SPT Corey Pasquarelli, SPT Renée Hakim, PT, DPT, NCS 2

3 Whole Body Vibration (WBV) WBV treatment occurs when a patient sits or stands on a vibrating platform WBV has been reported to improve bone density, lower muscular pain, and muscle strength 1 When used for pain alleviation WBV elicits pain reduction via Gate Theory 1,2 Image from: 3

4 Prevalence Lifetime prevalence of low back pain is reported as high as 84% 3 Prevalence of chronic low back pain approximately 23% % of population being disabled by low back pain 3 4

5 Purpose The purpose of this systematic review was to determine the effectiveness of whole body vibration (WBV) therapy as a treatment of chronic low back pain (CLBP) in adults. 5

6 Selection Criteria Diagnosis: Chronic Low Back Pain Age: Adults ( 18 years old) Outcomes: Oswestry Disability Index (ODI) Visual Analog Scale (VAS) 6

7 Search Terms (whole body vibration or vibration therapy or vibration) AND (low back pain or back pain or chronic back pain) 7

8 Search Limits Randomized Controlled Trials (RCT) Human subjects English language

9 9

10 PEDro Total Baard et al. Del-Pozo Cruz et al. Torabi et al. Y Y N Y N N N Y Y Y Y 6/10 Y Y N Y N Y Y Y Y Y Y 7/10 Y Y N Y N N Y Y Y Y Y 6/10 Yang et al. Y Y N Y N N Y Y N Y Y 5/10 Total = (24/40) 6/10 10

11 Results Two studies showed significant improvements in VAS and ODI using WBV (p<.05) 1,4 One study found between group significant improvements in both VAS and ODI (p=.006, p=.013) 4 One study found within group significant improvement in both VAS and ODI (p<.01) 1 No statistically significant differences found for other two studies 5,6 11

12 Results 1 Most effective programs included WBV followed by SS exercises and WBV alone SS exercises mainly composed of transversus abdominis (TrA) activation measured by a pressure biofeedback unit 12

13 Conclusion There is moderate evidence (PEDro=6/10) for WBV as a safe and effective method to decrease disability and pain scores in adults with CLBP when it is not performed concurrently with spinal stabilization (SS) exercises WBV performed alone or prior to SS exercise has shown positive results with significant reduction of pain and disability 13

14 Clinical Implications The use of a WBV device may be limited as resources may not be readily available in many clinics. If available, application of WBV is feasible as it does not require much time or effort for implementation The most effective treatment parameters for WBV were Hz x 5-6 minutes total per session for 6-12 weeks duration 1,4 If resources allow, physical therapists should consider the use of WBV therapy for patients with CLBP prior to SS exercises to optimize outcomes 14

15 Limitations Small samples sizes Variable protocols Likelihood of co-interventions Poorly operationalized SS exercise Number of databases 15

16 Future Research Future research is needed to determine the potential benefits of WBV on a larger sample with more homogeneous samples using a standardized exercise protocol and outcomes. 16

17 Thank You Renée Hakim, PT, Ph.D., NCS Paul Sung, Ph.D. Tracey Collins, PT, Ph.D., M.B.A., GCS John Sanko, PT, Ed.D. Bonnie Oldham University of Scranton DPT Faculty 17

18 References 1. Yang J, Seo D. The effects of whole body vibration on static balance, spinal curvature, pain, and disability of patients with low back pain. J Phys Ther Sci. 2015; 27(3): Russek, L. Chronic Pain. In: O Sullivan, S., Schmitz, T.J. Fulk, G. (2013). Physical rehabilitation. 6th ed. Philadelphia: F.A. Davis Balagué, Federico et al. Non-specific low back pain. Lancet. 2012;379(9814): del Pozo-Cruz, B, Mocholí, MH, Adsuar, J, Parraca, J, Muro, I, Gusi, N. Effects of whole body vibration therapy on main outcome measures for chronic non-specific low back pain: A single-blind randomized controlled trial. J Rehabil Med. 2011; 43(8): Baard M, Pietersen J, Rensburg S. Interventions for chronic low back pain: whole body vibration and spinal stabilisation. SAJSM. 2011; 23(2): Torabi, M, Okhovatian, F, Naimi, SS, Bagban, AA, Vafaee, R. The effect of core stability training with and without whole body vibration in chronic low back pain patients. J Paramed Sci. 4(3):

19 Questions? 19