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7. Catch the Wave! Intro to Whole Body Vibration in Pediatrics

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7. Catch the Wave! Intro to Whole Body Vibration in Pediatrics

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Understanding Whole Body Vibration as a Therapeutic Modality in Pediatric Therapy: Beginning interventions using side-alternating mechano-stimulation with children, with progressions, adaptations, and specifications to optimize PT, OT and ST outcomes

Our Popular Pediatric Courses presented by Mary Pengelley PT, DPT, ATP

Mary Pengelley has been a pediatric physical therapist since 1983. She has worked with children of all ages including young adults who have grown up with a variety of developmental disabilities, including cerebral palsy, traumatic brain injury, autism spectrum disorder, genetic disorders, muscular dystrophies, spinal muscular atrophy, brachial plexus injury, and torticollis. Mary is the Director of Research and Education at Progressive Pediatric Therapy and PPT4ed.org in West Palm Beach FL. She is also certified as an Assistive Technology Practitioner, teaches pediatric classes for DPT students, and also teaches continuing education webinars and live classes for licensed therapists.

Entry/Intermediate Level

Course Objectives:

  • Review of foundation knowledge of vibration as a therapeutic modality including side-alternating mechano-stimulation risks, benefits, parameters for therapy, and safety
  • Define physiological effects and benefits of various parameters on side-alternating mechano-stimulation platform
  • Understand how to use static and dynamic therapeutic body positions and activities on side-alternating mechano-stimulation platform related to functional activity
  • Develop patient specific goals related to age, diagnosis, and tolerance for use of side-alternating mechano-stimulation for pediatric PT, OT, and ST
  • Documentation, Pre-test/post-test assessment to measure effects of vibration on therapy outcomes
  • Review case studies of children with various diagnoses and ages using side-alternating mechano-stimulation

This course seeks to help pediatric PTs, OTs, and SLPs understand the basics of therapeutic vibration as a modality. Attendees will examine the underlying biomechanical forces that are applied to the body using the Galileo, a side-alternating mechano-stimulation platform. A brief review of all types of vibration intervention and exposure will help treating therapists clarify risk, understand benefits, and most effectively use the various parameters of the Galileo. An overview of optimal alignment and various positions to maximize functional outcomes with children will be presented, followed by hands-on lab time to allow attendees to practice UE, LE and trunk static and dynamic activities on the Galileo. Case studies of children with various diagnoses provide specific examples of therapeutic use of side-alternating mechano-stimulation, including specific parameters, positions and follow up activities to optimize pediatric PT, OT and speech therapy.

Course Agenda: The topics of this course will describe and discuss key concepts related to therapeutic use of vibration in the treatment of children:

  1. Lecture 1: Review Foundational Knowledge of vibration as therapeutic modality:
    1. Risks, benefits, parameters for therapy, safety precautions
    2. Physiological Benefits on Bone, Muscle Function/Power/Force, Flexibility, Muscle tone, Cardiovascular, Lymphatic, Pulmonary, Sensory Function, Pain
  2. Lab 1: Where do I start?
    1. Basic standing position, frequency, amplitude
    2. Lab 1 Stretching- Demo/try positions for PT, OT, Speech related goals
    3. Strengthening: Demo/try positions for PT, OT, ST related goals
      1. Tools and Props
      2. Goal Development, Assessment pre- and post-intervention
      3. Understand Body Positions Related to Therapeutic Goals
      4. Static and Dynamic Therapeutic Activities
      5. Observations from Lab 1
  1. Lecture 2: Putting the Knowledge into Action in Therapy
    1. Biotensegrity and Neuroplasticity
    2. Motor Learning and Sensory Motor Tolerance
    3. Alignment, Stretching, Strengthening
    4. Assessment and Documentation
    5. Postural Control
    6. Case Examples
  1. https://charconeurotech.com/blog/2020/10/29/professor-charcot-medical-innovator/
  2. https://stimdesigns.com/contact-us/our-german-partner/
  3. https://www.galileo-training.com/at-english/news/n281/galileo-therapy-celerbating-11-years-of-the-cologne-concept.html
  4. https://www.ccohs.ca/oshanswers/phys_agents/vibration/vibration_effects.html
  5. Pollock, Raphael E., et al. “Muscle activity and acceleration during whole body vibration: effect of frequency and amplitude”. Clinical Biomechanics, vol. 25, no. 8, 2010, p. 840-846. https://doi.org/10.1016/j.clinbiomech.2010.05.004
  6. Ritzmann R, Gollhofer A, Kramer A. The influence of vibration type, frequency, body position and additional load on the neuromuscular activity during whole body vibration. Eur J Appl Physiol. 2013;113(1):1-11. doi:10.1007/s00421-012-2402-0
  7. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, Langdon K, Namara MM, Paton MC, Popat H, Shore B, Khamis A, Stanton E, Finemore OP, Tricks A, Te Velde A, Dark L, Morton N, Badawi N. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3. doi: 10.1007/s11910-020-1022-z. PMID: 32086598; PMCID: PMC7035308.
  8. Wong, Ronald M., et al. “Fibrinolysis as a target to enhance osteoporotic fracture healing by vibration therapy in a metaphyseal fracture model”. Bone &Amp; Joint Research, vol. 10, no. 1, 2021, p. 41-50. https://doi.org/10.1302/2046-3758.101.bjr-2020-0185.r1
  9. Brites-Ferreira A, Taiar R, Cardoso ALBD, De Souza-Santos D, da Costa-Borges PP, Torres-Nunes L, Jaques-Albuquerque LT, Monteiro-Oliveira BB, Boyer FC, da Cunha Sá-Caputo D, et al. Therapeutic Approach of Whole-Body Vibration Exercise on Wound Healing in Animal Models: A Systematic Review. International Journal of Environmental Research and Public Health. 2023; 20(6):4925. https://doi.org/10.3390/ijerph20064925
  10. Coelho-Oliveira AC, Lacerda ACR, de Souza ALC, et al. Acute Whole-Body Vibration Exercise Promotes Favorable Handgrip Neuromuscular Modifications in Rheumatoid Arthritis: A Cross-Over Randomized Clinical. Biomed Res Int. 2021;2021:9774980. Published 2021 Dec 2. doi:10.1155/2021/9774980
  11. https://www.sciencenews.org/article/riding-roller-coasters-might-help-dislodge-kidney-stones
  12. Rohlmann, Antonius et al. “Loads on a spinal implant measured in vivo during whole-body vibration.” European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 19,7 (2010): 1129-35. doi:10.1007/s00586-010-1346-5
  13. Khosrawi, Saeid, and Salman Fallah. “Evaluation of the relation between triceps surae H-reflex, M-response latencies and thigh length in normal population.” Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences vol. 18,3 (2013): 188-92.
  14. Adolph, Karen E et al. “How do you learn to walk? Thousands of steps and dozens of falls per day.” Psychological science vol. 23,11 (2012): 1387-94. doi:10.1177/0956797612446346
  15. Lang CE, Macdonald JR, Reisman DS, et al. Observation of amounts of movement practice provided during stroke rehabilitation. Arch Phys Med Rehabil. 2009;90(10):1692-1698. doi:10.1016/j.apmr.2009.04.005
  16. Ritzmann R, Gollhofer A, Kramer A. The influence of vibration type, frequency, body position and additional load on the neuromuscular activity during whole body vibration. Eur J Appl Physiol. 2013 Jan;113(1):1-11. doi: 10.1007/s00421-012-2402-0. Epub 2012 Apr 27. PMID: 22538279.
  17. https://www.normandoidge.com/?page_id=1259
  18. https://developingchild.harvard.edu/science/key-concepts/brain-architecture/#:~:text=Brains%20are%20built%20over%20time%2C%20from%20the%20bottom%20up.&text=In%20the%20first%20few%20years,circuits%20to%20become%20more%20efficient.
  19. Mihee An, Stacey C Dusing, Regina T Harbourne, Susan M Sheridan, START-Play Consortium, What Really Works in Intervention? Using Fidelity Measures to Support Optimal Outcomes, Physical Therapy, Volume 100, Issue 5, May 2020, Pages 757–765, https://doi.org/10.1093/ptj/pzaa006
  20. Krause A, Gollhofer A, Freyler K, Jablonka L, Ritzmann R. Acute corticospinal and spinal modulation after whole body vibration. J Musculoskelet Neuronal Interact. 2016 Dec 14;16(4):327-338. PMID: 27973385; PMCID: PMC5259574.
  21. Invernizzi, Marco, et al. “Bone muscle crosstalk in spinal cord injuries: pathophysiology and implications for patients’ quality of life”. Current Osteoporosis Reports, vol. 18, no. 4, 2020, p. 422-431. https://doi.org/10.1007/s11914-020-00601-7
  22. Côté, Marie-Pascale, et al. “Activity-dependent increase in neurotrophic factors is associated with an enhanced modulation of spinal reflexes after spinal cord injury”. Journal of Neurotrauma, vol. 28, no. 2, 2011, p. 299-309. https://doi.org/10.1089/neu.2010.1594
  23. Schulte, Friederike A., et al. “Local mechanical stimuli regulate bone formation and resorption in mice at the tissue level”. PLoS ONE, vol. 8, no. 4, 2013, p. e62172. https://doi.org/10.1371/journal.pone.0062172
  24. Lipphaus, Andreas, et al. “Biomechanical study of the development of long bones: finite element structure synthesis of the human second proximal phalanx under growth conditions”. The Anatomical Record, vol. 302, no. 8, 2018, p. 1389-1398. https://doi.org/10.1002/ar.24006
  25. Arenales Arauz, Y Laurisa et al. “Short-term effects of side-alternating Whole-Body Vibration on cognitive function of young adults.” PloS one vol. 18,1 e0280063. 12 Jan. 2023, doi:10.1371/journal.pone.0280063
  26. Ritzmann, Ramona, Christina Stark, and Anne Krause. “Vibration therapy in patients with cerebral palsy: a systematic review.” Neuropsychiatric disease and treatment (2018): 1607-1625.