title: Neuromuscular training based on whole body vibration in children with spina bifida: a retrospective analysis of a new physiotherapy treatment program.
abstract: BACKGROUND
  Spina bifida is the most common congenital cause of spinal cord lesions resulting in paralysis and secondary conditions like osteoporosis due to immobilization. Physiotherapy is performed for optimizing muscle function and prevention of secondary conditions. Therefore, training of the musculoskeletal system is one of the major aims in the rehabilitation of children with spinal cord lesions.
  
  
  METHODS
  The neuromuscular physiotherapy treatment program Auf die Beine combines 6 months of home-based whole body vibration (WBV) with interval blocks at the rehabilitation center: 13 days of intensive therapy at the beginning and 6 days after 3 months. Measurements are taken at the beginning (M0), after 6 months of training (M6), and after a 6-month follow-up period (M12). Gait parameters are assessed by ground reaction force and motor function by the Gross Motor Function Measurement (GMFM-66). Sixty children (mean age 8.71 ± 4.7 years) who participated in the program until February 2014 were retrospectively analyzed.
  
  
  RESULTS
  Walking velocity improved significantly by 0.11 m/s (p = 0.0026) and mobility (GMFM-66) by 2.54 points (p = 0.001) after the training. All changes at follow-up were not significant, but significant changes were observed after the training period. Decreased contractures were observed with increased muscle function.
  
  
  CONCLUSIONS
  Significant improvements in motor function were observed after the active training period of the new neuromuscular training concept. This first analysis of the new neuromuscular rehabilitation concept Auf die Beine showed encouraging results for a safe and efficient physiotherapy treatment program which increases motor function in children with spina bifida.
authors.affiliation: Children's Hospital, University of Cologne, Cologne, Germany, christina.stark@uk-koeln.de.
authors.forename: C
authors.initials: C
authors.lastname: Stark
authors.forename: H-K
authors.initials: HK
authors.lastname: Hoyer-Kuhn
authors.forename: O
authors.initials: O
authors.lastname: Semler
authors.forename: L
authors.initials: L
authors.lastname: Hoebing
authors.forename: I
authors.initials: I
authors.lastname: Duran
authors.forename: R
authors.initials: R
authors.lastname: Cremer
authors.forename: E
authors.initials: E
authors.lastname: Schoenau
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D026741:Physical Therapy Modalities; D012189:Retrospective Studies; D016135:Spinal Dysraphism / Q000534:rehabilitation*; D016896:Treatment Outcome; D014732:Vibration