Observations of four children with severe cerebral palsy using a novel dynamic platform. A case report

Abstract

The aim was to evaluate effects on bone mineral content (BMC) in children with severe cerebral palsy (CP) standing on a self-controlled dynamic platform (vibrations, jumps and rotation), assess reactions expressed and record negative effects. An experimental design was used. Four children with severe CP participated. Two children used the platform for 8–9 months while two children were controls (period I). After 1 year, the former users were controls (period II). Dual-energy X-ray absorptiometry was performed. Children in period I (Child 1/Child 2) were exposed to whole body vibration for 330/394 min on 28/25 occasions and showed a percentage change in BMC values at the lumbar spine of +35/+23% (versus controls, Child 3/Child 4, −9/+7%), left legs −9/ −12% (vs. −2/ −12%) and right legs +61/+34% (vs. −18/+10%). Children in period II (Child 3/Child 4) were exposed for 524/635 min on 57/64 occasions. The corresponding percentage change in BMC values at the lumbar spine was +10/+10% (+21/+5%), left legs +26/+22% (0/+5%) and right legs +26/+17% (+15/ −1%). The children's reactions were perceived positive. No negative effects were recorded. Standing on a self-controlled dynamic platform may be an enjoyable method to increase BMC in children with severe CP.

Key words::

• biomechanics
• mechanical loading
• musculoskeletal
• orthopaedics
• paediatrics

Acknowledgements

The authors would like to thank the children, parents and personnel at Reimers Preschool and Joriel School, both of which have a programme for special needs education. Many thanks also go to Ylva Jonsson, Lena Berglund and Anette Fagler at Karolinska Hospital, for doing the DXA measurements, as well as to the nurses at Q62 at Astrid Lindgrens Children's Hospital, in Stockholm, Sweden.

This project was funded by ALMI Stockholm AB, the City of Stockholm Inventors Award, Norrbacka-Eugenia Foundation administered by Swedish Institute of Assistive Technology, Arts in Hospital and Care as Culture, and the Agne Johansson Memorial Foundation. The prototype of the platform was built by the Royal Institute for Technology (KTH) and Löfgren Engineering AB.

Conflict of interest statement

One of the authors (Y.D.) has Swedish, European and US patents for the platform. For this reason, Y.D. did not perform any measurements or tests. No other author has a conflict of interest in this study. The sponsors had no involvement in this study other than funding.