Impact of Whole-body Vibration on Balance Combined with Tailored-made Conventional Physiotherapy

Dear Editor, I am writing to report a case demonstrating the efficacy of whole-body vibration along with tailor-made exercise protocol on balance and strength in hemiparetic limbs in a 59-year-old male patient who was diagnosed with subacute infarct with hemorrhagic transformation involving pons and occlusion of the left vertebral artery. On arrival for physiotherapy outpatient department, his neurological examination was as follows: Glasgow Coma Scale 15/15, conscious, alert, followed verbal commands, faced difficulty to do the movements on the right upper (hand dexterity grossly affected), and difficulty in maintaining balance. Balance is the most important factor which plays a crucial role in human gait, most of the stroke survivor experiences the balance issues in poststroke which leads to increase in fall risk and poor quality of life.[1] Whole-body vibrator (WBV) might be the potentially safe technique used to increase the muscle strength and postural stability among the stroke patients, which was assessed by isometric and isokinetic muscle strength of quadriceps and hamstring by isokinetic dynamometer and dynamic posturography, respectively.[2] A study done by Sade et al. discovered that WBV has a promising effect on balance in gait parameters in patients with stroke.[3] Before commencement of the study, detailed written informed consent was taken from the patient, pre-physiotherapy assessment of balance and muscle strength was evaluated by Berg balance scale (24/56) and MRC (3+/5) grading, respectively. The physiotherapy intervention protocol consisted of 15 min of whole-body vibrator (WBV) at a frequency of 60 Hz, incorporating both anterior-posterior and lateral sway movements. This was followed by conventional physiotherapy, which included 5 min of cycling at a speed of 5 km/h, sit-to-stand exercises, dexterity exercises for the left hand, and stretching exercises targeting the long flexors and adductors of the left upper limb, as well as the hamstrings, adductors, and Achilles tendon of the lower limbs. Postintervention patient’s balance improved significantly (36/56) and also there is enhancement of muscle strength by (4/5) which indicates whole-body vibration is an effective tool in managing balance while it is given along with conventional physiotherapy. Limitation Carry over effect of WBV cannot be assessed since the follow-up with patient was not done. Pilot studies or studies on large samples size are required to check intergroup and intragroup variations. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.