Whole body vibration (v no intervention) on voluntary strength in people with SCI | SCI Physiotherapy Clinical Practice Guidelines

	Whole body vibration (v no intervention) on voluntary strength in people with SCI
P	People with SCI	Evidence recommendation No evidence recommendation Reason: No recommendation due to insufficient or inconclusive evidence.		Strong opinion statement AGAINST Whole body vibration should not be provided to improve voluntary strength in people with SCI.
I	Whole body vibration
C	No intervention	Consensus-based opinion statement Strong Against (77%)
O	Strength	Consensus-based opinion statement Strong Against (77%)
	SUMMARY	1 RCT		Mean difference (95% CI): Strength in kg 1.1 (-8.0 to 10.27) Favours vibration
	GRADE Very low certainty ⨁◯◯◯	Risk of bias Serious	Inconsistency Serious	Imprecision Very serious	Indirectness Serious	Publication bias Serious

VIBRATION ON VOLUNTARY STRENGTH PARTIALLY PARALYSED MUSCLES: GRADE Evidence to Decision
PROBLEM	No	Probably no	Probably yes	Yes		Don't know
DESIRABLE EFFECTS	Trivial	Small	Moderate	Large		Don't know
UNDESIRABLE EFFECTS	Large	Moderate	Small	Trivial		Don't know
CERTAINTY OF EVIDENCE	Very low	Low	Moderate	High		No included studies
HOW MUCH PEOPLE VALUE THE MAIN OUTCOME	Important uncertainty or variability	Possibly important uncertainty or variability	Probably no important uncertainty or variability	No important uncertainty or variability
BALANCE OF EFFECTS	Favours the Control	Probably favours the Control	Does not favour either the intervention (I) or the comparison (C)	Probably favours the I	Favours the I	Don't know
RESOURCES REQUIRED	Large costs	Moderate costs	Negligible costs and savings	Moderate savings	Large savings	Don't know
CERTAINTY OF EVIDENCE OF REQUIRED RESOURCES	Very low	Low	Moderate	High		No included studies
COST EFFECTIVENESS	Favours the comparison	Probably favours the comparison	Does not favour either the intervention or the comparison	Probably favours the intervention	Favours the intervention	No included studies
EQUITY	Reduced	Probably reduced	Probably no impact	Probably increased	Increased	Don't know
ACCEPTABILITY	No	Probably no	Probably yes	Yes		Don't know
FEASIBILITY	No	Probably no	Probably yes	Yes		Don't know

VIBRATION ON VOLUNTARY STRENGTH PARTIALLY PARALYSED MUSCLES: Randomised Controlled Trial Details
STUDY	COMPARISON	DOSAGE/DETAILS	PARTICIPANTS	N (Rx/C)	OUTCOME	ROB 2 PEDRo
BOSVELD 2015	Whole body vibration on platform V Sham vibration on platform	Whole body Vibration (four 45-second bouts with 1- minute intervening rest periods)	Chronic motor incomplete SCI C2 to T12F	12/12	Maximal isometric quadriceps strength in kg	Some Concerns of Risk of Bias PEDro = 4/10

The Australian and NZ SCI Physiotherapy guideline committee recommends against whole body vibration to improve strength in people with SCI. This is a consensus-based opinion statement supported by the opinions of the experts and one randomised controlled trial related to this topic. The guideline states:

Whole body vibration should not be provided to improve voluntary strength in people with SCI.

This statement was formed by considering the balance between benefits and harms, values and preferences, resource use, equity, accessibility, feasibility and personal experience.

This is a consensus-based opinion statement. Opinion statements are less robust than evidence-based recommendations. They can be strong or weak. This is a strong statement which means that the guideline panel is confident they can not recommend whole body vibration to improve strength based on opinion.

To learn more about the this intervention go to the research summary.

Bosveld R, Field-Fote EC. Single-dose effects of whole body vibration on quadriceps strength in individuals with motor-incomplete spinal cord injury. J Spinal Cord Med. 2015 Nov;38(6):784-91.