Is telehealth as effective as face to face therapy for delivery of whole body vibration training (WBVT) as an adjunct to physiotherapy in children and young people with cystic fibrosis (CF)?

Abstract

Introduction/Aim: An increased life expectancy of individuals with cystic fibrosis (CF), now recognises bone mineral deficits and reduced muscle mass (sarcopenia), as long term health concerns. Importantly, muscle mass has been shown as an independent predictor of bone accrual in individuals with CF. Whole body vibration training (WBVT) has shown a therapeutic impact on bone and muscle response in adults, and some paediatric cohorts, with CF. Our project aimed to demonstrate the utility of telehealthsupported home treatments with WBVT via a model of service delivery which reduces travel time, costs, and negative impacts on quality of life (QOL), while providing an efficacious clinical intervention. Methods: 15 pre-pubertal outpatients with CF, mean age 7.94 ± 1.35 years, were randomised to WBVT (n = 9) or usual care (n = 6, control). Individuals in WBVT cohort performed a 12 week standardised WBVT program (20 minutes, 5 times per week), combined with normal physiotherapy airway clearance. Rreviews either face-to-face (n = 3) or via telehealth (n = 6) were provided over the 12 weeks. The control cohort continued normal physiotherapy airway clearance. Anthropometric data and primary outcome measures of total body lean body mass (LBM) via dual-energy X-ray absorptiometry (DXA) were taken at baseline and 12 weeks. Secondary outcome measures include Cystic Fibrosis Quality of Life Questionnaire-Revised (CFQ-R), spirometry and bone parameters (DXA) were collected at these time points. Results: Baseline data were not different between groups, and while both groups showed increases in height and weight, they were not different between groups. Compared to usual care, over 12 weeks of intervention, the WBVT group showed: increased bone mineral content adjusted for height (P = 0.046) and bone mineral content for the amount of LBM (P = 0.041). Interestingly, upward trends in bone mineral content considered for LBM, fat mass, height and age seen in the WBVT group were not observed in the control group. There were no significant changes in QoL measures for either group. Conclusions: WBVT showed increased lean mass and bone mineral content for the individual's size that may imply a positive functional change in muscle and bone response. Further, the WBVT did not add a burden of care, as indicated by unchanged QoL scores. Our pilot study, with a small sample size, implies physiological changes that warrants further investigation.L6269404802019-04-02 <br />