Pauline Anderson

July 05, 2011

July 5, 2011 (Toronto, Ontario) — Lying in a reclining chair and listening to soothing music has a significant impact on motor symptoms in Parkinson's disease (PD) and on nonmotor symptoms, such as pain, anxiety, and fatigue,

A new study though shows that adding vibration does not increase the benefits seen with music alone.

"The study showed that it was worth sitting in the chair because it did significantly improve these various symptoms according to the rating scales we used, but there was not necessarily a statistically significant improvement of using vibration vs just lying in the chair and listening to the sounds," said the study's lead author, Sachin S. Kapur, MD, Department of Neurological Science, Rush University Medical Center in Chicago, Illinois.

The study results were presented at the Movement Disorder Society (MDS) 15th International Congress of Parkinson’s Disease and Movement Disorders. Senior author is Christopher Goetz, MD, along with coauthor Glenn Stebbins, PhD, both also at Rush.

Idea Not New

The idea that vibration might aid patients with PD dates back to celebrated neurologist Jean-Martin Charcot, who built a chair similar to the one used in this study after some of his patients had reported relief of pain and stiffness, along with improvement of walking and sleep, although not tremor, after long carriage or railway journeys.

In this study, the researcher used a reclining chair that is hooked up to an amplifier through which music is piped. In some chairs, the sound waves generate very strong vibrations through 4 locations on the chair — 2 under the back and 2 under the legs — that some believe travel through the spinal cord to the brain. "The intensity of the vibrations is variable, depending on the intensity of the sound coming through" the headphones, explained Dr. Kapur.

The randomized trial included 20 patients (14 men) with a mean age 64.3 years and mean duration of PD of 6.05 years. Half the patients had just the music therapy, which involved listening to nature-based sounds, such as flowing water and animals, and the other half had the music therapy plus the vibrations.

Baseline Unified Parkinson Disease Rating Scale (UPDRS) was 38.15. The MDS UPDRS motor scores were not significantly different between the 2 groups at baseline (36.1 for the vibration group vs 40.2 for the no vibration group; P = .33).

Subjects had one 30-minute session of the therapy in the clinic setting and then were set up with the chair at home and instructed to receive the therapy for 30 minutes a day for 4 weeks.

Motor Improvement

At the end of the trial, there was a significant improvement in UPDRS Part III (motor scale) score for all patients (5.5 points for the vibration group and 3.6 points for no vibration group), although the difference was not significant between groups.

There was also significant improvement in MDS UPDRS Part I (nonmotor aspects of daily living) and in depression, anxiety, fatigue, and nighttime sleep in both groups. Again, there were no significant differences between the groups.

"The therapy will help symptoms of anxiety and, if you're having trouble sleeping at night, it may help that as well," said Dr. Kapur. "These are 2 very common complaints of people with Parkinson's disease, so if it can only help those 2, it will have a great benefit."

The lack of significant added benefit of the vibrations was not necessarily due to a small sample size. "We actually did some statistical analysis and found that having more patients would not necessarily have helped that much," said Dr. Kapur.

Some patients in the study said they liked the vibrations, and some who were not in the vibration group wanted to experience it, said Dr. Kapur.

Cold Hard Facts

The vibration therapy recently received widespread exposure in the lay press, with Dr. Kapur getting up to 15 calls a day from interested patients during the peak of media interest. "But when you look at the cold hard facts," he says, the vibrations don't add anything of significance.

Costs for the study were absorbed "in house" at his institution, although the chairs were provided free of charge by the company. The model of chair used in the study (available through NexNeuro LLC) retails for more than $2000. Similar chairs are used as a therapy for multiple sclerosis and in sports medicine, geriatrics, and other specialties, said Dr. Kapur.

Although some of his colleagues have expressed skepticism about the vibration therapy, he said, many are curious. "There are not many treatments that are nonmedical in terms of not being a medication that are completely noninvasive, so this alternative form of therapy had a lot of people interested in it, but what to actually do with it is the question."

Asked to comment, Dr. Anthony Lang, Jack Clark Chair at the University of Toronto Centre for Research in Neurodegenerative Disease and senior scientist, Division of Patient Based Clinical Research, Toronto Western Research Institute, Ontario, said in an email to Medscape Medical News that although the study was interesting, "it's almost impossible to control for a placebo effect."

Movement Disorder Society (MDS) 15th International Congress of Parkinson's Disease and Movement Disorders: Abstract 391. Presented June 9, 2011.

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