Vibration as an exercise modality: how it may work, and what its potential might be. Eur J Appl Physiol. 2010;108:877-904. [PMID: 20012646 DOI: 10.1007/s00421-009-1303-3]

Does whole-body vibration training have a positive effect on balance and walking function in patients with stroke? A meta-analysis

Objective

After a stroke, patients usually suffer from dysfunction, such as decreased balance ability, and abnormal walking function. Whole-body vibration training can promote muscle contraction, stimulate the proprioceptive system, enhance the muscle strength of low limbs and improve motor control ability. The study aims to evaluate the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke.

Methods

PubMed, CNKI, VIP, CBM, EBSCO, Embase and Web of Science were searched. According to the inclusion and exclusion criteria, randomized controlled trials on the effectiveness of whole-body vibration training on the balance and walking function of patients with stroke were collected. The search time ranged from the date of database construction to November 2022. The included trials were evaluated by the Cochrane risk-of-bias tool. The meta-analysis was performed using two software packages, consisting of RevMan 5.4 and Stata 12.2. If the results included in the literature were continuous variables, use the mean difference (MD) and 95% confidence interval (CI) for statistics.

Results

(1) A total of 22 randomized controlled trials (RCTs) with a total of 1089 patients were included. (2) The results of meta-analysis showed that: compared with the controls, step length (MD = 6.12, 95%CI [5.63, 6.62], p < 0.001), step speed (MD = 0.14, 95%CI [0.09, 0.20], p < 0.001), cadence (MD = 9.03, 95%CI [2.23, 15.83], p = 0.009), stride length (MD = 6.74, 95%CI [-3.47, 10.01], p < 0.001), Berg Balance Scale (BBS) (MD = 4.08, 95%CI [2.39, 5.76], p < 0.001), Timed Up-and-Go test (TUGT) (MD = -2.88, 95%CI [-4.94, 0.81], p = 0.006), 10-meter Walk Test (10MWT) (MD = -2.69, 95%CI [-3.35, -2.03], p < 0.001), functional ambulation category scale (FAC) (MD = 0.78, 95%CI [0.65, 0.91], p < 0.001), Fugl-Meyer motor assessment of lower extremity (FMA-LE) (MD = 4.10, 95%CI [2.01, 6.20], p = 0.0001). (3) The results of subgroup analysis showed that, compared with other vibration frequencies, at 20-30 Hz frequency, WBV training had an obvious improvement effect only in TUGT. (4) The safety analysis showed that WBV training may be safe.

Conclusion

Whole-body vibration training has a positive effect on the balance and walking function of patients with stroke. Thus, whole-body vibration training is a safe treatment method to improve the motor dysfunction of patients with stroke.

Systematic review registration

[http://www.crd.york.ac.uk/PROSPERO], identifier [CRD4202348263].

Vibration therapy in young children with mild to moderate cerebral palsy: does frequency and treatment duration matter? A randomised-controlled study

BACKGROUND

Vibration therapy (VT) has been increasingly studied in children with cerebral palsy (CP) over the last years, however, optimal therapeutic VT protocols are yet to be determined. The present study compared the effects of side-alternating VT protocols varying in frequency and treatment duration on the health of young children with mild-to-moderate CP.

METHODS

Thirty-four participants aged 6.0 to 12.6 years with CP acted as their own controls and underwent two consecutive study periods: a 12-week lead-in (control) period prior to the intervention period of 20-week side-alternating VT (9 min/session, 4 days/week), with the frequency either 20 Hz or 25 Hz, determined by randomisation. Participants had 4 assessment visits: baseline, after the control period, after 12-week VT (12VT), and after further 8 weeks of VT (20VT). Assessments included 6-minute walk test (6MWT); dual-energy x-ray absorptiometry; gross motor function; muscle function testing on the Leonardo mechanography plate and by hand-held dynamometry, and a quality-of-life questionnaire (CP QOL). Analysis was carried out using linear mixed models based on repeated measures.

RESULTS

Side-alternating VT was well-tolerated, with occasional mild itchiness reported. The median compliance level was 99%. VT led to improvements in 6MWT (+ 23 m; p = 0.007 after 20VT), gross motor function in standing skills (+ 0.8 points; p = 0.008 after 12VT; and + 1.3 points; p = 0.001 after 20VT) and in walking, running and jumping skills (+ 2.5 points; p < 0.0001 after 12VT; and + 3.7 points; p < 0.0001 after 20VT), spine bone mineral density z-score (+ 0.14; p = 0.015 after 20VT), velocity rise maximum of the chair rising test (+ 0.14 m/s; p = 0.021 after 20VT), force maximum of the single two-leg jump test (+ 0.30 N/kg; p = 0.0005 after 12VT; and + 0.46 N/kg; p = 0.022 after 20VT) and in the health module of CP QOL (+ 7 points; p = 0.0095 after 20VT). There were no observed differences between the two VT frequencies (i.e., 20 Hz vs 25 Hz) on study outcomes.

CONCLUSIONS

The study confirms that side-alternating VT has positive effects on mobility, gross motor function, body composition, muscle function, and quality of life, independent of VT frequencies tested. Long-term, 20VT appears to be a more efficient treatment duration than a short-term, 12VT.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12618002026202 ; 18/12/2018.

Effect of whole-body vibration on neuromuscular activation and explosive power of lower limb: A systematic review and meta-analysis

OBJECTIVE

The review aimed to investigate the effects of whole-body vibration (WBV) on neuromuscular activation and explosive power.

METHODS

Keywords related to whole-body vibration, neuromuscular activation and explosive power were used to search four databases (PubMed, Web of Science, Google Scholar and EBSCO-MEDLINE) for relevant studies published between January 2000 and August 2021. The methodology of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. The eligibility criteria for the meta-analysis were based on PICOST principles. Methodological assessment used the Cochrane scale. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. The WBV training cycle is a random effect model. Publication bias was also assessed based on funnel plots. This study was registered in PROSPERO (CRD42021279439).

RESULTS

A total of 156 participants data in 18 studies met the criteria and were included in the meta-analysis for quantitative synthesis. Results of the meta-analysis showed significant improvements in lower limb neuromuscular activation immediately after WBV compared with the baseline (SMD = 0.51; 95% CI: 0.26, 0.76; p<0.001), and no significant heterogeneity was observed (I2 = 38%, p = 0.07). In addition, the highest increase in lower limb explosive power was observed (SMD = 0.32; 95% CI: 0.11, 0.52; p = 0.002), and no significant heterogeneity (I2 = 0%, p = 0.80) was noted.

CONCLUSIONS

WBV training could improve neuromuscular activation and explosive power of the lower limb. However, due to different vibration conditions, further research should be conducted to determine standardized protocols targeting performance improvement in athletes and healthy personnel experienced in training.

Whole-Body Vibration or Aerobic Exercise in Patients with Bronchiectasis? A Randomized Controlled Study

Background and Objectives: The whole-body vibration (WBV) technique is an exercise training method. It has been reported to improve muscle strength, exercise capacity, and the quality of life. However, there is no study on the use of the WBV technique in bronchiectasis. The aim of the present study is to compare the effect of aerobic exercise with whole-body vibration on exercise capacity, respiratory function, dyspnea, and quality of life (QoL) in bronchiectasis patients. Materials and Methods: Clinically stable bronchiectasis patients aged 18−74 years participated in this study. A pulmonary function test, 6 minute walk test (6MWT), five times sit-to-stand test (FTSST), Modified Medical Research Council (mMRC) Scale, an, St. Georges Respiratory Questionnaire (SGRQ) were used in the evaluation. In total, 41 patients (WBV group: 20, aerobic group: 21) completed the study. The patients were treated for eight weeks. Results: When the two groups were compared after the treatment, there was a significant difference between the mMRC scores in favor of the WBV group (p < 0.05). When the results of the WBV group were examined before and after treatment, a significant difference was found between the 5SST and 6MWT (p < 0.05). When the aerobic group was compared before and after the treatment, it was observed that there was a significant difference in FVC, FVC%, 5SST, 6MWT, and SGRQ total score, and activity and impact scores, which are the sub-parameters (p < 0.05). Conclusions: Eight weeks of WBV exercise can lead to significant improvements in patients with bronchiectasis, exercise capacity, and dyspnea. Larger studies are needed to define the optimal intensity and duration of WBV, as well as to investigate its possible long-term effects.

Focal vibration of the plantarflexor and dorsiflexor muscles improves poststroke spasticity: a randomized single-blind controlled trial

BACKGROUND

Post-stroke spasticity is a cause of gait dysfunction and disability. Focal vibration (FV) of agonist-antagonist upper limb muscle pairs reduces flexor spasticity; however, its effects on ankle plantarflexor spasticity are uncertain.

OBJECTIVE

To assess the effects of focal vibration administered by a trained operator to the ankle plantarflexor and dorsiflexor muscles on post-stroke lower limb spasticity.

METHODS

A randomized, single-blind controlled trial of 64 participants with stroke and plantarflexor spasticity assigned to 3 groups by centralized, computer-generated randomization (1:1:1): 1) physiotherapy alone (CON), 2) physiotherapy+gastrocnemius vibration (FV_GM) and 3) physiotherapy+tibialis anterior vibration (FV_TA). Physiotherapists and assessors were blinded to group assignment. The experimental groups underwent 15, 20-min vibration sessions at 40 Hz. We performed evaluations at baseline and after the final treatment: Modified Ashworth Scale (MAS), Clonus scale, Functional Ambulation Categories (FAC), Fugl-Meyer Assessment - Lower Extremity (FMA_LE), Modified Barthel Index (MBI), and electromyography and ultrasound elastography. Primary outcome was remission rate (number and proportion of participants) of the MAS.

RESULTS

MAS remission rate was higher in FV_GM and FV_TA than CON groups (CON vs. FV_GM: p=0.009, odds ratio 0.15 [95% confidence interval 0.03-0.67]; CON vs. FV_TA: p=0.002, 0.12 [0.03-0.51]). Remission rate was higher in the experimental than CON groups for the Clonus scale (CON vs. FV_GM: p<0.001, OR 0.07 [95% CI 0.01-0.31]; CON vs. FV_TA: p=0.006, 0.14 [95% CI 0.03-0.61]). FAC remission rate was higher in the FV_TA than the CON (p=0.009, 0.18 [0.05-0.68]) and FV_GM (p=0.014, 0.27 [0.07-0.99]) groups. Ultrasound variables of the paretic medial gastrocnemius decreased more in FV_GM than CON and FV_TA groups (shear modulus: p=0.006; shear wave velocity: p=0.008).

CONCLUSIONS

Focal vibration reduced post-stroke spasticity of the plantarflexor muscles. Vibration of the tibialis anterior improved ambulation more than vibration of the gastrocnemius or physiotherapy alone. Gastrocnemius vibration may reduce spasticity by changing muscle stiffness.

Effects of whole body vibration exercise combined with weighted vest in older adults: a randomized controlled trial

BACKGROUND

To evaluate the training effects of whole body vibration (WBV) combined with weighted vest (WV) in older adults.

METHODS

This randomized controlled trial study was conducted in healthy older adults living in the community. Fifty-one participants were randomly allocated into 3 groups: group 1 (n = 17), WBV alone, training on WBV at a frequency 30 Hz, amplitude 2 mm, 10 sets of 1 min squats, with 60 s rest, group 2 (n = 15), WV alone, squat exercise, 10 sets of 1 min, with 60 s rest, while WV loaded with 10% body weight and group 3 (n = 19), WBV + WV, combining WBV exercise with the addition of a WV. All groups completed training 3 times per week for 8 weeks. The outcomes were total muscle mass, muscle thickness, maximal isometric strength, single-leg-stance and timed-up-and-go evaluated at baseline and after training.

RESULTS

As a result of training all groups improved their isometric muscle strength with little difference between groups. The single-leg-stance significantly improved only in WBV + WV group 25.1 ± 10.8 s (mean ± 95% CI, p < 0.01). The timed-up-and-go improved in all groups, but the improvement was significantly greater in the WBV + WV group (17.5 ± 6.9%) compared to the WV (8.5 ± 3.2%) and WBV groups (9.2 ± 5.4%, p = 0.043, 0.023 respectively). Rectus femoris muscle thickness and total muscle mass were significantly increased in all groups equally with little difference between groups.

CONCLUSION

The combined WBV + WV had a greater effect on the single-leg-stance and the timed-up-and-go compared to WV or WBV alone.

TRIAL REGISTRATION

TCTR20190306001. Thai Clinical Trials Registry ( www.thaiclinicaltrials.org ). Date of registration: 6 March 2019.

Non-Invasive Pulsatile Shear Stress Modifies Endothelial Activation; A Narrative Review

The monolayer of cells that line both the heart and the entire vasculature is the endothelial cell (EC). These cells respond to external and internal signals, producing a wide array of primary or secondary messengers involved in coagulation, vascular tone, inflammation, and cell-to-cell signaling. Endothelial cell activation is the process by which EC changes from a quiescent cell phenotype, which maintains cellular integrity, antithrombotic, and anti-inflammatory properties, to a phenotype that is prothrombotic, pro-inflammatory, and permeable, in addition to repair and leukocyte trafficking at the site of injury or infection. Pathological activation of EC leads to increased vascular permeability, thrombosis, and an uncontrolled inflammatory response that leads to endothelial dysfunction. This pathological activation can be observed during ischemia reperfusion injury (IRI) and sepsis. Shear stress (SS) and pulsatile shear stress (PSS) are produced by mechanical frictional forces of blood flow and contraction of the heart, respectively, and are well-known mechanical signals that affect EC function, morphology, and gene expression. PSS promotes EC homeostasis and cardiovascular health. The archetype of inducing PSS is exercise (i.e., jogging, which introduces pulsations to the body as a function of the foot striking the pavement), or mechanical devices which induce external pulsations to the body (Enhanced External Pulsation (EECP), Whole-body vibration (WBV), and Whole-body periodic acceleration (WBPA aka pGz)). The purpose of this narrative review is to focus on the aforementioned noninvasive methods to increase PSS, review how each of these modify specific diseases that have been shown to induce endothelial activation and microcirculatory dysfunction (Ischemia reperfusion injury-myocardial infarction and cardiac arrest and resuscitation), sepsis, and lipopolysaccharide-induced sepsis syndrome (LPS)), and review current evidence and insight into how each may modify endothelial activation and how these may be beneficial in the acute and chronic setting of endothelial activation and microvascular dysfunction.

Whole-body vibration provides additional benefits to patients with patellofemoral pain: A protocol for systematic review and meta analysis of randomized controlled trials

BACKGROUND

The efficacy of the whole-body vibration (WBV) training for patients with patellofemoral pain (PFP) remains controversial. For this reason, we applied a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of WBV training in patients with PFP.

METHODS

Relevant studies found within PubMed, EMBASE, the Cochrane Library and Web of Science were examined from January 1, 1990 to December 30, 2021. Two evaluators independently screened the literatures, extracted relevant data and assessed the methodological quality of respective studies. Meta-analysis was conducted using RevMan 5.4 software.

RESULTS

A total of 5 RCTs with 174 patients were included. When comparing with exercise alone, WBV training in combination with exercise provided better reduction of pain assessed by visual analogue scale score (P = .04). There were no differences regarding changes of Kujala patellofemoral score, the physical component summary score for physical health, and the mental component summary score for mental health (P = .08, 0.76, 0.65 respectively) between patients with WBV training and those without WBV training.

CONCLUSIONS

Compared to the sole performance of exercise, WBV training in combination with exercise showed better pain reduction, but no superior improvement in function and on quality of life.

Effect of stabilization exercise combined with respiratory resistance and whole body vibration on patients with lumbar instability: A randomized controlled trial

BACKGROUND

Lumbar stability exercise promotes deep muscle functions, and it is an effective intervention method for increasing proprioceptive sensation. This study aims to explore and compare the effects of lumbar stability exercise with respiratory resistance and whole body vibration on patients with lumbar instability.

METHODS

This study is a 3-group randomized control trial. Through screening tests, 48 patients with lumbar instability were selected and randomly assigned to SE group (n = 16), stabilization exercise program using respiratory resistance (SER) group (n = 16), and stabilization exercise program using respiratory resistance and whole body vibration (SERW) group (n = 16). In order to compare the effects depending on the intervention methods, quadruple visual analogue scale (QVAS), Functional Ability Roland-Morris low back pain and disability questionnaire ([RMDQ], center of pressure path length, velocity, and area), Korean version of fear-avoidance beliefs questionnaire, and Pulmonary Function were used for measurement.

RESULTS

All of the groups showed significant improvements in QVAS, RMDQ, Korean version of fear-avoidance beliefs questionnaire, and balance abilities before and after the interventions. The SER group and SERW group showed a significant difference in QVAS and RMDQ than the SE group (P < .05). In addition, balance ability showed a significant difference in SERW group (P < .05), where only the SER group showed a significant difference in pulmonary function indexes including forced vital capacity, forced expiratory volume in 1 second, maximum inspiratory pressure, and maximum expiratory pressure (P < .05).

CONCLUSION

Stabilization exercise program using respiratory resistance and whole-body vibration administered according to the purpose of intervention methods may be effective exercise programs for people with lumbar instability.

Inflammatory Biomarker Responses to Whole-Body Vibration in Subjects with Different Clinical Status: A Systematic Review

BACKGROUND

Inflammation is considered to be a vital defense mechanism for health, acting as a protective response of the immune system through a satisfactory inflammatory biomarker response (IBR). IBR, as well as being beneficial to the organism, can be also responsible for a variety of chronic inflammatory diseases. Whole-body vibration (WBV) exercise is a type of physical exercise that can act on inflammation responses due its capacity for stimulating the sensory components that promote systemic responses. The objective of this study was to investigate the effects of WBV on IBR in different clinical status.

METHODS

This is a systematic review that includes randomized controlled trials (RCTs) on the effects of WBV exercise on IBR. The methodological quality, risk of bias, and level of evidence were rated.

RESULTS

Four RCTs met the selection criteria. The studies showed benefits associated with IBR (e.g., cytokines, adipokines, and C-reactive protein) in various clinical conditions, including healthy populations and some chronic diseases (such as obesity, aging disorders, and knee osteoarthritis), using several WBV protocols.

CONCLUSIONS

WBV might be useful in the management of inflammatory conditions.

Effects of vibration training on quality of life in older adults: a preliminary systematic review and meta-analysis

PURPOSE

Older adults experience reduced quality of life (QOL). Vibration training has been applied in older adults. However, it remains inconclusive whether vibration training improves QOL in this population. This review summarized the effects of vibration training in changing eight domains of the Short Form-36 (SF-36) among older adults.

METHODS

Five randomized controlled trials enrolling 212 participants were included. The mean difference (MD) was calculated as the effect size measurement. Meta-analyses were completed for each of the eight SF-36 domains.

RESULTS

Relative to control groups, vibration training is more effective in improving five QOL domains: physical function (MD = 15.61, p < 0.001), physical role limitations (MD = 12.71, p = 0.001), general health (MD = 10.59, p < 0.001), social function (MD = 11.60, p < 0.001), and vitality (MD = 6.86, p = 0.002). Vibration training may not lead to greater improvements for the other three domains (MD = 0.13-3.25, p values = 0.21-0.96) than the control groups. Vibration training showed a low attrition rate of 7.1%.

CONCLUSION

Vibration training programs may significantly improve five of eight SF-36 QOL domains. While three domains did not demonstrate significant improvements, results were slightly in favor of vibration training compared to the control groups. More rigorous studies are necessary to further confirm the effectiveness of vibration training on QOL in older adults.

Does the Addition of Whole-Body Vibration Training Improve Postural Stability and Lower Limb Strength During Rehabilitation Following Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis

OBJECTIVES

To investigate whether the addition of whole-body vibration therapy to standard rehabilitation improves postural stability and lower limb strength following anterior cruciate ligament (ACL) reconstruction.

DATA SOURCES

A computer-based literature search of MEDLINE, AMED, SPORTDiscus, Embase, CINAHL, CENTRAL, and Physiotherapy Evidence Database (PEDro) included studies up to October 2019.

MAIN RESULTS

Seven randomised controlled trials of moderate-to-high methodological quality involving 244 participants were included. Meta-analysis found statistically significant improvements in medial-lateral stability [standardized mean difference (SMD) = 0.50; 95% confidence interval (CI), 0.12-0.88] and overall stability (SMD = 0.60; 95% CI, 0.14-1.06) favoring whole-body vibration therapy, but effects were not significant for quadriceps strength (SMD = 0.24; 95% CI, -0.65 to 1.13), hamstring strength (SMD = 0.84; 95% CI, -0.05 to 1.72), lower limb strength (SMD = 0.76; 95% CI, -0.16 to 1.67), or anterior-posterior stability (SMD = 0.19; 95% CI, -0.39 to 0.76).

CONCLUSIONS

The addition of whole-body vibration therapy to standard postoperative rehabilitation following ACL reconstruction does not appear to significantly improve lower limb strength and anterior-posterior stability but may improve medial-lateral and overall postural stability. We found small sample sizes in all included trials, statistical heterogeneity, and methodological quality concerns, including publication bias, suggesting that larger high-quality trials are likely to be influential in this field. Registration: PROSPERO 155531.

Acute effects of quadriceps muscle versus tendon prolonged local vibration on force production capacities and central nervous system excitability

PURPOSE

The present study aimed to directly compare the effects of 30 min muscle (VIB_muscle) vs. tendon (VIB_tendon) local vibration (LV) to the quadriceps on maximal voluntary isometric contraction (MVIC) and rate of torque development (RTD) as well as on central nervous system excitability (i.e. motoneuron and cortical excitability).

METHODS

Before (PRE) and immediately after (POST) LV applied to the quadriceps muscle or its tendon, we investigated MVIC and RTD (STUDY #1; n = 20) or vastus lateralis (VL), vastus medialis (VM) and rectus femoris (RF) electromyography responses to thoracic electrical stimulation (TMEPs; motoneuron excitability) and transcranial magnetic stimulation (MEPs; corticospinal excitability) (STUDY #2; n = 17). MEP/TMEP ratios were further calculated to quantify changes in cortical excitability.

RESULTS

MVIC decreased at POST (P = 0.017) without any difference between VIB_tendon and VIB_muscle, while RTD decreased for VIB_tendon (P = 0.013) but not VIB_muscle. TMEP amplitudes were significantly decreased for all muscles (P = 0.014, P < 0.001 and P = 0.004 for VL, VM and RF, respectively) for both LV sites. While no changes were observed for MEP amplitude, MEP/TMEP ratios increased at POST for VM and RF muscles (P = 0.009 and P = 0.013, respectively) for both VIB_tendon and VIB_muscle.

CONCLUSION

The present results suggest that prolonged muscle and tendon LV are similarly effective in modulating central nervous system excitability and decreasing maximal force. Yet, altered explosive performance after tendon but not muscle LV suggests greater neural alterations when tendons are vibrated.

Effects of vibration training on motor and non-motor symptoms for patients with multiple sclerosis: A systematic review and meta-analysis

Background

Vibration therapy is one of the rehabilitation programs that may be effective in treating both motor and non-motor symptoms in Multiple Sclerosis patients. We conducted a comprehensive systematic review and meta-analysis to assess the effects of vibration therapy on motor and non-motor symptoms (functional mobility, balance, walking endurance, gait speed, fatigue, and quality of life) of this population.

Methods

A systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Physiotherapy Evidence Database, Scopus, Google Search Engine, and the China National Knowledge Infrastructure (CNKI). Two reviewers independently assessed the study quality.

Results

Fourteen studies with 393 participants were finally included in the meta-analysis. The pooled results showed that vibration therapy had a significant advantage over the control intervention in improving balance function [mean difference (MD) = 2.04, 95% confidence interval (CI): 0.24-3.84, P = 0.03], and walking endurance (SMD = 0.34, 95% CI: 0.07-0.61, P = 0.01). Meanwhile, the degree of disability subgroup analysis revealed that the Expanded Disability Status Scale (EDSS) score (3.5-6) significantly improved functional mobility (MD: -1.18, 95% CI: -2.09 to 0.28, P = 0.01) and balance function (MD: 3.04, 95% CI: 0.49-5.59, P = 0.02) compared with the control group, and the EDSS (0-3.5) were more beneficial in walking endurance. The duration subgroup analysis indicated a significant difference in the effect of the duration (<4 weeks) on enhancing walking endurance (SMD: 0.46, 95% CI: 0.04-0.87, P = 0.03). However, no significant improvement was found in functional mobility, gait speed, fatigue, and quality of life.

Conclusion

Vibration therapy may improve balance function and walking endurance, and the degree of disability and duration of intervention may affect outcomes. The evidence for the effects of vibration therapy on functional mobility, gait speed, fatigue, and quality of life remains unclear. More trials with rigorous study designs and a larger sample size are necessary to provide this evidence.

Systematic Review Registration

PROSPERO, https://www.crd.york.ac.uk/prospero/#recordDetails, identifier: CRD42022326852.

Effects of whole body vibration in postmenopausal osteopenic women on bone mineral density, muscle strength, postural control and quality of life: the T-bone randomized trial

Purpose

Osteopenia is common in postmenopausal women and effective interventions increasing or stabilizing bone mineral density (BMD) to prevent fractures are urgently needed.

Methods

Sixty-five postmenopausal women diagnosed with osteopenia (T-score between -1.0 and -2.5) were randomly assigned to either a vibration training group (VT), a resistance training group (RT), or a control group (CG). BMD T-score values (primary endpoint) were assessed at baseline (T0) and after 12 months (T12), secondary endpoints (muscle strength, postural control, and health-related quality of life) at baseline (T0), after 6 months (T6), after 12 months (T12), and as follow-up after 15 months (T15).

Results

After the intervention period, neither the VT nor the RT showed any significant changes in BMD T-score values compared to the CG. Isokinetic strength improved significantly within all training groups, with the exception of the flexors of VT at an angular velocity of 240°/s. Health-related quality of life as well as postural control improved significantly for the RT only.

Conclusions

We conclude that participants of all three groups were able to maintain their BMD. The improvements in quality of life and postural control after resistance training are nevertheless meaningful for postmenopausal osteopenic women and support the importance of regular loadings of the musculoskeletal system.

This study was retrospectively registered in January 2022 at the DRKS (S00027816) as clinical trial.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00421-022-05010-5.

Mapping the Hot Spots and Evolution Main Path of Whole-Body Vibration Training Since the 21st Century: A Bibliometric Analysis

To evaluate the global scientific output of the research on whole-body vibration training (WBVT) and explore the current status and trends in this field over the past decades using bibliometric methods, we retrieved the literature related to WBVT from 2000 to the present in the Web of Science Core Collection (WoSCC). We analyzed annual publications, citations, countries, organizations, productive authors, and source 14 journals by the Web of Science online bibliometric analysis. We visualized the WBVT research trends and explored influential organizations and authors through VOSviewer. Then, we constructed a citation chronology map by HistCite to obtain the knowledge base of this field and made a primary citation path analysis by Pajek. Finally, we mined the hot spots of WBVT by BICOMB and gCLUTO. Overall, there were 1,629 publications included in this study between 2000 and 2022. The United States contributed the most publications in this field, and the country with the most active partnership was Spain. The University of Cologne ranked highest among top productive organizations. Bernardo-Filho, Mario, from Universidade do Estado do Rio de Janeiro, ranked first among the top productive authors. The Journal of Strength and Conditioning Research topped the list of journals with the most publications on WBVT by a wide margin. The WBVT research field started from Rittweger’s study on the acute physiological effects of WBVT in 2000, which was divided into two stages. The first stage focused on improving athletic ability, and the second stage gradually turned to the application in medicine. A keyword analysis showed the exercise rehabilitation of several aging chronic diseases was the research trend and hot spot of WBVT. The current study provided a time-based development and a global network hub for WBVT research, contributing to identifying core target diseases of WBVT and providing various insights for researchers in the future.

Beneficial effects of whole-body vibration exercise for brain disorders in experimental studies with animal models: a systematic review

Brain disorders have been a health challenge and is increasing over the years. Early diagnosis and interventions are considered essential strategies to treat patients at risk of brain disease. Physical exercise has shown to be beneficial for patients with brain diseases. A type of exercise intervention known as whole-body vibration (WBV) exercise gained increasing interest. During WBV, mechanical vibrations, produced by a vibrating platform are transmitted, to the body. The purpose of the current review was to summarize the effects of WBV exercise on brain function and behavior in experimental studies with animal models. Searches were performed in EMBASE, PubMed, Scopus and Web of Science including publications from 1960 to July 2021, using the keywords "whole body vibration" AND (animal or mice or mouse or rat or rodent). From 1284 hits, 20 papers were selected. Rats were the main animal model used (75%) followed by mice (20%) and porcine model (5%), 16 studies used males species and 4 females. The risk of bias, accessed with the SYRCLE Risk of Bias tool, indicated that none of the studies fulfilled all methodological criteria, resulting in possible bias. Despite heterogeneity, the results suggest beneficial effects of WBV exercise on brain functioning, mainly related to motor performance, coordination, behavioral control, neuronal plasticity and synapse function. In conclusion, the findings observed in animal studies justifies continued clinical research regarding the effectiveness and potential of WBV for the treatment of various types of brain disorders such as trauma, developmental disorders, neurogenetic diseases and other neurological diseases.

A Comparison of the Effects of Stochastic Resonance Therapy, Whole-Body Vibration and Balance Training on Pain Perception and Sensorimotor Function in Patients with Chronic Non-Specific Neck Pain: Protocol for a Randomized Controlled Trial

Background

Neck pain is a prevalent pathological condition, and together with low back pain, it presents as the leading cause of years lived with disability worldwide in 2015 and continues to contribute substantially to the global burden of disease.

Objective

This study will investigate and compare the effects of stochastic resonance therapy (SRT), whole-body vibration (WBV), and balance training (BLT) in the management of chronic nonspecific neck pain.

Methods

In total, 45 participants with chronic neck pain will be randomly allocated into SRT, WBV, and BLT groups. Pain intensity, pressure pain threshold, neck disability, and cervical joint position sense will be measured before, immediately after, and 15 minutes after the first intervention session and after 4 weeks of intervention. A follow-up postintervention measurement would be taken after 4 weeks. The SRT group will train on an SRT device (SRT Zeptor Medical plus noise, Zeptoring). The WBV group will train on a Galileo vibration device (Novotec Medical), while the BLT group will perform balance exercises. All participants shall train 3 times a week for a period of 4 weeks. Mixed ANOVA will be used to determine the main and effects of interactions within (before intervention, post intervention 1, post intervention 2, post intervention 3, and follow-up) and between (SRT, WBV, and BLT) factors on the study outcome variables.

Results

Recruitment of participants started in May 2021, and as of May 2022, a total of 20 patients have been enrolled in the study. All participants are expected to have completed the trial by the end of 2022, and data analysis will commence thereafter.

Conclusions

The outcome of this study will shed closer light on the effects of SRT, WBV, and BLT on pain and function in patients with chronic neck pain.

Trial Registration

German Clinical Trials Register DRKS00023881; https://tinyurl.com/ycxuhj37

International Registered Report Identifier (IRRID)

DERR1-10.2196/34430

Whole-body vibration training for inpatient children and adolescents receiving chemotherapy for first cancer diagnosis: an exploratory feasibility study

Whole-body vibration (WBV) is a feasible and potentially beneficial exercise strategy for managing neuromuscular impairments like decreased strength or flexibility, mobility limitations and bone health in pediatric cancer survivors. However, as starting rehabilitation as early as possible is recommended to preserve physical function, this study investigated the feasibility of WBV for patients receiving cancer treatment for first cancer diagnosis. Eleven patients (various types of cancer, ages 7–17) participated in the supervised WBV intervention concomitant to acute cancer treatment, which involved chemotherapy. Training was implemented as part of a general exercise program and offered 3 days per week during hospitalization (warm-up, four progressive training exercises comprising 60–120 s, 21–27 Hz, 2 mm peak-to-peak-displacement). Feasibility, which was defined as the absence of WBV-related serious adverse events leading to study dropout, was primarily evaluated. Training documentation was additionally analyzed. As a main result, no serious adverse events leading to study dropout were reported. However, two incidents of bleeding (adverse events) were observed in patients with bleeding tendencies and low platelets (thrombocytes < 30,000/μL). After adjusting the platelet count threshold for WBV participation to 30,000/μL, no further incidents occurred. Moreover, due to WBV-related side effects like physical exhaustion, 11% of all training sessions had to be stopped and another 11% required reductions in the vibration load. Patients participated in 48% of the planned sessions. While main reasons for non-attendance were medical issues (35%), only few WBV sessions were missed, not completed or needed modifications due to motivational issues. Consequently, WBV seems to be feasible for inpatient pediatric patients receiving chemotherapy for first cancer diagnosis, given a sufficiently high platelet count of at least 30,000/μL. Although WBV tolerance and training motivation appear high, patient’s reduced medical condition during hospitalization can negatively impact training progression and attendance. Future research is required to confirm our findings on feasibility and to assess efficiency of WBV training for pediatric cancer patients receiving cancer treatment.

Effects of Low-Frequency Whole-Body Vibration on Muscle Activation, Fatigue, and Oxygen Consumption in Healthy Young Adults: A Single-Group Repeated-Measures Controlled Trial

CONTEXT

Whole-body vibration (WBV) training improves muscle strength and balance. Few studies have focused on the effects of WBV frequencies below 30 Hz. We aimed to investigate the effect of low-frequency WBV training on muscle activity, fatigue recovery, and oxygen consumption (VO2).

DESIGN

Prospective single-group, repeated-measures study.

METHODS

In this controlled laboratory setting study, 20 healthy adults (age 23.26 [1.66] y) performed half squats at 0, 4, 6, 8, 12, 16, 20, 24, and 30-Hz WBV. Muscle activity was evaluated using the root mean square and peak electromyography amplitude of 6 muscles (iliocostalis, rectus abdominis, rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius) obtained via surface electromyography. VO2 was measured during the squats using a gas analyzer, and fatigue recovery was evaluated using measurements of lactate after the squats and after a recovery period. Statistical significance was set at P < .05, and analysis of variance was conducted to determine differences in muscle activity, fatigue, recovery, and VO2, with post hoc analyses as appropriate.

RESULTS

Of the 6 muscles measured, the muscle activity of the gastrocnemius alone significantly increased from 0 Hz at 4, 8, 12, 16, 24, and 30 Hz based on the root mean square values and at 4, 8, 12, and 30 Hz based on the peak electromyography amplitude values. There were no significant differences in the other muscles. There were no significant differences in VO2 or in lactate levels.

CONCLUSIONS

Low-frequency WBV during squat exercises significantly increased the activity of the gastrocnemius medialis only at specific frequencies in healthy young adults. Low-frequency WBV is safe and has the potential to increase muscle activity.

The effect of whole body vibration on sensorimotor deficits in people with chronic ankle instability: A systematic review and meta-analysis

OBJECTIVE

To investigate the effects of whole body vibration on chronic ankle instability-associated sensorimotor deficits in balance, strength, joint position sense and muscle activity.

DATA SOURCES

Electronic databases including Cochrane Library, PubMed, Embase, Web of Science, EBSCO, China National Knowledge Infrastructure and WanFang were searched from database inception up to 31 March 2022.

METHODS

The risk of bias and methodological quality of included studies were assessed using the Cochrane tool and Physiotherapy Evidence Database (PEDro) scale respectively. Standardized mean difference (SMD) and mean differences (MD) with 95% confidence interval (CI) were calculated using the RevMan 5.3 software. Meta-regression was conducted with Stata 16.

RESULTS

Eight studies, with 315 subjects were eventually included in this review with an average PEDro score of 6.1/10. Significant effects of whole body vibration on balance (SMD = 0.61, 95% CI: 0.12 to 1.09, P = 0.01), and on the posterolateral direction (MD = 5.52, 95% CI: 1.02 to 10.01, P = 0.02) and medial direction (MD = 3.90, 95% CI: 0.87 to 6.94, P = 0.01) of the star excursion balance test were found. Whole body vibration significantly improved the peak torque (SMD = 0.36, 95% CI: 0.04 to 0.69, P = 0.03), joint position sense (SMD = 0.60, 95% CI: 0.10 to 1.11, P = 0.02), and muscle activity in tibialis anterior (SMD = 0.46, 95% CI: 0.04 to 0.88, P = 0.03) and gastrocnemius (SMD = 0.68, 95% CI: 0.14 to 1.23, P = 0.01).

CONCLUSIONS

The current evidence supports the use of whole body vibration to improve sensorimotor deficits involving balance, strength, joint position sense, and muscle activity in people with chronic ankle instability.

Whole-Body Vibration Effects on Flexibility in Artistic Gymnastics—A Systematic Review

It is well documented that whole body-vibration training has effects on muscle strength and flexibility, blood circulation, decreases pain perception and strengthens bone and tendon. Although whole body-vibration has benefits in athletes’ flexibility, we are not sure what its actual effects are in artistic gymnastics (since they already have stunning flexibility). Hence, the aim of this study was to analyse the studies on whole-body vibration in artistic gymnastics and to present the effects on flexibility. The search and analysis were carried out in accordance with PRISMA guidelines. The databases search (PubMed, Scopus, Google Scholar, Cochrane Library, ProQuest, EBSCOhost and Science Direct) yielded 18,057 potential studies. By the given inclusion criteria (studies from 2005 to 2022; full-text published in English; the study included male and female gymnasts as samples, and that participants were tested for evaluation of flexibility by whole-body vibration method), a total of 9 full-text studies were included, with a total of 210 participants, both male and female. As far as the measured flexibility tests conducted, front split, sit and reach and bridge were evaluated, while obtained results were 9.1–39.1%, 2.79–6.7%, 6.43–7.45%, respectively. All studies have conducted same vibration frequency (30 Hz) with same amplitude of displacements (2 mm), except for the one study who did not show the information of implemented amplitude. After analysing the obtained results, it can be concluded that the usage of whole-body vibration platform shows flexibility improvements in artistic gymnasts, both male and female. In addition, a combination of whole-body vibration and traditional static stretching may enhance the flexibility in artistic gymnasts. However, these results should be taken with caution. Since this review did not reveal the optimal vibrational protocol, it is necessary to invest time during the implementation of various vibrational experimental protocols, so future research is required.

Effect of semi-recumbent vibration exercise on muscle outcomes in older adults: a pilot randomized controlled clinical trial

Background

Many older adults with physical limitations living in residential care apartments are unable to exercise in a standing position and are at risk for declining in muscle function leading to falls and injury. Novel approaches to achieve exercise benefits are needed. The purpose of this study was to test the effect of semi-recumbent vibration exercise on muscle outcomes in older adults living in residential care apartment complexes (RCACs).

Methods

A randomized, crossover design was used to examine the effect of semi-recumbent vibration exercise on muscle function and mass among 32 RCAC residents (mean age 87.5 years) with physical limitations. Participants received a randomized sequence of two study conditions: sham or vibration for 8 weeks each separated by a 4-week washout. Before and after the 8 weeks of vibration treatment and sham treatment, muscle mechanography was used to assess muscle function including jump power, weight-corrected jump power, and jump height. Short physical performance battery (SPPB) and handgrip strength were also used to measure muscle function. Bioelectrical impedance spectroscopy was used to estimate skeletal muscle mass. The effect of the vibration treatment on muscle outcomes was analyzed through mixed effects linear regression models.

Results

Vibration exercise leads to better jump height (p < .05) compared to sham exercise but also poorer chair rise performance (p = 0.012). Other muscle functions tests and muscle mass parameters showed non-significant changes.

Conclusion

This small pilot study showed no conclusive results on the effect of semi-recumbent vibration exercise on muscle function and mass in older adults living in RCAC. However, the promising signals of improved jump performance could be used to power larger studies of longer duration with various vibration doses to determine the benefit of vibration exercise in this physically impaired, high-risk population with few exercise capabilities.

Trial registration

The study is registered at clinicaltrials.gov (NCT02533063; date of first registration 26/08/2015).

Characterisation of the transient mechanical response and the electromyographical activation of lower leg muscles in whole body vibration training

The aim of this study is to characterise the transient mechanical response and the neuromuscular activation of lower limb muscles in subjects undergoing Whole Body Vibration (WBV) at different frequencies while holding two static postures, with focus on muscles involved in shaping postural responses. Twenty-five participants underwent WBV at 15, 20, 25 and 30 Hz while in hack squat or on fore feet. Surface electromyography and soft tissue accelerations were collected from Gastrocnemius Lateralis (GL), Soleus (SOL) and Tibialis Anterior (TA) muscles. Estimated displacement at muscle bellies revealed a pattern never highlighted before that differed across frequencies and postures (p < 0.001). After stimulation starts, muscle oscillation peaks, drops and further stabilises, suggesting the occurrence of a neuromuscular activation to reduce the vibration-induced oscillation. The oscillation attenuation at the SOL muscle correlated with its increased activation (rho = 0.29, p < 0.001). Furthermore, only specific WBV settings led to a significant increase in muscle contraction: WBV-induced activation of SOL and GL was maximal in fore-feet (p < 0.05) and in response to higher frequencies (30 Hz vs 15 Hz, p < 0.001). The analysis of the mechanical dynamics of lower leg muscles highlights a resonant response to WBVs, that for the SOL correlates to the increased muscle activation. Despite differing across frequencies and postures, this resonant behaviour seems to discourage the use of dynamic exercises on vibrating platforms. As for the most efficient WBV combination, calf muscle response to WBVs is maximised if those muscles are already pre-contracted and the stimulation frequencies are in the 25–30 Hz range.

A scoping review of the contralateral effects of unilateral peripheral stimulation on neuromuscular function

It is known that resistance exercise using one limb can affect motor function of both the exercised limb and the unexercised contralateral limb, a phenomenon termed cross-education. It has been suggested that cross-education has clinical implications, e.g. in rehabilitation for orthopaedic conditions or post-stroke paresis. Much of the research on the contralateral effect of unilateral intervention on motor output is based on voluntary exercise. This scoping review aimed to map the characteristics of current literature on the cross-education caused by three most frequently utilised peripheral neuromuscular stimulation modalities in this context: electrical stimulation, mechanical vibration and percutaneous needling, that may direct future research and translate to clinical practice. A systematic search of relevant databases (Ebsco, ProQuest, PubMed, Scopus, Web of Science) through to the end of 2020 was conducted following the PRISMA Extension for Scoping Review. Empirical studies on human participants that applied a unilateral peripheral neuromuscular stimulation and assessed neuromuscular function of the stimulated and/or the unstimulated side were selected. By reading the full text, the demographic characteristics, context, design, methods and major findings of the studies were synthesised. The results found that 83 studies were eligible for the review, with the majority (53) utilised electrical stimulation whilst those applied vibration (18) or needling (12) were emerging. Although the contralateral effects appeared to be robust, only 31 studies claimed to be in the context of cross-education, and 25 investigated on clinical patients. The underlying mechanism for the contralateral effects induced by unilateral peripheral stimulation remains unclear. The findings suggest a need to enhance the awareness of cross-education caused by peripheral stimulation, to help improve the translation of theoretical concepts to clinical practice, and aid in developing well-designed clinical trials to determine the efficacy of cross-education therapies.

Short-term effects of Whole-Body Vibration on clinical, cardiac, and ambulatory electrocardiographic (Holter) parameters of healthy younger and older adult male non-athletic crossbreed dogs

ABSTRACT This study investigated the effects of WBV in clinical, cardiac, and ambulatory electrocardiographic (Holter) parameters of healthy young and aged male non-athletic dogs. Fourteen dogs were divided into two groups of seven animals: Group I (GI) - young dogs (12.0 and 84.0 months old); Group II (GII) - aged dogs (above 84.0 months old). Dogs were submitted to a single session of WBV (frequencies of 30 and 50 Hz), for 15-min. Variations were identified in the thickness of the interventricular septum and thickness of the left ventricle-free wall values: GI < GII at 5-min before the session. The diameter of the left atrium values showed a difference: GI < GII at 5-min before and 1-min after the session; and a decrease in GII between 5-min before and 1 min after the WBV. Several ambulatory electrocardiography (Holter) parameters demonstrated significant differences between both groups and time-points. A single session of WBV at frequencies of 30 and 50 Hz during 15-min by using a vibrating platform that delivered a vortex wave circulation did not induce significant changes in clinical, cardiac, and ambulatory electrocardiographic (Holter) parameters in healthy young and aged dogs.

Effect of Whole Body Vibration Conditions on Lower Limb Muscles during Sling Exercise

Exercising in an unstable environment, such as with the use of a sling, improves neuromuscular adaptation by providing effective training stimuli. Moreover, whole body vibration has been used to restore the physical function of patients with nervous system and musculoskeletal disorders. However, there have been few studies on the most appropriate exercise method of combining unstable surface and WBV. The purpose of this study was to investigate the effect of a sling and sonic vibration stimulation on muscle activation while performing a Bulgarian split squat (BSS). Twenty male subjects (age 25.95 ± 2.42 years old, height: 172.59 ± 5.56 cm, weight: 77.74 ± 10.82 kg) participated in the study. The participants randomly performed five types of BS using a sling and sonic vibration (BSS–0 Hz, BSS–4 Hz, BSS–8 Hz, BSS–12 Hz, BSS–20 Hz, and BSS–30 Hz). Each condition was repeated five times. A 60-s break was given for each condition to minimize muscle fatigue. We measured the muscular activities in the gluteus medius, biceps femoris, rectus femoris, vastus medialis, and vastus lateralis. It was observed that muscle activation increased during exercise conditions that provided a sling and sonic vibration in all muscles. In particular, the highest activation appeared in the condition wherein a vibration of 30 Hz was provided. Our results show that the sling exercise combined with a sonic vibration of 30 Hz during the BSS has positive effects on lower limb muscle activity.

Optimization of Exercise Countermeasures to Spaceflight Using Blood Flow Restriction

INTRODUCTION: During spaceflight missions, astronauts work in an extreme environment with several hazards to physical health and performance. Exposure to microgravity results in remarkable deconditioning of several physiological systems, leading to impaired physical condition and human performance, posing a major risk to overall mission success and crew safety. Physical exercise is the cornerstone of strategies to mitigate physical deconditioning during spaceflight. Decades of research have enabled development of more optimal exercise strategies and equipment onboard the International Space Station. However, the effects of microgravity cannot be completely ameliorated with current exercise countermeasures. Moreover, future spaceflight missions deeper into space require a new generation of spacecraft, which will place yet more constraints on the use of exercise by limiting the amount, size, and weight of exercise equipment and the time available for exercise. Space agencies are exploring ways to optimize exercise countermeasures for spaceflight, specifically exercise strategies that are more efficient, require less equipment, and are less time-consuming. Blood flow restriction exercise is a low intensity exercise strategy that requires minimal equipment and can elicit positive training benefits across multiple physiological systems. This method of exercise training has potential as a strategy to optimize exercise countermeasures during spaceflight and reconditioning in terrestrial and partial gravity environments. The possible applications of blood flow restriction exercise during spaceflight are discussed herein.Hughes L, Hackney KJ, Patterson SD. Optimization of exercise countermeasures to spaceflight using blood flow restriction. Aerosp Med Hum Perform. 2021; 93(1):32-45.

Impact of Local Vibration Training on Neuromuscular Activity, Muscle Cell, and Muscle Strength: A Review

This paper presents a review of studies on the effects of local vibration training (LVT) on muscle strength along with the associated changes in neuromuscular and cell dynamic responses. Application of local/direct vibration can significantly change the structural properties of muscle cell and can improve muscle strength. The improvement is largely dependent on vibration parameters such as amplitude and frequency. The results of 20 clinical studies reveal that electromyography (EMG) and maximal voluntary contraction (MVC) vary depending on vibration frequency, and studies using frequencies of 28-30 Hz reported greater increases in muscle activity in terms of EMG (rms) value and MVC data than the studies using higher frequencies. A greater muscle activity can be related to the recruitment of large motor units due to the application of local vibration. A greater increase in EMG (rms) values for biceps and triceps during extension than flexion under LVT suggests that types of muscles and their functions play an important role. Although a number of clinical trials and animal studies have demonstrated positive effects of vibration on muscle, an optimum training protocol has not been established. An attempt is made in this study to investigate the optimal LVT conditions on different muscles through review and analysis of published results in the literature pertaining to the changes in the neuromuscular activity. Directions for future research are discussed with regard to identifying optimal conditions for LVT and better understanding of the mechanisms associated with effects of vibration on muscles.

An overview of the effects of whole-body vibration on individuals with cerebral palsy

The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.

Characterizing the magnitude of vibration imposed by stochastic whole-body vibration platforms used in rehabilitation and training: a preliminary study

Abstract The use of devices that produce stochastic whole-body vibration as a resource for rehabilitation and training programs has been founded on the theory of stochastic resonance. However, the prescription of rehabilitation and training programs must be preceded by the verification of imposed-vibration magnitude and of how it can be affected by the presence of an individual on the devices. The aim of this research was to characterize and analyze the effect of an individual's mass on the vibratory stimulus provided by stochastic whole-body vibration (SWBV) devices. The sample consisted of 30 repetitions for each one of the 6 vibration levels of the SWBV device (level 02, 04, 06, 08, 10 and 12), performed in two experimental situations (Without Load; Load [70Kg]; ≈ 35 kg on the right and left surfaces of the platform). For the antero-posterior, latero-lateral, and vertical directions, all variables showed significant differences between treatments, levels and interaction between experimental factors (p<.05), except for the Disp variable between treatments (p=.075). To measure vibration magnitude, a triaxial accelerometer was attached at the center of the board of one of the platform surfaces. Load interferes with parameters of vibration imposed by SWBV platforms, increasing ARMS and APEAK in the latero-lateral and antero-posterior directions, reducing these same parameters in the vertical direction.

Sensory-Based Priming for Upper Extremity Hemiparesis After Stroke: A Scoping Review

Sensory priming is a technique to facilitate neuroplasticity and improve motor skills after injury. Common sensory priming modalities include peripheral nerve stimulation/somatosensory electrical stimulation (PNS/SES), transient functional deafferentation (TFD), and vibration. The aim of this study was to determine whether sensory priming with a motor intervention results in improved upper limb motor impairment or function after stroke. PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science, and EMBASE were the databases used to search the literature in July 2020. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and recommendations for the Cochrane collaboration. In total, 30 studies were included in the analysis: three studies examined TFD, 16 examined PNS/SES, 10 studied vibration, and one combined the three stimulation techniques. Most studies reported significant improvements for participants receiving sensory priming. Given the low risk, it may be advantageous to use sensory-based priming prior to or concurrent with upper limb training after stroke.

Effects of Sensory Interventions on Fatigue in People With Multiple Sclerosis: A Systematic Review

BACKGROUND

Fatigue is 1 of the most common and annoying symptoms in patients with multiple sclerosis (MS). The purpose of this study was to investigate the effect of sensory interventions on fatigue in people with MS based on a systematic review of sensory evidence.

METHODS

The Google Scholar, PubMed, Scopus, and Cochrane Library databases were searched from January 1990 to July 2020. Studies with nonpharmacologic sensory interventions as a main or secondary intervention according to the assessment of fatigue as the primary or secondary therapy outcome in patients with MS were included.

RESULTS

Nine articles were reviewed by examining the inclusion and exclusion criteria. Four types of interventions were related to exercises, including sensory integration exercises, vestibular rehabilitation, Frenkel exercises, and exercises with or without vibration; and 2 types were performed using robots and 1 type using vibration only. Vestibular rehabilitation therapies, exercise-based sensory integration interventions, and the use of vibration have shown significant effects in relieving fatigue in patients with MS.

CONCLUSIONS

The evidence in this study is insufficient to show a dramatic effect of sensory integration therapy in various forms. However, despite the studies, sensory integration therapy can be considered a potential treatment for fatigue in patients with MS. Further studies with stronger methods are needed to make this treatment a reality.

Effect of direct vibration on the activity of deep trunk muscles of patients with non-specific chronic low back pain

BACKGROUND

Vibration training is an adjuvant to muscle-strengthening exercises.

OBJECTIVE

To investigate the short-term effects of direct vibration on the deep trunk muscles of patients with non-specific chronic low back pain (CLBP).

METHODS

Participants with non-specific CLBP were randomly placed into two groups: the vibration-plus stabilization exercise (VSE) group (n= 31) and the conventional stabilization exercise (CSE) group (n= 31). The groups underwent 12 sessions of an exercise program. The thickness and activity of the trunk muscles were measured using ultrasonography and surface electromyography.

RESULTS

Ultrasonography revealed that the ratio of muscle thickness to contraction and relaxation was statistically increased after exercise in the bilateral transversus abdominis (TrA) and lumbar multifidus (LM) muscles in the CSE group (p= 0.031), and in the bilateral TrA, LM, and internal oblique (IO) muscles in the VSE group (p< 0.001). The LM/lumbar erector spinae (LES) ratio in the CSE group (p= 0.037), and the IO/rectus abdominis (RA), TrA/RA, and LM/LES ratios in the VSE group (p= 0.019) were statistically increased. Multiple regression analysis showed that symptom improvement was related to increased activity of the deep trunk muscles in the VSE group (p< 0.001).

CONCLUSION

Direct vibration can increase the selective activity of contracting deep trunk muscles.

Efficacy of Whole-Body Vibration Training on Brain-Derived Neurotrophic Factor, Clinical and Functional Outcomes, and Quality of Life in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial

This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels (p=0.045), a higher number of repetitions on the STS test (p=0.011), and increased walking distance on the 6MWT (p=0.010), compared to CG. Moreover, there was a reduction in the scores of the FIQ (p=0.001), the PSQI (p=0.001), the BDI (p=0.017), and pain assessed using VAS (p=0.008) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).

Effects of combined whole body vibration and resistance training on lower quadrants electromyographic activity, muscle strength and power in athletes

BACKGROUND

Whole body vibration (WBV) with resistance training is one of the increasing ways of gaining ankle and foot complex muscle strength and power for the rehabilitative and prophylactic purpose in athletes.

OBJECTIVE

The purpose of the study was to compare the effects of combined WBV and resistance training (RVE) with strength training alone (RE) on alteration of gastrocnemius lateralis and vastus medialis obliquus muscle activity and strength, and power performance in athletes.

METHODS

The study was performed on 23 university-level male athletes who were randomized into two groups as RVE (n = 12; age 22.2 ± 1.94 years) and RE (n = 11; age 21.60 ± 1.78 years). The training program was scheduled three times per week for six weeks (18 sessions). Gastrocnemius lateralis (GL) and vastus medialis obliquus (VMO) were measured for muscle activity and isometric strength with surface EMG device and handheld dynamometer respectively. Counter-movement jump (CMJ) was used for measuring power. All the participants were assessed for outcome measures at baseline and then after 6 weeks. Group (RVE vs. RE) by time (pre vs. post) effects were compared through a 2-way interaction utilizing mixed model repeated measure ANOVA.

RESULTS

After training, VMO muscle activity (group effects) increased significantly in the RVE group (p < 0.05). However, both the groups showed statistically significant time and group × time interaction effects for muscle activity of VMO, isometric strength (VMO and GL), and CMJ (p < 0.05).

CONCLUSION

WBV might serve as an adjunct modality for enhancement of the neuromuscular activity of the VMO muscle. However, RVE had no additive effect when compared to RE alone on muscle strength and power in athletes. The long-term impacts of combined WBV and resistance training on other foot and ankles muscle should be investigated in future studies.

Acute Response of Sclerostin to Whole-body Vibration with Blood Flow Restriction

Blood flow restriction may augment the skeletal response to whole-body vibration. This study used a randomised, crossover design to investigate the acute response of serum sclerostin and bone turnover biomarkers to whole-body vibration with blood flow restriction. Ten healthy males (mean±standard deviation; age: 27±8 years) completed two experimental conditions separated by 7 days: (i) whole-body vibration (10 1-minute bouts of whole-body vibration with 30 s recovery) or (ii) whole-body vibration with lower-body blood flow restriction (10 cycles of 110 mmHg inflation with 30 s deflation during recovery). Fasting blood samples were obtained immediately before and immediately after exercise, then 1 hour, and 24 hours after exercise. Serum samples were analysed for sclerostin, cross-linked C-terminal telopeptide of type I collagen, and bone-specific alkaline phosphatase. There was a significant time × condition interaction for bone-specific alkaline phosphatase (p=0.003); bone-specific alkaline phosphatase values at 24 hours post-exercise were significantly higher following whole-body vibration compared to combined whole-body vibration and blood flow restriction (p=0.028). No significant time × condition interaction occurred for any other outcome measure (p>0.05). These findings suggest that a single session of whole-body vibration combined with blood flow restriction does not significantly affect serum sclerostin or bone turnover biomarkers.

Local Vibration Reduces Muscle Damage after Prolonged Exercise in Men

Prolonged exercise can lead to muscle damage, with soreness, swelling, and ultimately reduced strength as a consequence. It has been shown that whole-body vibration (WBV) improves recovery by reducing the levels of stress hormones and the activities of creatine kinase (CK) and lactate dehydrogenase (LDH). The aim of the study was to demonstrate the effect of local vibration treatment applied after exercise on the level of selected markers of muscle fiber damage. The study involved 12 untrained men, aged 21.7 ± 1.05 years, with a VO2peak of 46.12 ± 3.67 mL·kg-1·min-1. A maximal intensity test to volitional exhaustion was performed to determine VO2peak and individual exercise loads for prolonged exercise. The subjects were to perform 180 min of physical effort with an intensity of 50 ± 2% VO2peak. After exercise, they underwent a 60 min vibration treatment or placebo therapy using a mattress. Blood samples were taken before, immediately after the recovery procedure, and 24 h after the end of the exercise test. Myoglobin (Mb) levels as well as the activities of CK and LDH were recorded. Immediately after the hour-long recovery procedure (vibration or placebo), the mean concentrations of the determined indices were significantly different from baseline values. In the vibration group, significantly lower values of Mb (p = 0.005), CK (p = 0.030), and LDH (p = 0.005) were seen. Differences were also present 24 h after the end of the exercise test. The results of the vibration group compared to the control group differed in respect to Mb (p = 0.002), CK (p = 0.029), and LDH (p = 0.014). After prolonged physical effort, topical vibration improved post-workout recovery manifested by lower CK and LDH activity and lower Mb concentration compared to a control group.

Local vibration training improves the recovery of quadriceps strength in early rehabilitation after anterior cruciate ligament reconstruction: A feasibility randomised controlled trial

BACKGROUND

After anterior cruciate ligament reconstruction (ACLR), quadriceps strength must be maximised as early as possible.

OBJECTIVES

We tested whether local vibration training (LVT) during the early post-ACLR period (i.e., ∼10 weeks) could improve strength recovery.

METHODS

This was a multicentric, open, parallel-group, randomised controlled trial. Thirty individuals attending ACLR were randomised by use of a dedicated Web application to 2 groups: vibration (standardised rehabilitation plus LVT, n=16) or control (standardised rehabilitation alone, n=14). Experimenters, physiotherapists and participants were not blinded. Both groups received 24 sessions of standardised rehabilitation over ∼10 weeks. In addition, the vibration group received 1 hour of vibration applied to the relaxed quadriceps of the injured leg at the end of each rehabilitation session. The primary outcome - maximal isometric strength of both injured and non-injured legs (i.e., allowing for limb asymmetry measurement) - was evaluated before ACLR (PRE) and after the 10-week rehabilitation (POST).

RESULTS

Seven participants were lost to follow-up, so data for 23 participants were used in the complete-case analysis. For the injured leg, the mean (SD) decrease in maximal strength from PRE to POST was significantly lower for the vibration than control group (n=11, -16% [10] vs. n=12, -30% [11]; P=0.0045, Cohen's d effect size=1.33). Mean PRE-POST change in limb symmetry was lower for the vibration than control group (-19% [11] vs. -29% [13]) but not significantly (P=0.051, Cohen's d effect size=0.85).

CONCLUSION

LVT improved strength recovery after ACLR. This feasibility study suggests that LVT applied to relaxed muscles is a promising modality of vibration therapy that could be implemented early in ACLR.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02929004.

Immediate Effects of Whole-Body Vibration Associated with Squatting Exercises on Hemodynamic Parameters in Sarcopenic Older People: A Randomized Controlled Trial

Whole-body vibration (WBV) exercises have recently been introduced as a nonpharmacological therapeutic strategy for sarcopenic older people. The present study aimed to evaluate the effect of WBV exercise on hemodynamic parameters in sarcopenic older people. Forty older people, divided into groups of nonsarcopenic (NSG = 20) and sarcopenic (SG = 20), participated in the study and were cross randomized into two interventions of eight sets of 40 s each, these being squatting with WBV and squatting without WBV. Heart rate (HR), peak heart rate (peak HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), double product (DP), mean arterial pressure (MAP), and subjective perception of effort (SPE), were assessed at baseline, during, and after a single WBV session. The HR, peak HR, and DP variables were similar at baseline between groups. WBV exercise increased all the hemodynamic parameters both during and immediately after the intervention, in both groups (SG and NSG). The MAP values were similar at baseline between groups; however, in the NSG there was a significant increase during and immediately after the squatting with WBV intervention (p < 0.05). The HR behavior, in both groups, showed that there was an increase in HR after the first set of exercises with vibration and this increase was maintained until the final set. The absence of adverse effects of WBV exercise on the cardiovascular system and fatigue suggests this exercise modality is adequate and safe for sarcopenic older people.

Tissue Mobilization During Double Source of Vibration Semioccluded Vocal Tract Exercises: A Neck and Face Surface Acceleration Study

Purpose This study primarily aimed at observing the possible tissue mobilization on facial, neck, and chest tissues caused by different double source of vibration semioccluded vocal tract exercises (DSV-SOVTEs). Another goal was to inspect the degree of self-perceived sensation of a massage-like sensation. Method Fifty-five participants engaged in a set of several DSV-SOVTEs: (a) phonation with a silicone tube submerged 2 and 8 cm below water surface, (b) Acapella Choice device, (c) lip trills, and (d) tongue trills. A self-perceived massage-like sensation was also assessed. All exercises were performed at three loudness levels. Tissue mobilization signal was captured by four accelerometers placed in four different body regions: (a) over the cheek, (b) over the neck, (c) over the thyroid cartilage, and (d) over the suprasternal notch. Results There is a differential effect of all DSV-SOVTEs on tissue mobilization. All four observed dependent variables from tissue oscillation modulation (frequency, amplitude, jitter, and shimmer) showed significant three-way interactions. In general, amplitude and frequency of tissue oscillation modulation increases with loudness. A self-perceived massage-like sensation showed highly significant differences between DSV-SOVTEs. Conclusions All DSV-SOVTEs do mobilize tissues. Type of exercise, loudness level, and body region produce an effect on all tissue oscillation variables. Acapella device produces the largest amplitude of vibration, lowest frequency, and more regular oscillation of tissue. Water resistance therapy showed the most irregular tissue oscillation. Control of these variables is likely to be relevant to obtain the best outcomes in patients.

Effects of Local Vibration on Dynamic Strength Training

ABSTRACT

Drummond, MDM, Couto, BP, Oliveira, MP, and Szmuchrowski, LA. Effects of local vibration on dynamic strength training. J Strength Cond Res 35(11): 3028-3034, 2021-The study aim was to compare the chronic effects of maximal dynamic strength training with and without the addition of local vibration (LV) on maximal force generation and hypertrophy of the elbow flexor muscles in trained subjects. Twenty men were divided into 2 groups (conventional training [CT] group and vibration training [VT] group). The CT group performed conventional maximal dynamic strength training, and the VT group performed maximal dynamic strength training with mechanical vibrations (frequency of 26 Hz and amplitude of 6 mm). CT and VT groups performed 5 sets of 3-4 repetitions, with 2-minute rest intervals between sets. The subjects trained 3 times per week for 12 weeks. After the training period, the CT group presented a significant increase in the mean 1 repetition maximum (1RM) value in the elbow flexion exercise in the orthostatic position (EFO) (7.2 ± 1.5%) (p < 0.0001) and elbow flexion exercise using the Scott bench (EFSB) (6.3 ± 1.8%) (p < 0.0001). The VT group also showed significant increases in 1RM values in the EFO (6.87 ± 0.8%) (p < 0.0001) and EFSB (6.56 ± 1.4%) (p < 0.0001). The CT group presented a significant increase in the mean maximal voluntary isometric contraction (MVIC) value after the training period (8.2 ± 2.3%) (p < 0.0001). The VT group also showed a significant increase in the mean MVIC value after training (9.1 ± 2.4%) (p < 0.0001). After the training period, both groups presented a significant increase in the mean value of elbow flexor thickness (CT = 5.6 ± 3.5%, VT = 5.1 ± 2.8%) (p = 0.001). The increases in 1RM, MVIC, and muscle thickness were statically similar between groups. Therefore, the addition of LV does not represent an additional stimulus for individuals trained in dynamic maximal strength training.

Visual feedback improves movement illusions induced by tendon vibration after chronic stroke

BACKGROUND

Illusion of movement induced by tendon vibration is commonly used in rehabilitation and seems valuable for motor rehabilitation after stroke, by playing a role in cerebral plasticity. The aim was to study if congruent visual cues using Virtual Reality (VR) could enhance the illusion of movement induced by tendon vibration of the wrist among participants with stroke.

METHODS

We included 20 chronic stroke participants. They experienced tendon vibration of their wrist (100 Hz, 30 times) inducing illusion of movement. Three VR visual conditions were added to the vibration: a congruent moving virtual hand (Moving condition); a static virtual hand (Static condition); or no virtual hand at all (Hidden condition). The participants evaluated for each visual condition the intensity of the illusory movement using a Likert scale, the sensation of wrist's movement using a degree scale and they answered a questionnaire about their preferred condition.

RESULTS

The Moving condition was significantly superior to the Hidden condition and to the Static condition in terms of illusion of movement (p < 0.001) and the wrist's extension (p < 0.001). There was no significant difference between the Hidden and the Static condition for these 2 criteria. The Moving condition was considered the best one to increase the illusion of movement (in 70% of the participants). Two participants did not feel any illusion of movement.

CONCLUSIONS

This study showed the interest of using congruent cues in VR in order to enhance the consistency of the illusion of movement induced by tendon vibration among participants after stroke, regardless of their clinical severity. By stimulating the brain motor areas, this visuo-proprioceptive feedback could be an interesting tool in motor rehabilitation. Record number in Clinical Trials: NCT04130711, registered on October 17th 2019 ( https://clinicaltrials.gov/ct2/show/NCT04130711?id=NCT04130711&draw=2&rank=1 ).

Effects of Whole-Body Vibration Training on Knee Muscle Strength After Anterior Cruciate Ligament Reconstruction: A Critically Appraised Topic

Clinical Scenario: Knee muscle strength weakness after anterior cruciate ligament (ACL) reconstruction is the most commonly seen impairment. Whole-body vibration (WBV) training has been shown to improve muscle strength in both healthy and injured individuals. However, it is not clear yet if WBV training has a beneficial effect in knee muscle strength recovery after ACL reconstruction. Clinical Question: Is adding WBV training to conventional rehabilitation more effective than conventional rehabilitation at improving quadriceps and hamstring muscles strength in individuals who have undergone ACL reconstruction? Summary of Key Findings: After the literature was reviewed, 4 randomized controlled trials met the inclusion criteria and were included in this critically appraised topic. Clinical Bottom Line: There is moderate- to high-quality evidence to support that adding WBV to conventional rehabilitation programs can result in better improvement in knee muscle strength after ACL reconstruction. Strength of Recommendation: Findings from 4 randomized controlled trials indicate that there is level B evidence supporting that WBV is effective for knee muscle strength recovery in patients who had undergone ACL reconstruction.

Reporting Guidelines for Whole-Body Vibration Studies in Humans, Animals and Cell Cultures: A Consensus Statement from an International Group of Experts

Simple Summary

Whole-body vibration (WBV) is an exercise or treatment method used in sports, physiotherapy, and rehabilitation. During WBV, people sit, stand, or exercise on a platform that generates vibrations. These vibrations generally occur between 20 and 60 times per second and have a magnitude of one or several millimeters. Research is focused on the effects of WBV on, for instance, physical and cognitive functions as well as the underlying mechanisms that may explain the effects. Research is not only done in humans but in animals and cell cultures as well. It is important to report the studies correctly, completely, and consistently. This way, researchers can interpret and compare each other’s studies, and data of different studies can be combined and analyzed together. To serve this goal, we developed new guidelines on how to report on WBV studies. The guidelines include checklists for human and animal/cell culture research, explanations, and examples of how to report. We included information about devices, vibrations, administration, general protocol, and subjects. The guidelines are WBV-specific and can be used by researchers alongside general guidelines for specific research designs.

Abstract

Whole-body vibration (WBV) is an exercise modality or treatment/prophylaxis method in which subjects (humans, animals, or cells) are exposed to mechanical vibrations through a vibrating platform or device. The vibrations are defined by their direction, frequency, magnitude, duration, and the number of daily bouts. Subjects can be exposed while performing exercises, hold postures, sitting, or lying down. Worldwide, WBV has attracted significant attention, and the number of studies is rising. To interpret, compare, and aggregate studies, the correct, complete, and consistent reporting of WBV-specific data (WBV parameters) is critical. Specific reporting guidelines aid in accomplishing this goal. There was a need to expand existing guidelines because of continuous developments in the field of WBV research, including but not limited to new outcome measures regarding brain function and cognition, modified designs of WBV platforms and attachments (e.g., mounting a chair on a platform), and comparisons of animal and cell culture studies with human studies. Based on Delphi studies among experts and using EQUATOR recommendations, we have developed extended reporting guidelines with checklists for human and animal/cell culture research, including information on devices, vibrations, administration, general protocol, and subjects. In addition, we provide explanations and examples of how to report. These new reporting guidelines are specific to WBV variables and do not target research designs in general. Researchers are encouraged to use the new WBV guidelines in addition to general design-specific guidelines.

The Application of Whole-Body Vibration Training in Knee Osteoarthritis

With the gradual increase of the aging population in Chinese society, the incidence of knee osteoarthritis showed an increasing trend. However, there are very few practical solutions for it. As a novel neuromuscular training technique, whole-body vibration training has become a candidate for treating knee osteoarthritis. In this review, we firstly elaborated on the mode of action and influence factors of the whole-body vibration training. Next, we summarized its effects in knee osteoarthritis, including improving knee function and some uncertain muscle function and proprioception effects. Next, we also summarized its possible mechanisms, including improving bone microstructure, delaying articular cartilage degeneration, modulating inflammatory cells and inflammatory factors. Then, we summarized the clinical effectiveness of whole-body vibration training by analyzing some clinical randomized controlled trials. Finally, based on the above summary, we analyzed and listed the limitations of whole-body vibration training in treating knee osteoarthritis and found the shortcomings in the existing studies. This review provides ideas for the future application of whole-body vibration training in the treatment of knee osteoarthritis.