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]

Engineering and Technology in Wheelchair Sport

Technologies capable of projecting injury and performance metrics to athletes and coaches are being developed. Wheelchair athletes must be cognizant of their upper limb health; therefore, systems must be designed to promote efficient transfer of energy to the handrims and evaluated for simultaneous effects on the upper limbs. This article is brief review of resources that help wheelchair users increase physiologic response to exercise, develop ideas for adaptive workout routines, locate accessible facilities and outdoor areas, and develop wheelchair sports-specific skills.

Is Vibration Training Good for Your Bones? An Overview of Systematic Reviews

Whole-body vibration (WBV) intervention studies and reviews have been increasing lately. However, the results regarding its effects on bone tissue in different populations are still inconclusive. The goal of this overview was to summarize systematic reviews assessing the effects of WBV training on bone parameters. Three electronic databases were scanned for systematic reviews and meta-analyses evaluating the effects of WBV on bone tissue. The search had no time restrictions and was limited to articles written in English. Vibration protocols and the main bone parameters included in each review were extracted. Methodological quality was assessed and analyses were conducted stratifying by age. 17 reviews and meta-analyses fulfilled the inclusion criteria. No increase or small improvements in bone mineral density (BMD) after WBV interventions were observed in reviews regarding postmenopausal women. One intervention study regarding young adults was included and reported no bone-related benefits from WBV. Most reviews including children and adolescents with compromised bone mass showed an improvement of BMD at lower limbs, lumbar spine, and whole body. In conclusion, WBV interventions seem to help children and adolescents with compromised bone mass to increase their BMD, but these improvements are limited in postmenopausal women and there is insufficient evidence for young adults. Further research is also needed to identify the ideal parameters of WBV training focused on bone health.

Physical strategies to prevent disuse-induced functional decline in the elderly

Disuse situations can have serious adverse health consequences in the elderly, including mainly functional impairment with subsequent increase in the risk of falls or morbimortality. The present review provides clinicians and care givers with detailed and practical information on the feasibility and effectiveness of physical strategies that are currently available to prevent or attenuate the functional decline that occurs secondarily to disuse situations in the elderly, notably in the hospital setting. In this context, active approaches such as resistance exercises and maximal voluntary contractions, which can be performed both isometrically and dynamically, are feasible during most immobilization situations including in hospitalized old people and represent powerful tools for the prevention of muscle atrophy. Aerobic exercise should also be prescribed whenever possible to reduce the loss of cardiovascular capacity associated with disuse periods. Other feasible strategies for patients who are unwilling or unable to perform volitional exercise comprise neuromuscular electrical stimulation, vibration, and blood flow restriction. However, they should ideally be applied synchronously with voluntary exercise to obtain synergistic benefits.

Whole body vibration to attenuate reduction of explosive force in chronic kidney disease patients: a randomized controlled trial

To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~-15% and -51%, P=0.038], RFDr at 30 msec [~-22% and -52%, P=0.044] and RFDr at 50 msec [~-11% and -54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~-8% and -55%, P=0.025), 200 msec (~-3% and -46%, P= 0.025); RFDr 100 msec (~0.01% and -56%, P=0.033), 200 msec (~-5% and -36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.

Effect of Horizontal Whole-Body Vibration Training on Trunk and Lower-Extremity Muscle Tone and Activation, Balance, and Gait in a Child with Cerebral Palsy

Patient: Male, 10

Final Diagnosis: Cerebral palsy

Symptoms: Movement disorder

Medication: —

Clinical Procedure: —

Specialty: Rehabilitation

Sensorimotor training and whole-body vibration training have the potential to reduce motor and sensory symptoms of chemotherapy-induced peripheral neuropathy-a randomized controlled pilot trial

Chemotherapy-induced peripheral neuropathy (CIPN) is a prevalent and clinically relevant side effect of chemotherapy. The symptoms diminish patients' quality of life and represent a decisive limiting factor for medical therapy. To date, effective treatment options are lacking. Specific exercise interventions have proven promising to target relevant symptoms. We conducted a prospective, four-armed, randomized, controlled trial, to evaluate the effects of sensorimotor training (SMT) and whole-body vibration training (WBV) on patients with CIPN. Participants (N = 40) were randomized to either one of two intervention groups (SMT N = 10 or WBV N = 10) or oncological control group (N = 10) and matched by gender and age with a healthy control (N = 10). The intervention groups exercised twice a week for 6 weeks. Primary endpoint was the reduction of CIPN-related symptoms (improve peripheral deep sensitivity, Achilles tendon reflex (ASR) and patellar tendon reflex (PSR), light-touch perception, sense of position, and lower leg strength). Secondary endpoints were nerve conduction velocity and amplitude, balance control, quality of life, and CIPN-related pain. Patients exercising improved sensory and associated motor symptoms. Significant intergroup differences were found for the tendon reflexes (ASR P = .017 and PSR P = .020), peripheral deep sensitivity (P = .010), and pain (P = .043). Furthermore, tendencies were found regarding the subjective improvement of symptoms (P = .075) and two subscales of the EORTC-QLQ-C30 questionnaire: pain (P = .054) and dyspnea (P = .054). The results for the SMT group were superior regarding the tendon reflexes, and a tendency regarding the subjective report of symptoms, while WBV was superior regarding pain. SMT and WBV behold a large potential to reduce CIPN-related symptoms and can be considered feasible and safe for patients with CIPN (compliance 97.5%, no adverse events).Registration: DRKS00013027.

Whole-body vibration in children with disabilities demonstrates therapeutic potentials for pediatric cancer populations: a systematic review

PURPOSE

Low levels of physical activity often observed in pediatric oncology might be attributed to various functional deficits, especially those of the lower limbs as these affect gait, mobility, and, consequently, physical activity. In the past few years, whole-body vibration (WBV) has emerged as a new therapy modality for improving physical functioning. Although WBV is increasingly applied in children with disabilities, its impact on lower limb function in pediatric cancer patients and survivors has not yet been investigated.

METHODS

To establish whether there is evidence that WBV may be beneficial for pediatric cancer patients and survivors, this review summarizes current data on WBV studies among children with disabilities and extracts relevant information for the pediatric cancer population. Two independent reviewers performed a systematic literature search following the PRISMA guidelines.

RESULTS

Nine studies were included in the analysis. Results demonstrate that WBV is a safe, highly compliant, and effective approach in cohorts of children with disabilities. The largest effects of WBV were observed in lower extremity muscle mass and strength, balance control, gait, and walking ability. Furthermore, we were able to develop first recommendations for WBV protocols.

CONCLUSIONS

WBV seems to be feasible and effective for improving parameters that may be relevant to the pediatric cancer population. Efforts are needed to conduct first WBV interventions in children with cancer proving the effects. The developed recommendations for WBV protocols might help to implement these intervention studies.

Transforming growth factor beta 1 mediates the low-frequency vertical vibration enhanced production of tenomodulin and type I collagen in rat Achilles tendon

Vertical vibration (VV) is a whole-body vibration with mechanical loading that commonly used in rehabilitation and sports training to increase athlete muscle strength. Our previous study showed that low-magnitude, low-frequency VV at 8 Hz and 10 Hz increased myoblast myogenesis. Herein, we investigated whether a VV frequency at low-frequency 5-10 Hz has anabolic effects on tenocytes and improves tendon stiffness. In primary tenocytes, 10 Hz VV treatment increased the tenogenic marker gene expression of tenomodulin and extracellular matrix type I collagen but decreased decorin expression. qPCR and Enzyme-Linked Immunosorbent Assay (ELISA) results showed that TGF-β1 expression was increased in tenocytes after 3 days of 10 Hz VV treatment in vitro and in Achilles tendons after 3 weeks in vivo. Tenomodulin expression and Achilles tendon stiffness were significantly increased in Achilles tendons after 3 weeks in vivo. We also showed that the TGF-β1 receptor inhibitor SB431542 (10 μM) decreased the expression of tenomodulin and type I collagen but increased the decorin expression in tenocytes. These results indicated that the 10 Hz VV stimulated anabolic effects in tenocytes by increasing TGF-β1 expression that subsequently increases the expression of tenomodulin and type I collagen, and increased the Achilles tendon stiffness. This study provides insight into the low-frequency 10 Hz VV treatment improves tendon properties and can minimizes the risk of ligament/tendon reinjure during rehabilitation.

The effect of whole body vibration training on quadriceps voluntary activation level of people with age-related muscle loss (sarcopenia): a randomized pilot study

BACKGROUND

Whole body vibration was an effective training for improving muscle performance. The purpose of this study was to explore the effects of 12-week whole-body vibration training program on voluntary activation of quadriceps muscles of older people with age-related muscle loss (sarcopenia).

METHODS

Twelve community dwelling seniors with age-related muscle loss were randomly allocated into whole body vibration training group and control group. The training lasted for 12 weeks. Twitch interpolation were conducted to examine the voluntary activation of quadriceps at pre- and post-intervention.

RESULTS

Although there was no significant difference between whole body vibration training group and control group on the absolute values of the interpolated twitch ratio after 12 weeks of training. The changed values of ratio (Post minus Pre) were significantly different between the two groups (p = 0.044).

CONCLUSIONS

The voluntary activation of quadriceps muscles of older people with age-related muscle loss was facilitated after 12 weeks of WBV training with 40 Hz × 4 mm × 360 s. Considering the small sample size of this study, it may only provide a piece of evidence that WBV is effective for facilitating the central motor drive in seniors with age-related muscle loss. More subjects are needed to confirm the present finding.

TRIAL REGISTRATION

ISRCTN63583948 , registered on 16th January 2017, retrospectively registered.

Whole-Body Vibration Training Designed to Improve Functional Impairments After Pediatric Inpatient Anticancer Therapy: A Pilot Study

PURPOSE

To assess a whole-body vibration (WBV) intervention for children after cancer treatment.

METHODS

Eleven children after inpatient anticancer therapy participated in a 12-week supervised WBV intervention, which consisted of one 9- to 13-minute WBV session per week, with 5 to 9 minutes' overall vibration time. Feasibility was defined as the ability to participate in WBV training without reporting adverse events. The number of offered and completed training sessions, program acceptance, and measures of function were assessed.

RESULTS

Nine participants completed the WBV intervention without any WBV-related adverse events. The adherence rate was 87.96%. Only minor side effects were reported and there was general program acceptance. We found indications that WBV has positive effects on knee extensor strength and active ankle dorsiflexion range of motion.

CONCLUSIONS

WBV was feasible, safe, and well received among children after inpatient anticancer therapy. No health deteriorations were observed. Positive effects need to be confirmed in future trials.

Effect of whole-body vibration on neuromuscular performance: A literature review

BACKGROUND

Whole-body vibration (WBV) is a neuromuscular training method that has recently received popularity in health and fitness centers, as an additional or substitute method to conventional training and therapy, in order to improve muscle strength and power.

OBJECTIVE

The purpose of this review is to critically observe the effect of WBV training on neuromuscular performance in view of its ability to enhance the muscles strength, power, and flexibility; and also to investigate the influence of the different vibration characteristics (viz., method of application of vibration, frequency, and amplitude) and exercise protocols on the effect of this training.

METHOD

For this review 24 studies or articles were examined, and based on exclusion and inclusion criteria, 5 studies were finally selected; and an attempt was made to uncover the factors influencing the improvement in neuromuscular performance as a result of WBV intervention. During the review, it was considered to include and discuss as many characteristics as possible, such as, knee extension, knee flexion, counter movement jump (CMJ), squat exercise, and jumping height (JH).

RESULT

Whole-body vibration, along with additional exercise training, has a potential to induce substantial improvement in neuromuscular performance.

CONCLUSION

Whole-body vibration can bring about improvement in muscles strength, power, and flexibility. The main factors associated with the improvement in muscles performance are range of amplitude and frequency, type of vibration and its method of application, training intensity, exercise protocol, and the characteristics of the participants.

Acute Effects of Whole-Body Vibration on the Pain Level, Flexibility, and Cardiovascular Responses in Individuals With Metabolic Syndrome

The aim of the study was to assess the acute effect of whole-body vibration (WBV) exercise, with low frequency (5 Hz), on the pain level (PL), trunk flexibility, and cardiovascular responses (blood pressure [BP] and heart rate [HR]) in individuals with metabolic syndrome (MetS). Forty-four individuals were included in the study (control: 15) or in (WBV exercise: 29) groups. They were submitted to 3 bouts (1 minute each) of WBV exercise (5 Hz and peak-to-peak displacements of 2.5, 5.0, and 7.5 mm, corresponding to peak accelerations of 0.12, 0.25, and 0.35 g, respectively, sitting in a chair with the feet on the platform with knees flexed, followed by 1 minute of interset rest. The Control Group performed the same protocol, but the platform was turned off. The PL was measured through the visual analog pain scale, and the flexibility was measured through the anterior trunk flexion test. Significant improvements on PL (P = .031) and flexibility (P = .004) were found only in the WBV exercise group. The BP and HR remained at physiological levels. In conclusion, the WBV exercise would lead to physiological response decreasing PL and increasing flexibility as well as maintaining the cardiovascular responses in individuals with MetS.

Feasibility of whole body vibration during intensive chemotherapy in patients with hematological malignancies - a randomized controlled pilot study

BACKGROUND

Hospitalized cancer patients undergoing intensive or high-dose chemotherapy often experience a considerable decline in functional performance associated with the increased risk of adverse health events. Exercises, particularly resistance-based exercises that may counteract this decline are restricted by therapy-related side effects. Since whole body vibration (WBV) is known to efficiently stimulate the neuromuscular system without significantly raising blood pressure, we hypothesize that especially WBV is particularly feasible even during intensive or high-dose chemotherapy (primary endpoint) and thus induces beneficial functional adaptations.

METHODS

Twenty hospitalized patients with hematological malignancies scheduled for intensive or high-dose chemotherapy were randomly allocated to an intervention group (IG) undergoing WBV, or an active control group (CG) cycling. Feasibility was determined by comparing the IG's and CG's training compliance. Furthermore, to assess feasibility, WBV-induced changes in chemotherapy-related side effects, blood pressure, and heart rate immediately after exercising were documented. To assess patients' functional performance, we measured jump height (cm), the duration (sec) of performing the chair rising- (CRT) and timed-up-and-go test (TUG), maximum power output during jumping and CRT (watt/kg) as well as sway path (mm) during balance tasks.

RESULTS

Training compliance was similar between groups (IG: median 62%, range 39-77; CG: 67%, 58-100; p = 0.315). Moreover, we observed neither the IG's reported side effects worsening, nor any increase in blood pressure after WBV. IG's jump height (+ 2.3 cm, 95%CI 0.1-4.4, p = 0.028) and TUG performance (- 1.3 s, 95%CI -2.53 - -0.65, p = 0.027) improved significantly, while sway paths in semi-tandem stance were augmented after the intervention (eyes open: + 60 mm, 95%CI 2-236, p = 0.046; eyes closed: + 88 mm, 95%CI 49-214, p = 0.028). The CG's performances did not change over time. Maximum power output during CMJ and CRT and time during CRT did not change.

CONCLUSION

Our study is the first proving the feasibility of WBV during intensive/high-dose chemotherapy of hospitalized cancer patients. Additionally, WBV-induced neuromuscular adaptations resulted in functional benefits relevant to patients' autonomy. We believe that WBV can be implemented as an alternative training method during intensive chemotherapy, although the relative benefit compared to conventional resistance training requires more evaluation in future studies.

TRIAL REGISTRATION

German Register of Clinical Trials No.: DRKS00004338 , prospectively registered on 11/30/2012.

Clinical Approaches of Whole-Body Vibration Exercises in Individuals with Stroke: A Narrative Revision

Stroke is associated with long-term disability and patients experience numerous physical impairments including muscle weakness, particularly in the paretic limbs, balance, and functional mobility. During acute stroke rehabilitation, when individuals are less likely to be functionally independent and rely on rehabilitative care, the efficacy of low skill interventions that can reduce sedentary behaviour should be established. As such, this narrative revision focused on the use of empirical studies of whole-body vibration exercise (WBVE) on different health outcomes in stroke patients. The effects of WBVE on neuromuscular performance (muscular strength and power), mobility, spasticity, and cardiovascular responses have been highlighted. Although some positive results were reported we can conclude that there is no solid evidence confirming the beneficial effects of WBVE among people with stroke compared with either other types of physical activities or sham WBVE. Therefore, further research should be performed in this area, testing the feasibility and efficacy of using WBVE in a more homogeneous sample of stroke patients or comparing different WBVE parameters.

Whole body vibration exercise in the management of cancer therapy-related morbidities: A systematic review

The purpose of this systematic review was to investigate the effects of whole body vibration (WBV) exercise in the management of cancer therapy-related morbidities. The PubMED and PEDro databases were used to access publications published in English about the use of whole body vibration (WBV) exercises in cancer patients until February 22^nd 2017. The studies included were classified according to the level of evidence (LE) by the National Health and Medical Research Council Hierarchy of evidence and the methodological quality (MQ) by the PEDro scale. The four included studies (2 of them with "high" LE-II and MQ) were performed in patients with different types of cancer (i.e. breast, lung, prostate, solid or hematological), treated with WBV exercise to counteract the cancer therapy-related morbidities. The variables evaluated were muscle activity, subjective rate of perceived exertion, exercise capacity, muscle strength, quality of life, resting urinary incontinence and severity of peripheral neuropathy. Although WBV exercise appears to be a potential treatment procedure of cancer therapy-related morbidities, further additional studies are required to determine specific and tailored protocols to be used in the different stages of the disease.

Acute effects of partial-body vibration in sitting position

AIM

To investigate the acute effects of sinusoidal and stochastic resonance partial-body vibration in sitting position, including muscle activity, heart rate variability, balance and flexibility.

METHODS

Fifty healthy participants were assigned randomly to two training conditions: A sinusoidal partial-body vibration (SIN, 8 Hz) or a stochastic resonance partial-body vibration (STOCH, 8 ± 2 Hz). For baseline assessment participants sat on the vibration platform without vibration. Both training conditions consisted of five series of a one-minute vibration training and a one-minute break between them. In this experimental study surface electromyography (EMG) of the erector spinae (ES), one of the back muscles, and heart rate variability (HRV) was measured at baseline and during training. Balance and flexibility were assessed at baseline and immediately after training. Balance was measured with the modified star excursion balance test (mSEBT) and flexibility was assessed through the modified fingertip-to-floor method (mFTF).

RESULTS

Paired sample t-test showed a significant increase in balance that was restricted to STOCH (t = -2.22, P = 0.018; SIN: t = -0.09, P = 0.466). An increase in flexibility was also restricted to STOCH (t = 2.65, P = 0.007; SIN: t = 1.41, P = 0.086). There was no significant change of muscle activity in the ES-EMG in STOCH or SIN conditions. In both training conditions, HRV decreased significantly, but remained in a low-load range (STOCH: t = 2.89, P = 0.004; SIN: t = 2.55, P = 0.009).

CONCLUSION

In sitting position, stochastic resonance partial-body vibration can improve balance and flexibility while cardiovascular load is low. STOCH can be a valuable training option to people who are unable to stand (e.g., people, who are temporarily wheelchair-bound).

Whole body vibration of different frequencies inhibits H-reflex but does not affect voluntary activation

This study aimed to investigate the effects of whole-body vibration (WBV) at a frequency spectrum from 20 to 50 Hz on the Hoffmann (H) reflex and the voluntary motor output of ankle plantar-flexor muscles. A single-group (n: 8), repeated measures design was adopted with four conditions: standing (no vibration), 20, 35 and 50 Hz, each lasting one minute. H-reflex of the soleus muscle, maximal voluntary contraction (MVC) and central activation ratio (CAR) of the plantar-flexors were evaluated before, 1 and 5 min after each frequency condition. H-reflex decreased by 36.7% at 20 Hz, by 28% at 35 Hz, and by 34.8% at 50 Hz after one minute from WBV compared to baseline. Neither MVC nor CAR changed after WBV at all frequency conditions. The short-term, acute inhibition of the H-reflex after WBV at 20, 35 and 50 Hz suggested that decreased excitability of spinal motoneurons is not frequency dependent. On the other hand, the lack of vibration induced effects on MVC and CAR indicated that a 1-min WBV stimulus is not sufficient to affect the voluntary motor output.

Adjuvant treatments associated with botulinum toxin injection for managing spasticity: An overview of the literature

BACKGROUND AND OBJECTIVE

A wide range of adjunct therapies after botulinum toxin administration have been proposed. The aim of the present paper is to provide an overview of major writings dealing with adjuvant (non-pharmacological) treatments associated with botulinum toxin for managing spasticity in order to provide some up-to-date information about the usefulness of the most commonly used procedures.

METHODS

The literature in PubMed was searched with the MeSH terms botulinum toxins, muscle spasticity, physical therapy modalities, and rehabilitation. The results were limited to studies focusing on adjuvant treatments associated with botulinum toxin for managing spasticity. We excluded papers on the use of non-drug treatments for spasticity not associated with botulinum toxin serotype A (BoNT-A) injection. Relevant literature known to the authors along with this complementary search represented the basis for this overview of the literature.

RESULTS

Adhesive taping and casting effectively improved the botulinum toxin effect in patients with upper- and lower-limb spasticity. There is level 1 evidence that casting is better than taping for outcomes including spasticity, range of motion and gait. However, consensus about their most appropriate timing, duration, target and material is lacking. In terms of physical modalities combined with botulinum toxin injection, we found level 1 evidence that extracorporeal shock wave therapy is better than electrical stimulation for some post-injection outcomes including spasticity and pain. Furthermore, electrical stimulation of injected muscles might be useful to boost the toxin effect. However, the best stimulation protocol has not been defined. In addition, we found level 2b evidence that whole-body vibration therapy might reduce spasticity with cerebral palsy.

CONCLUSION

Future research in this field should focus on investigating the most appropriate post-injection treatment protocol for each goal to achieve.

Whole-body vibration training in obese subjects: A systematic review

OBJECTIVE

(i) to determine the outcomes of whole-body vibration training (WBVT) on obese individuals, and the intervention settings producing such effects; (ii) identify potential improper or harmful use of WBVT.

DESIGN

Systematic review.

DATA SOURCES

Medline, Scopus, Web of Science, PEDro and Scielo until July 2018.

ELIGIBILITY CRITERIA

Full papers evaluating the effect of WBVT on body composition, cardiovascular status and functional performance in obese adults. Papers with PEDro score<4 were excluded.

STUDY APPRAISAL AND SYNTHESIS

Risk of bias and quality of WBVT reporting were assessed with PEDro scale (randomized controlled trials) or TREND checklist (non-randomized studies) and a 14-items checklist, respectively. Weighted acceleration, daily exposure and Hedges' adjusted g were computed.

RESULTS

We included 18 papers published 2010-2017. Typical interventions consisted in three sessions/week of exercises (squats, calf-raises) performed on platforms vibrating at 25-40 Hz (amplitude: 1-2 mm); according to ISO 2631-1:1997, daily exposure was "unsafe" in 7/18 studies. Interventions lasting ≥6 weeks improved cardiac autonomic function and reduced central/peripheral arterial stiffness in obese women; 10 weeks of WBVT produced significant weight/fat mass reduction, leg strength improvements as resistance training, and enhanced glucose regulation when added to hypocaloric diet. No paper evidenced losses of lean mass. Isolated cases of adverse effects were reported.

SUMMARY

To date, WBVT is a promising adjuvant intervention therapy for obese women; long-term studies involving larger cohorts and male participants are required to demonstrate the associated safety and health benefits. The therapeutic use of WBVT in the management of obese patients is still not standardised and should be supported by an extensive knowledge on the causality between vibration parameters and outcomes.

Determining the potential sites of neural adaptation to cross-education: implications for the cross-education of muscle strength

Cross-education describes the strength gain in the opposite, untrained limb following a unilateral strength training program. Since its discovery in 1894, several studies now confirm the existence of cross-education in contexts that involve voluntary dynamic contractions, eccentric contraction, electrical stimulation, whole-body vibration and, more recently, following mirror feedback training. Although many aspects of cross-education have been established, the mediating neural mechanisms remain unclear. Overall, the findings of this review show that the neural adaptations to cross-education of muscle strength most likely represent a continuum of change within the central nervous system that involves both structural and functional changes within cortical motor and non-motor regions. Such changes are likely to be the result of more subtle changes along the entire neuroaxis which include, increased corticospinal excitability, reduced cortical inhibition, reduced interhemispheric inhibition, changes in voluntary activation and new regions of cortical activation. However, there is a need to widen the breadth of research by employing several neurophysiological techniques (together) to better understand the potential mechanisms mediating cross-education. This fundamental step is required in order to better prescribe targeted and effective guidelines for the clinical practice of cross-education. There is a need to determine whether similar cortical responses also occur in clinical populations where, perhaps, the benefits of cross-education could be best observed.

Effects of localized vibration on knee joint position sense in individuals with anterior cruciate ligament reconstruction

BACKGROUND

Anterior cruciate ligament injury can disrupt one's mechanoreceptors and result in decreased proprioception such as joint position sense and ultimately altered motor function. The application of localized vibration has been used to investigate the integrity of the sensorimotor system and the mechanisms of quadriceps function after anterior cruciate ligament injury and reconstruction. The purpose of the study is to evaluate joint position sense with and without vibration and compare among anterior cruciate ligament reconstructed, contralateral, and control limbs.

METHODS

Fourteen subjects with anterior cruciate ligament reconstruction (8 males and 6 females) and fourteen control subjects (7 males and 7 females) participated in the study. Subjects sat on an isokinetic dynamometer chair with localized vibration strapped on the quadriceps tendon while visual and auditory cues were removed. Subjects were asked to remember an active target position and replicate that position actively. The absolute difference between the target and replicated trial was used as joint position sense. There were three trials at three target positions (15, 45, and 75 degrees of knee flexion) with and without vibration. The order of testing conditions was randomized. One-way analysis of variance or non-parametric equivalent (Kruskal-Wallis test) was used to compare among limbs. Significance was set at P < 0.05 a priori.

FINDINGS

There were no significant joint position sense differences among anterior cruciate ligament reconstructed, contralateral, and control limbs with or without vibration (P = 0.207-0.914).

INTERPRETATION

There are several potential reasons for the current findings: vibration-induced post effect, locations of vibration, types of vibration, and rehabilitation status. Future studies should expand the current investigation and explore both sensory and motor functions in anterior cruciate ligament reconstructed subjects.

Effect of two months whole body vibration on hoof growth rate in the horse: A pilot study

Hoof problems are commonly seen in veterinary practice and manipulation of hoof growth rate can be practical and beneficial for that matter. The purpose of this research was to evaluate the effect of whole body vibration (WBV) on hoof growth rate of front feet in the horse. The study was an experimental, single subject, repeated measure design, with all horses serving as control and treatment. Ten horses were subject to WBV, 30 min, twice daily, five days a week, for 60 days in addition to their regular exercise routine. Hoof growth was measured from the reference hairline down to a horizontal groove in both front feet at 30-day (monthly) intervals starting 30 days before the start of treatment (WBV) up until 60 days post cessation of the treatment (WBV). The data analysis was carried out, by applying several paired t-tests to the mean 30-day hoof growth before, during, and after treatment (WBV). A significant mean increase in hoof growth was seen after 30 days WBV (p < 0.001) as well as after 60 days WBV (p = 0.001) with the increase occurring mainly during the first 30 days of WBV. No prolonged effect on hoof growth rate was seen after cessation of WBV. These results indicate that whole body vibration can be used as a non-invasive, safe and non labor-intensive therapeutic modality to accelerate hoof growth in the horse.

The Impact of Whole Body Vibration Therapy on Spasticity and Disability of the Patients with Poststroke Hemiplegia

OBJECTIVE

To determine if whole body vibration therapy (WBV) effectively improves functional outcome in patients with poststroke hemiplegia.

MATERIALS AND METHODS

In this single-blind RCT, WBV group (n = 10) had 40 hz frequency/4 mm amplitude vibration during 5 minutes/session, 3 days a week, for a duration of 4 weeks. The control group (n = 11) had no vibration therapy for the same duration while standing on the same platform. Patients in both of the groups did 15 minutes of stretching and active range of motion exercises before the intervention. Outcome measures were Modified Ashworth Scale (MAS), Functional Independence Measurement (FIM), and Timed 10-Meter Walk Test (10 mWT).

RESULTS

Only 10 mWT improved at the 1st week (p = 0.002), 1st month (p < 0.001), and 3rd month (p < 0.001) in favor of the intervention group. There was positive correlation also between 10 mWT and ankle spasticity (p < 0.001, r = 0.931).

CONCLUSION

This study suggests that WBV therapy may be a complementary therapy in gait rehabilitation and functional outcome of the patients with calf muscle spasticity.

Comparison of vibration rolling, nonvibration rolling, and static stretching as a warm-up exercise on flexibility, joint proprioception, muscle strength, and balance in young adults

Warm-up is an essential component for optimizing performance before an exercise session. This study investigated that the immediate effects of vibration rolling (VR), nonvibration rolling (NVR), and static stretching as a part of a warm-up regimen on the flexibility, knee joint proprioception, muscle strength, and dynamic balance of the lower extremity in young adults. Compared with the preintervention, VR induced the range of motion of knee flexion and extension significantly increased by 2.5% and 6%, respectively, and isokinetic peak torque and dynamic balance for muscle strength and dynamic balance increased by 33%-35% and 1.5%, respectively. In the three conditions, most outcomes between VR and NVR were comparable; however, the participants had a significantly higher knee joint reposition error after NVR than after VR, indicating that NVR would have a hampering knee joint proprioception effect. In particular, compared with static stretching, VR significantly increased the quadriceps muscle strength by 2-fold and dynamic balance by 1.8-fold. These findings suggest that athletic professionals may take VR into account for designing more efficient and effective preperformance routine to improve exercise performances. VR has high potential to translate into an on-field practical application.

Results From a Pilot Study of Handheld Vibration: Exercise Intervention Reduces Upper-Limb Dysfunction and Fatigue in Breast Cancer Patients Undergoing Radiotherapy: VibBRa Study

Purpose:

Although there is evidence that breast cancer patients benefit from exercising during treatment, exercising during radiotherapy and especially the effects on upper-limb dysfunctions have been infrequently assessed. Therefore, we primarily aimed to confirm our interventions’ feasibility and secondarily aimed to affect upper-limb dysfunctions and fatigue.

Methods:

Twenty-two breast cancer patients scheduled for radiotherapy were allocated to an intervention (IG) or a passive control group (CG) as they preferred. IG exercised 3×/week during 6 weeks of radiotherapy: cycling endurance, handheld vibration, and balance training. We documented adverse events and training compliance (feasibility) and assessed the range of shoulder motion (ROM), isometric hand grip strength, vibration sense on the first metacarpophalangeal joint of the affected upper limb, and fatigue.

Results:

We observed no adverse events and a training compliance of 98 %. IG’s ROM improved significantly (abduction: 11°; 95% confidence interval [CI] 5 to 20; external rotation: 5°, 95% CI 0 to 10), as did the hand grip strength (1.6 kg, 95% CI −0.6 to 3.1), while CG’s ROM did not change. CG’s vibration sense worsened (−1.0 points, 95% CI −1.5 to −0.5), while IG’s remained stable. Changes in general fatigue levels between IG (−2.0 points, 95% CI −3.0 to −1.0) and CG (0.5 points, 95% CI −1.0 to 4.5) revealed significant differences (P = .008)

Conclusions:

Our intervention proved to be feasible and provides novel findings: it reduced fatigue levels and interestingly, handheld vibration exercises improved upper-limb function due to shoulder ROM, hand grip strength, and vibration sense.

A clinical single blind study to investigate the immediate effects of plantar vibration on balance in patients after stroke

Balance disorder is a very common cause of disability in patients after a stroke. Vibration therapy is one of the physiotherapeutic modalities used to improve balance.

OBJECTIVE

To investigate the immediate effects of plantar vibration on balance in patients with stroke.

METHODS

In this single blind comparative study, 22 patients with stroke (8 females, 14 males; age 55.82 ± 11.87 years old) participated. Patients underwent treatment, first with the placebo vibration and 1 week later with active vibration (frequency 100 HZ, 5 min). Mini-BESTest score, Modified Modified Ashworth Scale for plantar flexor spasticity, and ankle dorsiflexion passive range of motion (PROM) were evaluated before and immediately after the placebo or active vibration.

RESULTS

A significant clinical improvement in balance, ankle plantar flexor spasticity, and the ankle dorsiflexion PROM was observed following either placebo or active vibration. The improvements after active vibration were significantly greater for all outcome measures compared with placebo vibration. There was a large effect size (Cohen's d = 0.85) for balance after active vibration.

CONCLUSION

The vibration applied to the sole of the affected foot of patients after stroke was effective for improving balance, reducing ankle plantar flexor spasticity, and increasing ankle dorsiflexion PROM.

Effects of vibration-induced fatigue on the H-reflex

Vibration exercise (VE) has been suggested as an effective training for improving muscle strength and coordination. However, the underlying physiological adaptation processes are not yet fully understood, limiting the development of safe and effective exercise protocols. To better understand the neuromuscular responses elicited by VE, we aimed at investigating the acute effects of superimposed vibration on the Hoffmann reflex (H-reflex), measured after fatiguing exercise. Twenty-five volunteers performed four isometric contractions of the right Flexor Carpi Radialis (FCR) with baseline load at 80% of their maximal voluntary contraction (MVC), both with no vibration and with superimposed vibration at 15, 30, and 45 Hz. Fatigue was estimated by MVC test and estimation of electromyographic spectral compression. H-reflex suppression was estimated as the relative decrease after exercise. Our results show that fatiguing exercise determined a decrease in H-reflex amplitude compared to rest condition while vibration determined a lower H-reflex suppression as compared to no vibration. The superimposition of 30-Hz vibration determined the largest acute reduction in force generating capacity (36 N, p < 0.05) and the lowest H-reflex suppression (20%, p < 0.05). These results suggest VE to be particularly suitable in rehabilitation programs for rapid restoration of muscle form and function after immobilization periods.

The Effect of Whole-Body Vibration on Lower-Body Resistance Detraining in College-Age Women

PURPOSE

This study explored the effect of whole-body vibration (WBV) using accelerations of 2.56 g to 7.68 g on lower-body detraining.

METHODS

All participants (N = 20) were trained using a lower-body resistance-training program for 30 min twice per week from Week 0 to Week 6. At the end of the program, they were randomly assigned to a control group that performed no further training or a WBV group that performed a progressive static WBV program. Data for the 5-repetition-maximum (5RM) squat and extensors and flexors of the knee and ankle were collected at Weeks 0, 6, 8, 10, and 12 for all participants.

RESULTS

Two-way (condition vs. time) analysis of variance revealed that although the WBV group maintained strength in the 5RM from Week 6 through Week 8 and the control group had a lower 5RM in Week 8 from Week 6, no differences in the 5RM squat existed between the groups at Week 8. Two-way factorial multivariate analysis of variance revealed no differences between the groups at any of the time for torque of knee flexion, dorsiflexion, or plantar flexion.

CONCLUSION

Static WBV of 2.56 g to 7.68 g did not attenuate detraining of the flexors and extensors of the knee and ankle.

Metabolic effect of bodyweight whole-body vibration in a 20-min exercise session: A crossover study using verified vibration stimulus

The ability of whole body vibration (WBV) to increase energy expenditure (EE) has been investigated to some extent in the past using short-term single exercises or sets of single exercises. However, the current practice in WBV training for fitness is based on the execution of multiple exercises during a WBV training session for a period of at least 20 min; nevertheless, very limited and inconsistent data are available on EE during long term WBV training session. This crossover study was designed to demonstrate, in an adequately powered sample of participants, the ability of WBV to increase the metabolic cost of exercise vs. no vibration over the time span of a typical WBV session for fitness (20 min). Twenty-two physically active young males exercised on a vibration platform (three identical sets of six different exercises) using an accelerometer-verified vibration stimulus in both the WBV and no vibration condition. Oxygen consumption was measured with indirect calorimetry and expressed as area under the curve (O_2(AUC)). Results showed that, in the overall 20-min training session, WBV increased both the O_2(AUC) and the estimated EE vs. no vibration by about 22% and 20%, respectively (P<0.001 for both, partial eta squared [η²] ≥0.35) as well as the metabolic equivalent of task (+5.5%, P = 0.043; η² = 0.02) and the rate of perceived exertion (+13%, P<0.001; ŋ² = 0.16). Results demonstrated that vibration is able to significantly increase the metabolic cost of exercise in a 20-min WBV training session.

Efficacy of mechano-acoustic vibration on strength, pain, and function in poststroke rehabilitation: a pilot study

BACKGROUND

Vibration therapy may be used to help cortical reorganization after stroke as it can cause different adaptive metabolic and mechanical effects.

OBJECTIVE

This study examined whether the application of mechano-acoustic vibration on upper limb muscles could induce changes in range of motion (ROM), function, pain, and grip strength in individuals with chronic stroke.

METHODS

Out of 52 individuals post stroke with upper limb spasticity who were eligible,16 received mechano-acoustic vibration therapy (ViSS device) 3 times weekly for 12 sessions. The frequency of vibration was set to 300 Hz for 30 minutes. The treated muscles were the extensor carpi radialis longus and brevis and triceps brachii during voluntary contraction. All participants were evaluated in both upper limbs before (T0) and at the end (T1) of treatment with a dynamometer (hand grip strength), Modified Ashworth Scale, QuickDASH, FIM score, Fugl-Meyer scale, Verbal Numerical Rating Scale of pain, and Jebsen-Taylor Hand Function Test.

RESULTS

After 4 weeks, hand grip power had improved and pain and spasticity had decreased. Improvements were recorded for all parameters and were considered statistically significant.

CONCLUSIONS

Application of vibratory stimuli to a muscle can increase the motor-evoked potential recorded from the muscle, suggesting an enhancement of corticospinal excitability. Low amplitude, high-frequency vibration treatment (300 Hz) can significantly decrease tone and pain and improve strength in upper limb of hemiplegic individuals, when applied for 30 minutes, 3 times a week over 4 weeks.

The preventive effect of sensorimotor- and vibration exercises on the onset of Oxaliplatin- or vinca-alkaloid induced peripheral neuropathies - STOP

BACKGROUND

Chemotherapy-induced peripheral neuropathy (CIPN) is a common and clinically relevant side effect of chemotherapy. Approximately 50% of all leukemia, lymphoma, colorectal- and breast cancer patients are affected. CIPN is induced by neurotoxic chemotherapeutic agents and can manifest with sensory and/or motor deficits. It is associated with significant disability and poor recovery. Common symptoms include pain, altered sensation, reduced or absent reflexes, muscle weakness, reduced balance control and insecure gait. These symptoms not only affect activities of daily living, subsequently reducing patients' quality of life, they have far more become a decisive limiting factor for medical therapy, causing treatment delays, dose reductions, or even discontinuation of therapy, which can affect the outcome and compromise survival. To date, CIPN cannot be prevented and its occurrence presents a diagnostic dilemma since approved and effective treatment options are lacking. Promising results have recently been achieved with exercise. We have revealed that sensorimotor training (SMT) or whole body vibration (WBV) can reduce the symptoms of CIPN and attenuate motor and sensory deficits. We furthermore detected a tendency that it may also have a preventive effect on the onset of CIPN.

METHODS

We are therefore conducting a prospective, multicentre, controlled clinical trial involving 236 oncological patients receiving either oxaliplatin (N = 118) or vinca-alkaloid (N = 118) who are randomized to one of two interventions (SMT or WBV) or a treatment as usual (TAU) group. Primary endpoint is the time to incidence of neurologically confirmed CIPN. Secondary endpoints are pain, maintenance of the functionality of sensory as well as motor nerve fibres as well as the level of physical activity. The baseline assessment is performed prior to the first cycle of chemotherapy. Subsequent follow-up assessments are conducted at 12 weeks, after completion of chemotherapy, and at a 3-month follow-up. Patients who develop CIPN receive an additional assessment at this time point, as it represents the primary endpoint.

DISCUSSION

We hypothesize that SMT and WBV prevent the onset or delay the progression of CIPN, decrease the likelihood of dose reductions or discontinuation of cancer treatment and improve patients' quality of life.

TRIAL REGISTRATION

Deutsche Register Klinischer Studien ( DRKS00006088 , registered 07.05.2014).

Vibration therapy in patients with cerebral palsy: a systematic review

The neurological disorder cerebral palsy (CP) is caused by unprogressive lesions of the immature brain and affects movement, posture, and the musculoskeletal system. Vibration therapy (VT) is increasingly used to reduce the signs and symptoms associated with this developmental disability. The purpose of this narrative review was systematically to appraise published research regarding acute and long-term effects of VT on functional, neuromuscular, and structural parameters. Systematic searches of three electronic databases identified 28 studies that fulfilled the inclusion criteria. Studies were analyzed to determine participant characteristics, VT-treatment protocols, effect on gross motor function (GMF), strength, gait, posture, mobility, spasticity, reflex excitability, muscle tone, mass, and bone strength within this population, and outcome measures used to evaluate effects. The results revealed that one acute session of VT reduces reflex excitability, spasticity, and coordination deficits. Subsequently, VT has a positive effect on the ability to move, manifested for GMF, strength, gait, and mobility in patients with CP. Effects persist up to 30 minutes after VT. Long-term effects of VT manifest as reduced muscle tone and spasticity occurring concomitantly with improved movement ability in regard to GMF, strength, gait, and mobility, as well as increased muscle mass and bone-mineral density. Posture control remained unaffected by VT. In conclusion, the acute and chronic application of VT as a nonpharmacological approach has the potential to ameliorate CP symptoms, achieving functional and structural adaptations associated with significant improvements in daily living. Even though further studies including adult populations validating the neuromuscular mechanisms underlying the aforementioned adaptations should be fostered, growing scientific evidence supports the effectiveness of VT in regard to supplementing conventional treatments (physiotherapy and drugs). Therefore, VT could reduce CP-associated physical disability and sensorimotor handicaps. Goals for patients and their caregivers referring to greater independence and improved safety may be achieved more easily and time efficiently.

The effect of long-term confinement and the efficacy of exercise countermeasures on muscle strength during a simulated mission to Mars: data from the Mars500 study

Background

Isolation and long duration spaceflight are associated with musculoskeletal deconditioning. Mars500 was a unique, high-fidelity analogue of the psychological challenges of a 520-day manned mission to Mars. We aimed to explore the effect of musculoskeletal deconditioning on three outcome measures: (1) if lower limb muscle strength was reduced during the 520-day isolation; (2) if type I or II muscle fibres were differentially affected; and (3) whether any 70-day exercise interventions prevented any isolation-induced loss of strength.

Methods

Six healthy male subjects (mean ± SEM) (34 ± 3 years; 1.76 ± 0.02 metres; 83.7 ± 4.8 kg) provided written, informed consent to participate. The subjects’ maximal voluntary contraction (MVC) was assessed isometrically in the calf (predominantly type I fibres), and maximal voluntary isokinetic force (MVIF) was assessed in the quadriceps/hamstrings (predominantly type II fibres) at 0.2 and 0.4 ms⁻¹ using the Multifunctional Dynamometer for Space (MDS) at 35-day intervals throughout Mars500. Exercise interventions were completed 3–7 days/week throughout the 520-day isolation in a counterbalanced design excluding 142–177 days (rest period) and 251–284 days (simulated Mars landing). Exercise interventions included motorized treadmill running, non-motorized treadmill running, cycle ergometry, elastomer-based resistance exercise, whole-body vibration (WBV), and resistance exercise using MDS.

Results

Calf MVC did not reduce across the 520-day isolation and MDS increased strength by 18% compared to before that of 70-day exercise intervention. In contrast, there was a significant bilateral loss of MVIF across the 520 days at both 0.2 ms⁻¹ (R² = 0.53; P = 0.001) and 0.4 ms⁻¹ (0.4 ms⁻¹; R² = 0.42; P = 0.007). WBV (+ 3.7 and 8.8%) and MDS (+ 4.9 and 5.2%) afforded the best protection against isolation-induced loss of MVIF, although MDS was the only intervention to prevent bilateral loss of calf MVC and leg MVIF at 0.2 and 0.4 ms⁻¹.

Conclusions

Mars500 induced significant loss of quadriceps/hamstrings MVIF but not calf MVC. Collectively, these data suggest that muscles with predominantly type I fibres were affected less by isolation compared to type II dominant muscles. MDS and WBV afforded the best protection against isolation-induced loss of strength and thus may have virtue in exploration class missions.

Electronic supplementary material

The online version of this article (10.1186/s40798-017-0107-y) contains supplementary material, which is available to authorized users.

Effect of Training Exercises Incorporating Mechanical Devices on Fatigue and Gait Pattern in Persons with Relapsing-Remitting Multiple Sclerosis

Purpose: The aim of this study was to evaluate the effects of regular exercise incorporating mechanical devices on fatigue, gait pattern, mood, and quality of life in persons with relapsing-remitting multiple sclerosis (RRMS). Method: A total of 55 individuals with RRMS with an Expanded Disability Status Scale (EDSS) score of 0-4.5 and a Fatigue Severity Scale (FSS) score of 4.0 or more were randomly assigned to one of two exercise groups or a control group (n=18). Exercise programmes used aerobic, body weight, coordination, and balance exercises with either whole-body vibration (WBV; n=19; drop-outs, n=3) or the Balance Trainer system (n=18; drop-outs, n=4). Outcome measures included the FSS, Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory (BDI-II), and Multiple Sclerosis International Quality of Life (MusiQoL). Spatiotemporal gait parameters were assessed using the GAITRite electronic walkway. Pre- and post-intervention assessments were performed by a blinded assessor. Intra- and inter-group analysis was performed, using the paired-samples t-test, by calculating the effect size with Cohen's d analysis and one-way analysis of variance, respectively. Results: Significant improvements in fatigue and mood were identified for both intervention groups (p<0.05). Gait parameters also improved significantly in the WBV group: velocity and step length increased (12.8% and 6.5%, respectively; p<0.005), and step time, stance time, double support time, and step length asymmetry decreased (-5.3%, -1.4%, -5.9%, and -43.7%, respectively; p<0.005). Conclusions: The results of this study support the hypothesis that combined training programmes help to reduce fatigue and improve mood in persons with mild to moderate RRMS. WBV combined with a standard exercise programme significantly improves spatiotemporal gait parameters.

Effects of whole body vibration training and mental training on mobility, neuromuscular performance, and muscle strength in older men

This study was designed to evaluate the effects of whole body vibration (WBV) exercise, mental training (MT), and the concurrent effect of WBV and MT on lower body balance, neuromuscular performance, and leg muscle strength in elderly men. In a randomized control trial study with parallel group design, 42 older men (mean±standard deviation age, 68±5.78 years) were randomly divided into four groups: WBV (n=11), MT (n=12), WBV+MT (n=10), and control (n=9) groups. The protocol of training consisted of three sessions per week for 8 weeks and about 30 min for each session. The WBV exercise was performed on a vibration machine. In MT group, participants were asked to mentally visualize to do the Timed Up and Go and relaxation technics. postural stability, the Timed Up and Go test, 5-repetition chair-rising test, 6-m tandem gait test, 10-m walking, and leg isometric strength were measured in baseline and after 8-week intervention. Repeated measures-analysis of variance followed by post hoc was used to analyses the data. The results of this study showed that there were significant improvements (P<0.05) in postural stability, Timed Up and Go, 5-repetition chair-rising, 6-m tandem gait test, 10-m walking, and leg isometric strength in WBV, MT, and WBV+MT in comparison with baseline and in comparison with control group. It seems that older adults can take benefit from WBV and MT and WBV+MT exercise as a cost-effective and practical way without side effects to improve postural control, mobility, and functional performance.

The Influence of an Acute Bout of Whole Body Vibration on Human Postural Control Responses

The use of vibrating platforms has become increasingly available, and popular at sports and rehabilitation institutes. Given the discrepancies in the literature regarding whole body vibration (WBV) and human reflexive responses, the purpose of this study was to examine the acute effects of WBV on postural response latencies, as well as associated electromyography measures of the lower extremities during balance perturbations. Reflexive responses during backward and forward balance perturbations were examined before, after, and 10 min after a bout of WBV. The findings suggest that following an acute bout of whole body vibration, muscle activity of the lower extremities is decreased during a reflexive response to an unexpected perturbation, and may be associated with faster reaction time.

Whole-Body Vibration Combined with Treadmill Training Improves Walking Performance in Post-Stroke Patients: A Randomized Controlled Trial

BACKGROUND Stroke is characterized by an asymmetrical gait pattern that causes poor stability and reduces overall activity levels. The aim of this study was to investigate the effect of whole-body vibration combined with treadmill training (WBV-TT) on walking performance in patients with chronic stroke. MATERIAL AND METHODS Thirty ambulatory chronic stroke patients were randomly allocated to the WBV-TT group or the treadmill training (TT) group. The participants in the WBV-TT group performed 6 types of exercises on a vibrating platform for 4.5 minutes and then walked on the treadmill for 20 minutes. The participants in the TT group conducted the same exercise on a platform without vibration and then walked on the treadmill in the same manner. The vibration lasted for 45 seconds in each exercise, and the intervention was performed 3 times weekly for 6 weeks. The treadmill walking speed was gradually increased by 5% in both groups. The outcome measures included the temporospatial parameter of gait (GAITRite®) and 6-minute walk test. RESULTS The WBV-TT group showed significant improvements in walking performance with respect to walking speed, cadence, step length, stride length, single-limb support, double-limb support, and 6-minute walk test compared with baseline (p<0.05). Significant improvements were also seen in walking speed, step length, stride length, and double-limb support compared with the TT group (p<0.05). CONCLUSIONS These findings indicate that WBV-TT is more effective than TT for improving walking performance of patients with chronic stroke.

Can whole body vibration exercises affect growth hormone concentration? A systematic review

Whole body vibration (WBV) has been recognized as an effective alternative exercise modality to resistance exercise for its ability in enhancing force and power, generating capacity in skeletal muscle, increasing bone mass and improving cardiovascular function. Since the effect of WBV exercises on growth hormone (GH) levels has been never compared and discussed, the aim of this study was to review systematically the literature to verify the WBV effects on GH concentration. By using PubMed, Scopus and PEDRo databases with the keywords 'growth hormone' or GH and 'whole body vibration' or WBV, we found and analysed 12 papers (182 subjects recruited), verifying their level of evidence (National Health and Medical Research Council hierarchy of evidence) and the methodological quality (PEDRo scale). Although WBV induced GH responses in nine out of 12 publications, caution should be however taken when considering the results due to the markedly different methodologies among these publications.

Effect of localised vibration on muscle strength in healthy adults: a systematic review

OBJECTIVE

To investigate the effects of local vibration on muscle strength in healthy adults.

DATA SOURCES

The electronic databases PubMed, CINAHL, Scopus and Web of Science were searched using a combination of the following keywords: vibration, vibration therapy, power, maximal voluntary contraction, performance, rate of force development and vibratory exercise. In addition, the Medical Subject Headings 'vibration', 'strength' and 'exercise' were used. The bibliographical search was limited to articles published in English.

STUDY SELECTION

Trials that evaluated the effect of localised vibration on muscle strength in healthy humans were included.

DATA EXTRACTION

Two independent evaluators verified the quality of the selected studies using the PEDro Scale and the Cochrane Collaboration's tool for assessing the risk of bias. Muscle strength was calculated for each intervention.

RESULTS

In total, 29 full-text studies were assessed for eligibility. Eighteen studies did not match the inclusion criteria, and were excluded. The 11 studies included in this review had an average PEDro score of 5.36/10. Most of the studies reported significant improvements in muscle strength after the application of local vibration. There was considerable variation in the vibration training parameters and target muscle location.

CONCLUSIONS

The use of local vibration on the target muscle can enhance muscle strength in healthy adults. Further well-designed controlled studies are required to confirm the effect of local vibration training on muscle strength.

Whole body vibration exercise training for fibromyalgia

BACKGROUND

Exercise training is commonly recommended for adults with fibromyalgia. We defined whole body vibration (WBV) exercise as use of a vertical or rotary oscillating platform as an exercise stimulus while the individual engages in sustained static positioning or dynamic movements. The individual stands on the platform, and oscillations result in vibrations transmitted to the subject through the legs. This review is one of a series of reviews that replaces the first review published in 2002.

OBJECTIVES

To evaluate benefits and harms of WBV exercise training in adults with fibromyalgia.

SEARCH METHODS

We searched the Cochrane Library, MEDLINE, Embase, CINAHL, PEDro, Thesis and Dissertation Abstracts, AMED, WHO ICTRP, and ClinicalTrials.gov up to December 2016, unrestricted by language, to identify potentially relevant trials.

SELECTION CRITERIA

We included randomized controlled trials (RCTs) in adults with the diagnosis of fibromyalgia based on published criteria including a WBV intervention versus control or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected trials for inclusion, extracted data, performed risk of bias assessments, and assessed the quality of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences.

MAIN RESULTS

We included four studies involving 150 middle-aged female participants from one country. Two studies had two treatment arms (71 participants) that compared WBV plus mixed exercise plus relaxation versus mixed exercise plus relaxation and placebo WBV versus control, and WBV plus mixed exercise versus mixed exercise and control; two studies had three treatment arms (79 participants) that compared WBV plus mixed exercise versus control and mixed relaxation placebo WBV. We judged the overall risk of bias as low for selection (random sequence generation), detection (objectively measured outcomes), attrition, and other biases; as unclear for selection bias (allocation concealment); and as high for performance, detection (self-report outcomes), and selective reporting biases.The WBV versus control comparison reported on three major outcomes assessed at 12 weeks post intervention based on the Fibromyalgia Impact Questionnaire (FIQ) (0 to 100 scale, lower score is better). Results for HRQL in the control group at end of treatment (59.13) showed a mean difference (MD) of -3.73 (95% confidence interval [CI] -10.81 to 3.35) for absolute HRQL, or improvement of 4% (11% better to 3% worse) and relative improvement of 6.7% (19.6% better to 6.1% worse). Results for withdrawals indicate that 14 per 100 and 10 per 100 in the intervention and control groups, respectively, withdrew from the intervention (RR 1.43, 95% CI 0.27 to 7.67; absolute change 4%, 95% CI 16% fewer to 24% more; relative change 43% more, 95% CI 73% fewer to 667% more). The only adverse event reported was acute pain in the legs, for which one participant dropped out of the program. We judged the quality of evidence for all outcomes as very low. This study did not measure pain intensity, fatigue, stiffness, or physical function. No outcomes in this comparison met the 15% threshold for clinical relevance.The WBV plus mixed exercise (aerobic, strength, flexibility, and relaxation) versus control study (N = 21) evaluated symptoms at six weeks post intervention using the FIQ. Results for HRQL at end of treatment (59.64) showed an MD of -16.02 (95% CI -31.57 to -0.47) for absolute HRQL, with improvement of 16% (0.5% to 32%) and relative change in HRQL of 24% (0.7% to 47%). Data showed a pain intensity MD of -28.22 (95% CI -43.26 to -13.18) for an absolute difference of 28% (13% to 43%) and a relative change of 39% improvement (18% to 60%); as well as a fatigue MD of -33 (95% CI -49 to -16) for an absolute difference of 33% (16% to 49%) and relative difference of 47% (95% CI 23% to 60%); and a stiffness MD of -26.27 (95% CI -42.96 to -9.58) for an absolute difference of 26% (10% to 43%) and a relative difference of 36.5% (23% to 60%). All-cause withdrawals occurred in 8 per 100 and 33 per 100 withdrawals in the intervention and control groups, respectively (two studies, N = 46; RR 0.25, 95% CI 0.06 to 1.12) for an absolute risk difference of 24% (3% to 51%). One participant exhibited a mild anxiety attack at the first session of WBV. No studies in this comparison reported on physical function. Several outcomes (based on the findings of one study) in this comparison met the 15% threshold for clinical relevance: HRQL, pain intensity, fatigue, and stiffness, which improved by 16%, 39%, 46%, and 36%, respectively. We found evidence of very low quality for all outcomes.The WBV plus mixed exercise versus other exercise provided very low quality evidence for all outcomes. Investigators evaluated outcomes on a 0 to 100 scale (lower score is better) for pain intensity (one study, N = 23; MD -16.36, 95% CI -29.49 to -3.23), HRQL (two studies, N = 49; MD -6.67, 95% CI -14.65 to 1.31), fatigue (one study, N = 23; MD -14.41, 95% CI -29.47 to 0.65), stiffness (one study, N = 23; MD -12.72, 95% CI -26.90 to 1.46), and all-cause withdrawal (three studies, N = 77; RR 0.72, 95% CI -0.17 to 3.11). Adverse events reported for the three studies included one anxiety attack at the first session of WBV and one dropout from the comparison group ("other exercise group") due to an injury that was not related to the program. No studies reported on physical function.

AUTHORS' CONCLUSIONS

Whether WBV or WBV in addition to mixed exercise is superior to control or another intervention for women with fibromyalgia remains uncertain. The quality of evidence is very low owing to imprecision (few study participants and wide confidence intervals) and issues related to risk of bias. These trials did not measure major outcomes such as pain intensity, stiffness, fatigue, and physical function. Overall, studies were few and were very small, which prevented meaningful estimates of harms and definitive conclusions about WBV safety.

Adding Whole-Body Vibration to Preconditioning Squat Exercise Increases Cycling Sprint Performance

Duc, S, Rønnestad, BR, and Bertucci, W. Adding whole-body vibration to preconditioning squat exercise increases cycling sprint performance. J Strength Cond Res 34(5): 1354-1361, 2020-This study investigated the effect of performing a preconditioning exercise with or without whole-body vibration (WBV) on a subsequent cycling sprint performance. Fourteen trained subjects performed 2 separate test sessions in randomized order. After a warm-up, the preconditioning exercise (body-loaded half-squats) was applied: 30 seconds of half-squats with WBV (40 Hz, 2 mm) or 30 seconds of half-squats without WBV with a 10-second all-out sprint performed after 1 minute. Surface electromyography (EMG) was measured from the vastus medialis, vastus lateralis, and gastrocnemius medialis during the sprints. Blood lactate level (BL), heart rate (HR), and rating of perceived exertion (RPE) were determined immediately after the 10-second sprint. Performing preconditioning exercise with WBV resulted in superior peak (1,693 ± 356 vs. 1,637 ± 349 W, p ≤ 0.05) and mean power output (1,121 ± 174 vs. 1,085 ± 175 W, p ≤ 0.05) compared with preconditioning exercise without WBV. Effect sizes showed a moderate and large practical effect of WBV vs. no WBV on peak and mean power output, respectively. No differences were observed between the conditions for BL, HR, and RPE after the sprints and in EMG activity during the sprints. In conclusion, it is plausible to suggest that body-loaded half-squats with WBV acutely induce higher power output levels. The practical application of the current study is that body-loaded squats with WBV can be incorporated into preparations for specific sprint training to improve the quality of the sprint training and also to improve sprint performance in relevant competitions.

Chenopodium ambrosioides associated with whole body vibration exercises alters the feed intake in Wistar rats

The consequences of treatment involving the use of a natural product and whole body vibration (WBV) exercise have been investigated. The aim of the present study was to evaluate the effects of the joint treatment with an aqueous extract of Chenopodium ambrosioides and WBV on physiological parameters in rats. Wistar rats (n=20) were divided equally into four groups: control group (CG), treated with C. ambrosioides (CHE) group, exposed to 50 Hz of mechanial vibration (VBR), and treated with C. ambrosioides and exposed to 50 Hz of mechanical vibration (VBR + CHE) daily for 6 weeks. The body mass of the animals was determined weekly, the feed intake and the stool consistency were measured daily. One day after the 6 weeks of treatment, samples of blood were collected and used for biochemical analysis. Along 6 weeks, there was an increase (P<0.001) in the feed intake in VBR group and a decrease in the CHE group in comparison with other groups. The levels of the enzyme aspartate aminotransferase (AST) in VBR + CHE group decreased (P<0.05) in comparison with other groups. No differences were found in body mass and stool consistency. WBV altered the feed intake without directly affecting the body mass. Moreover, WBV in association with C. ambrosioides caused alteration in the enzymatic activity of AST.

Alleviation of Motor Impairments in Patients with Cerebral Palsy: Acute Effects of Whole-body Vibration on Stretch Reflex Response, Voluntary Muscle Activation and Mobility

INTRODUCTION

Individuals suffering from cerebral palsy (CP) often have involuntary, reflex-evoked muscle activity resulting in spastic hyperreflexia. Whole-body vibration (WBV) has been demonstrated to reduce reflex activity in healthy subjects, but evidence in CP patients is still limited. Therefore, this study aimed to establish the acute neuromuscular and kinematic effects of WBV in subjects with spastic CP.

METHODS

44 children with spastic CP were tested on neuromuscular activation and kinematics before and immediately after a 1-min bout of WBV (16-25 Hz, 1.5-3 mm). Assessment included (1) recordings of stretch reflex (SR) activity of the triceps surae, (2) electromyography (EMG) measurements of maximal voluntary muscle activation of lower limb muscles, and (3) neuromuscular activation during active range of motion (aROM). We recorded EMG of m. soleus (SOL), m. gastrocnemius medialis (GM), m. tibialis anterior, m. vastus medialis, m. rectus femoris, and m. biceps femoris. Angular excursion was recorded by goniometry of the ankle and knee joint.

RESULTS

After WBV, (1) SOL SRs were decreased (p < 0.01) while (2) maximal voluntary activation (p < 0.05) and (3) angular excursion in the knee joint (p < 0.01) were significantly increased. No changes could be observed for GM SR amplitudes or ankle joint excursion. Neuromuscular coordination expressed by greater agonist-antagonist ratios during aROM was significantly enhanced (p < 0.05).

DISCUSSION

The findings point toward acute neuromuscular and kinematic effects following one bout of WBV. Protocols demonstrate that pathological reflex responses are reduced (spinal level), while the execution of voluntary movement (supraspinal level) is improved in regards to kinematic and neuromuscular control. This facilitation of muscle and joint control is probably due to a reduction of spasticity-associated spinal excitability in favor of giving access for greater supraspinal input during voluntary motor control.

Acute and chronic neuromuscular adaptations to local vibration training

Vibratory stimuli are thought to have the potential to promote neural and/or muscular (re)conditioning. This has been well described for whole-body vibration (WBV), which is commonly used as a training method to improve strength and/or functional abilities. Yet, this technique may present some limitations, especially in clinical settings where patients are unable to maintain an active position during the vibration exposure. Thus, a local vibration (LV) technique, which consists of applying portable vibrators directly over the tendon or muscle belly without active contribution from the participant, may present an alternative to WBV. The purpose of this narrative review is (1) to provide a comprehensive overview of the literature related to the acute and chronic neuromuscular changes associated with LV, and (2) to show that LV training may be an innovative and efficient alternative method to the 'classic' training programs, including in the context of muscle deconditioning prevention or rehabilitation. An acute LV application (one bout of 20-60 min) may be considered as a significant neuromuscular workload, as demonstrated by an impairment of force generating capacity and LV-induced neural changes. Accordingly, it has been reported that a training period of LV is efficient in improving muscular performance over a wide range of training (duration, number of session) and vibration (frequency, amplitude, site of application) parameters. The functional improvements are principally triggered by adaptations within the central nervous system. A model illustrating the current research on LV-induced adaptations is provided.