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]

Effects of low-frequency vibration training on walking ability and body composition among older adults: a randomized controlled trial

Background

As life expectancy rises, age-related decline in mobility and physical function poses challenges for older adults. While traditional exercise can help, limitations and injury risks persist. This study explores low-frequency vibration training as a potential alternative to improve walking ability and body composition in older adults.

Methods

A lottery was used to randomly assign 50 participants (mean age 80.08 years) to either a vibration group (n = 25, 10 males, 15 females) or a control group (n = 25, 11 males, 14 females). While the control group continued their regular daily schedule, the vibration group completed 8 weeks of low-frequency vibration training (frequency: 4-13 Hz; amplitude: two mm), three sessions per week, with each session lasting 20-30 minutes. The walk ability was assessed using the 30-second Chair Stand Test (30-s CST), Timed Up and Go (TUG), and six-meter (six m) walk speed, while body composition was measured via body mass index (BMI), body fat percentage, and waist circumference (WC), hip circumference (HC), and waist-to-hip ratio (WHR).

Results

Low-frequency vibration training significantly increased walking speed in the six m walk speed (F (1,36) = 4.50, p = 0.04, η p 2 = 0.11) and TUG (z =  - 2.72, p = 0.007), compared with the control group. Observed improvements on the 30-s CST were not statistically significant (F (1,36) = 0.05, p = 0.81, η p 2 = 0.002). In the WC, the effect of time (F (1,36) = 7.19, p = 0.01, η p 2 = 0.16) was significant. The main effect of the group for HC (F (1,36) = 0.06, p = 0.80, η p 2 = 0.002) and WHR (F (1,36) = 2.00, p = 0.16, η p 2 = 0.05) were not significant, but the interaction effects for HC (F (1,36) = 6.37, p = 0.01, η p 2 = 0.15) and WHR (F (1,36) = 9.08, p = 0.005, η p 2 = 0.20) were significant. However, the intervention showed no statistically significant effects on BMI and body fat percentage.

Conclusion

Low-frequency vibration training significantly enhanced walking speed and WHR in older adults. This low-intensity intervention is especially beneficial for those with exercise limitations or a high risk of injury. Although its effects on BMI and body fat percentage were limited, the study offers valuable insights for developing personalized vibration training programs.

Massage-Like Sensation and Tissue Mobilization During Phonation With Two Oscillatory Positive Expiratory Pressure Devices

PURPOSE

This study primarily aimed at observing whether high-frequency vibration devices generate tissue mobilization on facial, neck, and chest tissues. An additional objective was to inspect resulting self-perceived sensation of massage-like sensation.

METHOD

Fifty-two participants engaged in a set of three phonatory tasks: (a) phonation with Shaker Medic Plus device, (b) phonation with Acapella Choice device, and (c) sustained vowel [a:] (control task). Self-perceived massage-like sensation was also assessed. All exercises were performed at three loudness levels. Tissue mobilization was captured by four accelerometers placed in four different locations: (a) over the cheek, (b) over the neck, (c) over the thyroid cartilage, and (d) over the suprasternal notch. Frequency, amplitude, and regularity of tissue oscillation were measured.

RESULTS

Analyses of variance showed significant second-order interactions for vibration amplitude and frequency. A two-way interaction (Task × Location) was observed for jitter, and no significant interactions were found for shimmer. Self-perceived massage-like sensation results showed that Acapella and Shaker generate almost identical effects, both being significantly higher to the one delivered by vowel [a:].

CONCLUSION

Both Acapella and Shaker devices are able to mobilize tissues. Tasks, loudness level, and location could produce an effect on tissue oscillation variables. The Acapella device tends to produce a larger amplitude of vibration than the Shaker does. However, self-reported sensation of massage is virtually the same for both devices. Control of dependent variables of tissue oscillation (frequency, amplitude, and regularity) is apparently relevant to obtain the greatest massage-like effect in patients.

Frequency-Regulated Repeated Micro-Vibration Promotes Osteoblast Differentiation Through BMP Signaling in MC3T3-E1 Cells

Physical stimulation, which is a key factor affecting the metabolism of osteoblasts and their precursor cells, plays an important role in bone remodeling; however, the role of micro-vibrations in osteoblast differentiation is unclear. In the present study, we determined the effects of frequency-regulated repeated micro-vibration (FRMV) on cell proliferation and established a method to induce osteoblast differentiation through FRMV using the mouse pre-osteoblast-like cell line MC3T3-E1, which is widely used in bone metabolism research. The results indicated that FRMV significantly influenced the proliferation of MC3T3-E1 cells in a normal growth medium. FRMV at 42.2 Hz significantly promoted proliferation, whereas FRMV at 92.1 Hz showed no effect on the proliferation rate. Moreover, FRMV at 42.2 Hz significantly increased alkaline phosphatase (ALP) enzyme activity and ALP gene expression in MC3T3-E1 cells. Treatment with LDN193189, a bone morphogenetic protein (BMP) signaling inhibitor, revealed that the FRMV-induced upregulation in ALP enzyme activity and ALP gene expression were significantly suppressed in MC3T3-E1 cells. The results suggest that the FRMV protocol developed in the present study induces osteoblast differentiation through the BMP signaling pathway. Thus, FRMV may contribute to the development of effective bone regeneration technologies.

Feasibility within-subject RCT of neuromuscular electrical stimulation; an Intervention to Maintain and improve neuroMuscular function during period of Immobility (IMMI)

INTRODUCTION

Neuromuscular electrical stimulation (NMES) is a potentially effective intervention to improve outcomes after a fragility fracture, but its feasibility in this group has not been established.

METHODS

A feasibility study was conducted in two phases: 1) in the hospital only, and 2) hospital, rehabilitation centres, and participants' homes. Patients with fragility fracture were randomised to receive NMES for 6 weeks/discharge either to the right or left leg, with the other leg serving as control. Patients who had no mobility issues had contraindications to NMES and were unable to give consent were excluded. NMES was applied to quadriceps and tibialis anterior muscles for 30 min, 3 days/week. Sessions were progressed to achieve 60 min, 5-7 days/week. Feasibility outcomes included participant characteristics, recruitment rate, tolerability, and number of NMES sessions. Clinical outcomes included muscle strength, and ADL at six months.

RESULTS

Overall, 1052 patients were identified, of whom 113 (11%) were eligible, and 29 (3%) were recruited (median Clinical Frailty Score 3, median Barthel ADL score 93/100). The recruitment rate was 0.45/week in phase 1 and 0.9/week in phase 2. Fifty-three percent achieved the target of 24 NMES sessions. However, 5/29 withdrew due to intolerance of NMES. Leg muscle strength improved in both treated and untreated legs, with marginally greater improvement observed in the tibialis anterior of treated legs.

CONCLUSION

Although it would be feasible to evaluate the specific effect of NMES in fragility fracture patients in a multi-centre trial using home-based NMES, this would be possible only in a minority of mildly frail fragility fracture patients with little premorbid disability.

Investigating the effects of percussion massage therapy on pain, functionality, muscle diameter, and proprioception in ındividuals with ACL reconstruction: a randomized controlled trial

BACKGROUND

Percussion massage therapy (PMT) integrates traditional massage with vibration therapy. This study examined the effects of adding PMT to a structured exercise program for individuals who underwent surgery after an anterior cruciate ligament (ACL) injury.

METHODS

A total of 24 individuals aged 18-40 were included in the study. Participants were divided into the PMT and structured exercise groups (SEG). The SEG group received a progressive neuromuscular exercise program, and the PMT group received the same structured exercise program and PMT. Range of motion (ROM) was assessed using the Goniometer Pro smartphone application, joint position sense (JPS) was measured goniometer, pain intensity was evaluated with the Visual Analog Scale (VAS), functionality was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), balance was measured with the Berg Balance Scale, quality of life was evaluated using the Short Form-36 (SF-36), and muscle diameter was measured via ultrasonography.

RESULTS

Significant improvements were observed in all parameters in both groups post-treatment (p < 0.05). The PMT group showed superior results compared to the SEG group in ROM, JPS (60°), pain, functionality, balance, and quality of life (particularly in the general health perception sub-parameter of SF-36) (p < 0.05).

CONCLUSIONS

The findings of this study suggest that incorporating PMT, a novel approach in the literature, into the rehabilitation program following ACL reconstruction could be effective. PMT could be an alternative treatment method that can be used in conjunction with exercise programs in ACL rehabilitation.

TRIAL REGISTIRATION

NCT06185231.

Integrating deliberate shaking into daily living: a paradoxical exercise for Parkinsonian tremor

PURPOSE

Medication often falls short in controlling tremors in Parkinson's disease. While physical activities suggest potential benefits, current exercise regimes have limitations. This paper explores the concept of deliberate shaking as an intervention to aid exercise uptake and potentially leverage synergies between medication and physical activity. It examines the rationale for and mechanisms of deliberate shaking before exploring its further examination and implementation for tremor rehabilitation.

METHOD

This conceptual article draws on relevant literature using the SANRA guide to explore the potential of deliberate shaking to relieve tremors in Parkinson's disease.

RESULTS

Deliberate shaking is a controlled exercise where an individual consciously initiates and partially surrenders to rhythmic movements while maintaining the ability to stop at will. Integrated into daily activities, this practice may target and stimulate specific muscle groups. It may alleviate tremor through various mechanisms: neurobiological, physiological, and cognitive and psychological. Before implementation, empirical research is needed to assess its feasibility, safety, and effectiveness. Implementation requires assessing eligibility for a shaking prescription, setting personalized goals, providing guidance as needed, and ensuring appropriate safety measures are in place.

CONCLUSIONS

Deliberate shaking is a potential adjunct treatment for Parkinsonian tremor. However, it requires further testing.

Vibrotactile stimulation at 40 Hz inhibits Aβ-induced changes in SH-SY5Y, BV2 cells, and pericytes

Alzheimer's disease (AD) poses a major societal challenge, yet no definitive cure exists. Noninvasive brain stimulation methods, such as transcranial magnetic stimulation and transcranial direct current stimulation, have shown promise in alleviating cognitive symptoms associated with neurodegenerative disorders. This study investigated the effects of 40 Hz vibrotactile stimulation on AD-related cellular responses using SH-SY5Y neuroblastoma cells, primary human brain pericytes, and BV2 microglia. SH-SY5Y cells and brain pericytes treated with oligomeric beta-amyloid (Aβ) underwent 40 Hz vibrational stimulation for varying durations. Cell viability was determined via the CCK-8 assay, while intracellular calcium levels in pericytes were assessed. Protein expression was measured using western blotting, and gene expression was quantified via a real-time quantitative polymerase chain reaction. Detailed vibrational parameters were employed to ensure precise stimulation. Notably, 40 Hz vibrotactile stimulation improved cell viability in Aβ-exposed SH-SY5Y cells, reduced intracellular calcium ion (Ca2+) levels in Aβ-treated pericytes, activated autophagy, and mitigated tau hyperphosphorylation in SH-SY5Y cells. Additionally, it exhibited anti-neuroinflammatory properties in BV2 microglia. These findings highlight the potential of 40 Hz vibrotactile stimulation as a therapeutic strategy for AD.

Myoelectric Fatigue and Motor-Unit Firing Patterns During Sinusoidal Vibration Superimposed on Low-Intensity Isometric Contraction

Vibration exercise (VE) has shown promising results for improving muscle strength and power performance when superimposed on high-level muscle contraction. However, low-level contraction may be more preferable in many rehabilitation programs due to the weakness of the patients. Unfortunately, the effects and underlying physiological mechanisms of VE superimposed on low-level contraction are unclear. This study aims to investigate the fatiguing effects and motor unit (MU) firing patterns during VE with low-level muscle contraction. Twenty-one healthy participants performed 60-s isometric contraction of the upper limb under a baseline force at 30% maximum voluntary contraction and superimposed vibration with an amplitude of 50% baseline and different frequencies at 0 Hz (control), 15, 25, 35, and 45 Hz. High-density surface electromyography (EMG) was recorded on the biceps brachii. The decay in muscle fiber conduction velocity, calculated in 3-s sliding windows, was employed as an indicator of myoelectric fatigue. MU firing patterns were obtained by decomposing the high-density EMG into MU spike trains. VE, particularly at 25 Hz, produces increased myoelectric fatigue as compared to the control condition. Besides, synchronized MU discharges are observed at the vibration frequency for 15- and 25-Hz VE and the sub-harmonics for 35- and 45-Hz VE. Furthermore, VE-induced increase in MU synchronization (as compared to control) seems to decrease with myoelectric fatigue. Significance: Our findings suggest that VE may be a suitable modality for rehabilitation programs, providing useful insights for subscribing appropriate VE training protocols.

Impact of whole-body vibration training on ankle joint proprioception and balance in stroke patients: a prospective cohort study

BACKGROUND

Although whole-body vibration (WBV) training is acknowledged for its benefits in enhancing motor functions across several neurological disorders, its precise influence on ankle joint proprioception and balance in stroke patients is still not well understood. This research seeks to assess the impact of WBV training on ankle joint proprioception and balance in stroke patients, thereby filling this important research void.

METHODS

In this prospective cohort study, thirty-five stroke patients were randomly assigned to either the WBV group (n = 17) or a control group (n = 18) using a random number table method. The control group received daily general rehabilitation for four weeks, while the WBV group received an additional 30 min of WBV training each day with the Trunsan S110 Vibration Training System. Blinded outcome assessments were conducted at baseline and post-treatment, utilizing the Berg balance scale (BBS), Functional reach test (FRT), Romberg test length (RTL) and area (RTA), and completion rates of ankle joint dorsiflexion-plantar flexion (DP) and inversion-eversion (IE) tests. Follow-up assessments were performed after four weeks of intervention, focusing on RTL, RTA, DP, and IE as primary outcomes.

RESULTS

Analysis of intra-group changes from baseline to post-treatment revealed significant improvements across the BBS, FRT, RTL, RTA, and DP and IE assessments (p < 0.001). Notably, the WBV group showed significant enhancements compared to the control group in DP and IE (p < 0.001 and p < 0.05, respectively), with mean values increasing from 13.556 to 16.765 (23.7%) and from 5.944 to 8.118 (36.6%), respectively. However, WBV did not provide additional benefits over the control treatment for balance recovery parameters such as BBS, FRT, RTL, and RTA (p > 0.05).

CONCLUSIONS

This study demonstrates that WBV therapy is equally effective as conventional methods in enhancing proprioception and balance in stroke patients, but it does not provide additional benefits for balance recovery. WBV significantly improves proprioceptive functions, particularly in DP and IE parameters. However, it does not surpass traditional rehabilitation methods in terms of balance recovery. These findings indicate that WBV should be incorporated into stroke rehabilitation primarily to enhance proprioception rather than to optimize balance recovery.

TRIAL REGISTRATION

This study was retrospectively registered in the ISRCTN Registry on 29/07/2024 ( https://www.isrctn.com/ , ISRCTN64602845).

Acute effects of whole-body vibration on ankle motion smoothness in individuals with chronic ankle instability

BACKGROUND

High ankle motion smoothness involves small acceleration or deceleration, which is related to ankle stability. Interventions for ankle motion smoothness are important to reduce the progression of chronic ankle instability (CAI) symptoms and prevent recurrent ankle sprains. Training using whole-body vibration (WBV) may easily and effectively improve ankle motion smoothness; however, its effects have not yet been investigated.

OBJECTIVES

We aimed to clarify the acute effects of WBV training on ankle motion smoothness in patients with CAI.

DESIGN

Randomized controlled trials.

METHOD

Overall, 31 university students from a basketball team with CAI were included. Training was performed using a WBV device in both groups. The WBV group was administered with WBV using the device, whereas the NWBV group was not administered with WBV. Only one training session was performed in each group immediately after the premeasurements. The main outcome measure was the mean angular jerk cost of the ankle joint in plantar/dorsal flexion and in inversion/eversion during the star excursion balance test (SEBT), which were measured using accelerometers.

RESULTS/FINDINGS

No significant group × time interaction was noted for the mean angular jerk cost of the ankle joint in any direction (anterior, posterolateral, or posteromedial) during ankle inversion/eversion or plantar/dorsal flexion. Pre and postintervention comparisons of each group showed no significant differences in any of the SEBT directions in both ankle inversion/eversion and plantar/dorsal flexion in the NWBV and WBV groups.

CONCLUSIONS

Using WBV training on individuals with chronic ankle instability did not acutely improve ankle motion smoothness.

A comparison between the effects of vibration exercise and needle therapy on fibromyalgia symptoms and well-being in community-dwelling older adults: A randomized control study

This randomized controlled pilot study compared the efficiency of exercise on a vibration machine combined with needle therapy versus needle therapy alone in managing fibromyalgia symptoms and well-being among older adults. Conducted at King Khalid Hospital in Alkharj, Saudi Arabia, the study involved eighty-six patients aged 60 to 67 years. Participants were randomly assigned to either the VENT (Vibration Exercise Device) group or the NT (Needle Therapy) group. The VENT group underwent 10-minute vibration training sessions twice a week, paired with 30-minute needle acupuncture sessions once a week, while the NT group received needle therapy alone. Both interventions were carried out over 12 weeks. Pre- and post-intervention assessments measured disability, pain, balance, and quality of life. Data analysis showed that 94.1% of participants completed the study, with significant improvements in disability observed in the VENT group. Both groups demonstrated significant improvements in pain, balance, and well-being. However, post-intervention comparisons favored the VENT group, showing significantly better outcomes. The findings suggest that combining vibratory exercise with needle therapy offers enhanced benefits for older adults with fibromyalgia.

Effects of focal vibration on changes in sports performance in amateur athletes: A randomized clinical trial

The aim of this study was to evaluate the effectiveness of a focal vibration protocol added to an activation protocol with active muscle contractions and to see what repercussions it has on sprint, countermovement jump (CMJ), and lower limb isometric strength. A double-blind randomized clinical trial was conducted in the Functional Anatomy Laboratory and the sample consisted of 70 athletes. The main outcome measures were knee extension force, CMJ, sprint, and surface electromyography. Repeated-measures analysis of variance revealed significant improvements. They were found in the within-group analysis for the Experimental Group in the isometric extension force (p < 0.001; η2 = 0.368), CMJ (p < 0.001; η2 = 0.301) and 30 m sprint (p < 0.001; η2 = 0.376). In the electromyography, there are changes in the Sham Group in all muscles, in CMJ and Sprint tests, and no differences in the Experimental Group, except for the RF muscle. In the between-group analysis, statistically significant differences were found only in favor of the Experimental Group in CMJ (p = 0.017; η2 = 0.81) and 30 m sprint (p < 0.001; η2 = 0.152). These results confirm a significant improvement in the sprint, CMJ performance, and quadriceps strength, after a focal vibration protocol, added to a muscle active contraction, compared to a focal vibration sham protocol. Therefore, our results suggest that the focal vibration can be a very useful tool in sports involving high-powered actions.

Pressure, Flow, and Glottal Area Waveform Profile Changes During Phonation Using the Acapella Choice Device

INTRODUCTION

Vibratory positive expiratory pressure (PEP) devices are now commonly used as a resource for voice therapy. PEP devices promote improved vocal economy with the added benefit of producing a massage effect in the vocal tract. Although the benefits of PEP devices for voice have already been demonstrated, their impact on the vocal source is still not very clear. This study assesses the impact of phonation into the Acapella Choice (a type of PEP device) on the voice.

METHODS

Three normophonic subjects underwent high-speed videoendoscopy assessment while pressure, flow and electroglottographic data was collected.

RESULTS

Phonation into the Acapella device produces large changes in the pressure and flow profiles consequently affecting the voice source. In specific, when intraoral pressure increases as a consequence of the downward movement of the rocker arm in the Acapella device (reduction of the airflow outlet), phonation is hindered, demonstrated by the lower amplitude of vibration of the vocal folds and weaker modulation of the pressure and flow values by the glottal cycle. When the rocker arm in the Acapella device opens (increasing the airflow outlet), the opposite trend is observed where vocal fold vibration is aided and the modulation of pressure and flow by the vocal cycle increases. Based on the pressure and flow signals, we can assume that the impedance of the vocal tract alternates between two dominant regimes: increased inertive reactance (aided vibration) and increased resistance (hindered vibration).

CONCLUSIONS

PEP devices, such as the Acapella device, are efficient in modulating the pressure and flow profiles in the vocal tract leading to the alternation of glottal vibration from aided to hindered. These changes in the glottal vibration can be considered an additional consequence of the massage effect caused by the Acapella device.

Acute effects of whole-body vibration on unilateral isometric knee extensors maximal torque and fatigability during an intermittent endurance task in adult males

Whole-body vibration (WBV) has been employed for performance-enhancing purposes. WBV may positively affect muscular endurance and its underlying neural mechanisms due to an enhanced muscular blood circulation and oxygen uptake. However, the effects of WBV on endurance-related torque signal complexity have been understudied. This study aims to investigate the acute effects of WBV on i) maximal isometric torque production; ii) isometric knee extensors fatigability and iii) torque signal complexity during an isometric endurance task. Thirty adult males performed an isometric intermittent endurance protocol on their dominant lower limb after performing: static half squat with WBV (WBV), static half squat without WBV (HS), and no exercise protocol (CC). For each repetition the maximal torque was identified. The maximal torque of the first repetition was identified as the PeakT. The Mean torque (MTorque) and fatigue index (pFatigue) were calculated as the mean and the percentage decay in torque across the entire set of eighteen repetitions (MTorque0-100 %, pFatigue0-100 %), and across shorter blocks of six repetitions (MTorque0-33 %, pFatigue0-33 %; MTorque34-66 %, pFatigue34-66 %, and MTorque67-100 %, pFatigue67-100 %). Torque fluctuations were analysed computing Sample Entropy (SampEn) and the coefficient of variation (CV). PeakT was significantly higher in CC than in WBV (p < 0.01) and in HS (p < 0.01). PeakT was significantly higher in HS than in WB (p < 0.05). MTorque0-100 %, MTorque0-33 %, MTorque34-66 %, and MTorque67-100 % were significantly higher in CC than in WBV (all p-values <0.01) and in HS (p < 0.01). MTorque67-100 % was significantly higher in HS than in WB (p = 0.049). pFatigue34-66 % was significantly higher in WBV than in CC (p < 0.05) whereas pFatigue67-100 % was significantly higher in CC than in WB (p < 0.01) and in HS (p < 0.01). No effect of condition was observed for SampEn and CV. Acute WBV does not lead to beneficial effects on maximal torque production and isometric knee extensors fatigability. These acute detrimental effects may be related to long-term WBV-related adaptations.

Acute Effect of Whole-Body Vibration on Trunk Endurance and Balance in Obese Female Students: Randomized Controlled Trial

Background and Objectives: Compared to other subjects, obese people have inferior trunk muscle endurance and balance. A modern method of neuro-muscular training called whole body vibration (WBV) may improve trunk muscle endurance and balance. This study evaluates the impact of a 4-week WBV program on trunk endurance and balance in obese female students. Materials and Methods: Sixty participants from 18 to 25 years of age and with BMI values ≥ 30 were randomly distributed into two equal groups: Group A (WBV group), who received 4 min of WBV, and Group B (sham WBV group), who received WBV with a turn-off device. The training was conducted two days/week for six weeks. Trunk endurance was evaluated using the Sorensen Test (ST) and Trunk Flexor Endurance Test (TFET). The Single-Leg Test (SLT) was used to assess static balance, while the Biodex Stability System measured dynamic balance. Results: The current study demonstrated no significant differences (p > 0.05) in pre-treatment variables between Groups A and B. Post-treatment, Group A showed a significantly higher duration of the Sorensen test, TFET and SLS than Group B (p < 0.001). Moreover, Group A showed significantly lower dynamic balance (p < 0.001) than Group B. Conclusions: WBV has a short-term effect on trunk endurance and balance in obese female students. WBV can be added to the rehabilitation program for obese subjects with deficits in trunk endurance and balance.

Effect of Local Vibration Therapy on Pain, Joint Position Sense, Kinesiophobia, and Disability in Cervical Disc Herniation: A Randomized Controlled Trial

Background/Objectives: Vibration therapy approaches are an effective and safe treatment option for musculoskeletal disorders. This study examines the effects of vibration therapy using a percussion massage gun (PMG) on joint position sense, range of motion, pain, functionality, and kinesiophobia in individuals with cervical disc herniation (CDH). Methods: This single-blind randomized controlled trial involved 44 CDH patients divided into a Vibration Group (VG) and a Conventional Group (CG). The CG underwent a standard physiotherapy treatment heat application, Transcutaneous Electrical Nerve Stimulation (TENS), and exercises for range of motion and strengthening. VG received conventional therapy augmented with vibration therapy (VT) via a PMG. Joint position sense (JPS) using the Laser Pointer Assisted Angle Repetition Test; pain intensity with the Visual Analog Scale, kinesiophobia with the Tampa Scale for Kinesiophobia, and cervical dysfunction with the Neck Disability Index were assessed. Results: Both groups showed statistically significant improvements in pain, kinesiophobia, disability, and proprioception after treatment (p < 0.05). When comparing the difference values between groups, the VG was found to be more effective than the CG in the parameters of VAS activity (p = 0.013). The CG had more improvement in JPS neck left rotation than the VG (p = 0.000). Conclusions: VT, when combined with conventional physiotherapy, is effective in improving pain, proprioception, and functionality in individuals with CDH. These findings support the inclusion of VT as a beneficial adjunct therapy. Further research with larger sample sizes and longer follow-ups is recommended to validate these results and explore the long-term effects of VT on CDH.

Effect of 10-Week Whole-Body Vibration Training on Falls and Physical Performance in Older Adults: A Blinded, Randomized, Controlled Clinical Trial with 1-Year Follow-Up

Whole-body vibration training (WBV) training has shown positive effects on bone strength, muscle strength, and balance, but the evidence on fall prevention is not yet persuasive. This study aimed to evaluate the effectiveness of WBV training in preventing falls and improving physical performance among older adults at fall risk. The study was an assessor- and participant-blinded, randomized, and controlled 10-week training trial with a 10-month follow-up. One hundred and thirty older adults (mean age 78.5 years, 75% women) were randomly allocated into the WBV group (n = 68) and the low-intensity wellness group (n = 62). Falls were prospectively collected using monthly returned and verified diaries. Physical performance was evaluated at baseline before randomization, after the intervention, and follow-up with established methods. The data were analyzed on an intention-to-treat basis. Negative binomial regression was used to estimate the incidence rate ratios for falls, and Cox regression models were used to calculate the hazard ratios for fallers. Between-group differences in physical performance were estimated by generalized linear mixed models. The retention rate was 93%, and the mean adherence to the WBV training was 88% and 86% to the wellness training. Sixty-eight participants fell at least once, and there were 156 falls in total. In the WBV group, the incidence rate of falls was 1.5 (95% confidence interval 0.9 to 2.5) compared to the wellness group (p = 0.11). The hazard ratio for fallers in the WBV group was 1.29 (0.78 to 2.15) (p = 0.32). There was no between-group difference in physical performance after the training period, but by the end of the follow-up, WBV-related benefits appeared. The chair-rising capacity was maintained in the WBV group, while the benefit disappeared in the wellness group (p = 0.004). Also, the 0.5-point difference in short physical performance battery (SPPB) score favored WBV training (p = 0.009). In conclusion, progressive side-alternating WBV training was feasible and well-tolerated among fall-prone older adults. During the one-year follow-up, WBV training was associated with improved physical performance but did not prevent falls compared to chair-based group exercises.

Preliminary feasibility and acute physiological effects of a single session of upper limb vibration training for persons with spinal cord injury

CONTEXT

Strong upper limb musculature is essential for persons with spinal cord injury (SCI) to operate a manual wheelchair and live independently. Targeted upper limb vibration may be a viable exercise modality to build muscle efficiently while eliminating some of the barriers associated with exercise for persons with SCI.

OBJECTIVE

The purpose of this study was to assess preliminary feasibility of completing a single exercise session of upper limb vibration and compare the acute physiological effects to a single session of standard dumbbell resistance exercise.

METHODS

Individuals with SCI performed seven upper limb exercises (1) isometrically using a vibrating dumbbell at 30 Hz for 60 s (n = 22) and (2) using a standard isotonic resistance protocol (n = 15).

RESULTS

Nineteen (86.4%) of 22 participants were able to perform all vibration exercises at 30 Hz but hold time success rates varied from 33% (side flies and front raises) to 95% (internal rotation). No significant differences were found between vibration exercise and standard resistance protocol for blood lactate, power output, and heart rate (P > 0.05). Perceptions of the training were positive, with most participants (>70%) expressing interest to train with vibration in the future.

CONCLUSIONS

Vibration training was not feasible for all participants, suggesting an individualized approach to starting weight and progression may be necessary. Similar acute physiological changes were seen between vibration exercise and standard resistance protocol, suggesting they could have similar benefits. Additional research is needed to determine if vibration exercise is feasible and beneficial to incorporate into a long-term training program.

The effect of whole-body vibration on glucose and lipid profiles in type-2 diabetes: a systematic review and pairwise and network meta-analyses of randomized trials

Whole-body vibration (WBV), a training method based on the stimulation of muscle contraction by mechanical vibration generated in a vibrating platform, is claimed to be effective in diabetes management. This meta-analysis evaluated WBV effects against other exercises, placebo, or no intervention in type-2 diabetes. Medline, Scopus, and Web of Science databases were systematically searched through June 2023. Randomized controlled trials reported the effect of WBV on glucose (hemoglobin A1C and fasting blood glucose), and lipid profiles (total cholesterol, triglycerides, high, and low-density lipoprotein) were included. Two researchers independently extracted the characteristics of the studies, participants, WBV intervention and comparisons, and the outcomes from the included articles. The Physiotherapy Evidence Database (PEDro) scale assessed trial quality. In this review, all articles had no high risk of bias according to the PEDro scale, with studies achieving optimal, excellent, and good scores. Network meta-analysis revealed that WBV was effective for reducing hemoglobin A1C when compared with conventional (mean difference: - 1.58%, 95%CrI: - 2.51, - 0.47) and resistance exercise (mean difference: - 1.32%, 95%CrI: - 1.96, - 0.33). WBV had also a desirable but insignificant effect on hemoglobin A1C compared to stretching and balance exercises, placebo, and no intervention. The current pairwise meta-analysis did not show that WBV favors fasting blood glucose and lipids. WBV may have potential advantages for glycemic control in type-2 diabetes. However, uncertainties in the findings remain due to the limited number of studies and their heterogeneity.

Whole-Body Vibration to Improve Physical Function Parameters in Nursing Home Residents Older Than 80 Years: A Systematic Review With Meta-Analysis

OBJECTIVE

Loss of functional independence is more likely in older adults who reside in an institution as a consequence of a decline in muscle mass and a loss of force production capacity. The aim of this review was to assess the effect of whole-body vibration (WBV) interventions on the strength, balance, and mobility of nursing home residents older than 80 years.

METHODS

An electronic search in MEDLINE, Scopus, and CINAHL databases was conducted. Randomized controlled trials that involved nursing home residents older than 80 years, that investigated WBV interventions compared with nonintervention, usual care, or placebo, and that measured physical function outcomes including strength, balance, gait, and mobility were included. Risk of bias was assessed by 2 reviewers using the Physiotherapy Evidence Database scale. The standardized mean differences (SMD) between the experimental and control groups were calculated with a random-effects model for each outcome, and subgroup analysis was conducted for different outcomes.

RESULTS

In total, 2864 articles were identified; of these, 14 randomized controlled trials met the inclusion criteria. The meta-analysis revealed that WBV significantly increased the lower limb muscle strength (SMD = 0.59; 95% CI = 0.16 to 1.03), mobility (SMD = 0.45; 95% CI = 0.10 to 0.81), gait score (SMD = 0.26; 95% CI = 0.01 to 0.51), balance (SMD = 0.41; 95% CI = 0.01 to 0.81), and physical performance (SMD = 1.33; 95% CI = 0.33 to 2.33).

CONCLUSION

WBV may be an effective intervention to improve the strength, balance, mobility, walking ability, and physical performance of older nursing home residents.

IMPACT

WBV presents a safe, accessible alternative for improving health in this vulnerable population, warranting further research and integration into health care practices.

Nurse-Assisted Rehabilitation Protocols Following Anterior Cruciate Ligament Reconstruction

Despite significant advancements in surgical instruments and operation skills, short- and long-term outcomes following anterior cruciate ligament reconstruction (ACLR) remain unsatisfactory, as many patients fail to return to their pre-injury level of sports. Inadequate ACL rehabilitation is the primary cause of poor outcomes. Nurses have become a crucial element in the rehabilitation process. Although there is no consensus regarding the optimal post-operative rehabilitation protocols, restoring muscle strength and neuromuscular control are consistently the primary goals. This literature review presents nurse-assisted rehabilitation protocols aiming at improving muscle strength and neuromuscular control. The review discusses postoperative rehabilitation, including home-based and supervised rehabilitation, open and closed kinetic chain exercises, eccentric and concentric training, blood flow restriction training, and plyometric training. Each training protocol has its benefits and drawbacks, and should be used cautiously in specific stages of rehabilitation. Neuromuscular training, such as neuromuscular electrical stimulation, neuromuscular control exercises, and vibration therapy, is considered crucial in rehabilitation.

The Efficacy of Whole-Body Vibration in Managing Postburn Victims' Complications: A Systematic Review

Burn injury is a complicated traumatic event with both systemic and local consequences. These complications include long periods of bed rest, pain, muscle weakness, vitamin D deficiency, and bone mineral density loss. Whole-body vibration demonstrated effectiveness in improving muscle power and bone mineral density in various musculoskeletal populations. This systematic review of randomized controlled trials aims to assess evidence for the effectiveness of using whole-body vibration on postburn survivors with at least 1% total body surface area on sensory and motor outcomes. A systematic search was conducted across six databases, which are, PubMed, Cochrane, PEDro, Scopus, Web of Science, and Google Scholar, from inception till March 2022. Retrieved studies were screened by title and abstract and full-text in two stages using Rayyan web-based. Included studies were assessed for risk of bias using the Cochrane risk of bias tool ROB 2.0. Six randomized controlled trials with 203 participants were included. Five of the included studies demonstrated an overall high risk of bias. Compared to conventional physiotherapy programs, whole-body vibration demonstrated improvement in functional mobility and balance using timed up and go and Biodex balance assessment, respectively. However, there were no differences between whole-body vibration and conventional physiotherapy program alone in bone mineral density and muscle power. Although the current evidence of whole-body vibration is limited, whole-body vibration combined with traditional physical therapy programs may improve functional mobility and balance in postburn survivors compared to physical therapy programs alone.

Effects of whole-body vibration exercise on physical function in patients with chronic kidney disease: a systematic review and meta-analysis

BACKGROUND

The current state of knowledge regarding the efficacy of whole-body vibration (WBV) training for individuals with chronic kidney disease (CKD) is limited. To address this gap, the present study seeks to undertake a comprehensive systematic review and meta-analysis of clinical trials to evaluate the impact of WBV on physical function and quality of life outcomes in CKD patients.

METHODS

A systematic search was performed on the PubMed, Embase, Web of Science, and Scopus databases from inception to March 2023 and updated in June 2023. The inclusion criteria comprised randomized controlled studies, quasi-experimental studies, and single-arm trials that evaluated the impact of WBV on physical function, encompassing cardiopulmonary fitness, muscle strength, mobility, and balance, in CKD patients. Adverse events that were included in the study reports were recorded. The pooled evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method.

RESULTS

Nine studies were identified, of which seven were included in the meta-analysis. The results of the meta-analysis indicated a statistically significant improvement in upper (mean difference: 3.45 kg; 95% confidence interval 1.61 to 5.29) and lower (standardized mean difference: 0.34, 95% confidence interval 0.08 to 0.59) extremity muscle strength in patients with CKD who underwent WBV training compared to baseline (low-level evidence). Furthermore, WBV training favored improved cardiorespiratory fitness, mobility, and balance function, but no statistical difference was observed. The impact of WBV training on quality of life in patients with CKD requires further validation. Notably, only one adverse event (nausea) was reported in the included studies.

CONCLUSIONS

WBV has demonstrated efficacy and feasibility in enhancing muscle strength among patients with CKD. However, further investigation is warranted to determine its potential for improving cardiorespiratory adaptations, mobility, balance function, and quality of life. Additionally, future research should prioritize comprehensive reporting of WBV protocols to establish an optimal training regimen for the CKD population.

Effects of whole-body vibration on chronic ankle instability: a systematic review

Background and objective

Chronic ankle instability (CAI) is one of the most common sports injuries, and whole-body vibration (WBV) training has been used lately as a potential rehabilitation modality for these patients. The authors conducted a systematic review and meta-analysis to assess whether WBV training positively affects patients with CAI.

Materials and methods

The authors systematically searched four databases, including MEDLINE (PubMed), Scopus, Web of Science, and Cochrane Central Register of Controlled Trials, for randomized and non-randomized trials evaluating the effects of WBV on individuals with CAI. The authors used Cochrane RoB2 to assess the risk of bias in randomized trials. A meta-analysis was conducted if three or more studies measured the same outcome. Effect estimates were pooled using a random-effects model.

Results

Results were retrieved from seven articles encompassing 288 participants who had CAI. The reach distance of the Star Excursion Balance Test (SEBT) was regarded as the study's main finding. The authors saw a significant training effect on certain planes of motion on dynamic balance. The findings showed that the post-intervention measurements in the WBV group compared to control groups showed improvements in the posterolateral, posteromedial, and medial directions, respectively. There were also promising results on improvements in muscle activity, strength, and proprioception sense measurements with a great diversity in the reported parameters.

Conclusion

The authors observed a significant WBV training effect on dynamic balance over posterolateral, posteromedial, and medial reach distances. These findings suggest future studies on the effects of WBV on muscle activity, strength, and proprioception in addition to dynamic and static balance.

Effects of vibration therapy for post-stroke spasticity: a systematic review and meta-analysis of randomized controlled trials

BACKGROUND

The efficacy of vibration therapy (VT) in people with post-stroke spasticity (PSS) remains uncertain. This study aims to conduct a comprehensive meta-analysis to assess the effectiveness of VT in PSS.

METHODS

PubMed, Embase, Cochrane Library, Physiotherapy Evidence Database, and Web of Science were searched from inception to October 2022 for randomized controlled trials (RCTs) of VT in people with PSS. The primary outcome was spasticity, and secondary outcomes included pain, motor function, gait performance, and adverse events. A meta‑analysis was performed by pooling the standardized mean difference (SMD) with 95% confidence intervals (CI).

RESULTS

A total of 12 studies met the inclusion criteria. Overall, VT had significant effects on reducing spasticity (SMD = - 0.77, 95% CI - 1.17 to - 0.36, P < 0.01) and pain (SMD =  - 1.09, 95% CI - 1.74 to - 0.45, P < 0.01), and improving motor function (SMD = 0.42, 95% CI 0.21 to 0.64, P < 0.01) in people with PSS. However, VT had no significant effect on gait performance (SMD =  - 0.23, 95% CI - 0.56-0.10). In addition, subgroup differences in short-term anti-spasticity effects between different vibration subtypes, vibration frequencies, vibration durations, frequency of sessions, control therapy, spasticity distribution, and population classification were not significant.

CONCLUSION

We found that VT significantly alleviated spasticity and pain in people with PSS and improved motor function, but its effect on gait performance was unclear. However, further studies are needed to validate these findings.

Effects of whole-body vibration or resistive-vibration exercise on blood clotting and related biomarkers: a systematic review

Whole-body vibration (WBV) and resistive vibration exercise (RVE) are utilized as countermeasures against bone loss, muscle wasting, and physical deconditioning. The safety of the interventions, in terms of the risk of inducing undesired blood clotting and venous thrombosis, is not clear. We therefore performed the present systematic review of the available scientific literature on the issue. The review was conducted following the guidelines by the Space Biomedicine Systematic Review Group, based on Cochrane review guidelines. The relevant context or environment of the studies was "ground-based environment"; space analogs or diseased conditions were not included. The search retrieved 801 studies; 77 articles were selected for further consideration after an initial screening. Thirty-three studies met the inclusion criteria. The main variables related to blood markers involved angiogenic and endothelial factors, fibrinolysis and coagulation markers, cytokine levels, inflammatory and plasma oxidative stress markers. Functional and hemodynamic markers involved blood pressure measurements, systemic vascular resistance, blood flow and microvascular and endothelial functions. The available evidence suggests neutral or potentially positive effects of short- and long-term interventions with WBV and RVE on variables related to blood coagulation, fibrinolysis, inflammatory status, oxidative stress, cardiovascular, microvascular and endothelial functions. No significant warning signs towards an increased risk of undesired clotting and venous thrombosis were identified. If confirmed by further studies, WBV and RVE could be part of the countermeasures aimed at preventing or attenuating the muscular and cardiovascular deconditioning associated with spaceflights, permanence on planetary habitats and ground-based simulations of microgravity.

Whole Body Vibration Therapy for Children with Disabilities: A Survey of Potential Risks and Benefits

The purpose of this report is to remind providers of the potential risks of Whole Body Vibration Therapy (WBVT) for children with disabilities. We reviewed the current state of knowledge and learned that WBVT may have potential risk of injury for some children. To the best of our knowledge this review is the first to clarify WBVT risks. We believe WBVT may have therapeutic value but we recommend caution and offer suggestions for future research.

Long-Term Effects of Whole-Body Vibration on Hind Limb Muscles, Gait and Pain in Lame Dogs with Borderline-to-Severe Hip Dysplasia-A Pilot Study

This pilot study aimed to evaluate the long-term effects of Whole-Body Vibration (WBV) on hind limb muscles, gait and pain in lame dogs with borderline-to-severe hip dysplasia. Ten lame client-owned dogs with borderline-to-severe hip dysplasia, aged from 1.5 to 9.0 years and weighing 14.5 to 53.0 kg, were enrolled. The WBV training program consisted of 15 min sessions three times weekly for 16 weeks. Muscles of the hind limbs were evaluated using measurements of thigh circumference, the cross-sectional thickness of selected hind limb muscles by ultrasound assessment, and vastus lateralis muscle activity determined by surface electromyography (EMG). Lameness and clinical signs of pain were assessed by visual lameness scoring, orthopedic examination and an owner-based questionnaire. Kinetic analysis was performed by using a pressure-sensitive walkway. Manual thigh circumference measurements of both hind limbs showed significant increases over the trial period with a greater degree of change observed after week 8. Ultrasound measurements of the left gluteal muscles and the quadriceps femoris muscles of both hind limbs showed significant increases in the cross-section thickness post WBV. Owner's perception of pain also showed a decrease in signs of pain at week 12 and week 16 compared to baseline. Based on graphs of the EMG activity patterns of the vastus lateralis muscle, 65% of the hind limbs had an improvement after 48 WBV sessions when compared to pre-session patterns. However, no significant differences were observed in visual lameness evaluation and kinetic analysis. Therefore, further studies will help to better clarify the role of WBV in canine rehabilitation protocols.

Evidence of whole-body vibration exercises on body composition changes in older individuals: a systematic review and meta-analysis

Introduction: The aging process is associated with changes in body composition, including fat gain and skeletal muscle loss from middle age onward. Moreover, increased risk of functional decline and the development of chronic diseases are also related to aging. Objective: This systematic review and meta-analysis aimed to evaluate the effects of whole-body vibration exercise (WBVE), as a physical exercise, on body composition in people over 60 years of age. Methods: Searches were performed on PubMed, Scopus, Web of Science, and Embase. Only randomized clinical trials evaluating the effects of WBVE on body composition in older individuals were considered. The methodological quality of the studies involved was assessed using the Physiotherapy Evidence Database (PEDro) scale, recommendations from the Cochrane Collaboration were used to assess risk of bias, and quality of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. RevMan 5.4 was used to calculate standardized mean differences and confidence intervals of 95% (CIs). Results: Eight studies were included in this review with a mean methodological quality score of 7.5, which is considered high quality on the PEDro scale. The included studies suggest that more robust research with protocols and well-designed comparison groups is required to better assess changes in the body composition of older individuals through WBVE. Quantitative results were calculated, with differences in weighted means, differences in standardized means, and 95% confidence intervals (CIs). Conclusion: WBVE evaluated by the studies included in this review did not demonstrate improvements in body composition, and no significant effect of WBVE was found on fat mass with standardized differences (SD = -1.92; 95% CI: -4.81 to -0.98; p = 0.19), lean mass with standardized mean differences (SMD = 0.06 CI 95% [-0.21; -0.33]; p = 0.67), or skeletal muscle mass with standardized differences (SD = 0.10; CI 95% [-1.62; 1.83]; p = 0.91). Therefore, to date, there is lack of adequate evidence to state that WBVE can benefit the body composition of men and women over 60 years of age. However, further studies are required to better understand the physiological impacts of WBVE on body composition. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#myprosperoCRD42021248871, identifier CRD42021248871.

Effects of Whole-Body Vibration Training on Lower Limb Muscle Strength and Physical Performance Among Older Adults: A Systematic Review and Meta-analysis

OBJECTIVE

To evaluate the effects of whole-body vibration training (WBVT) on lower limb muscle strength and physical performance in older adults.

DATA SOURCES

Web of Science, PubMed, Cochrane Library, and MEDLINE databases were searched for papers published in English, from January 1, 2000, to May 30, 2022.

STUDY SELECTION

Randomized controlled trials of WBVT in older adults (mean age, 65 years or older) published in English. The Physiotherapy Evidence Database Scale was used to assess the quality of the selected studies.

DATA EXTRACTION

Two investigators independently assessed articles according to the evaluation criteria. Differences between investigator assessments were resolved by consulting a third investigator before reassessment.

DATA SYNTHESIS

Systematic review of 18 randomized controlled studies found that WBVT produced significant improvements in lower limb muscle strength and physical performance among older adults. We used the Cochrane Collaboration method to assess risk of bias and RevMan version 5.4a to extract means and calculate SDs. WBVT significantly improved knee strength (standard mean difference [SMD]=0.72, 95% confidence interval [CI] [0.38, 1.07], P<.0001, I2=58%) and explosive power (SMD=0.47, 95% CI [0.10, 0.83], P=.01, I2=0%) among older adults. Significant improvements in each physical performance were observed in the sit-to-stand test (SMD=0.57, 95% CI [0.30, 0.84], P<.0001, I2=35%), the subgroup of studies that evaluated balance with timed Up and Go test, SMD was 0.53 (95% CI [0.19, 0.88], P=.002, I2=56%) and the Tinetti total score, SMD was 0.72 (95% CI [0.04, 1.41], P=.04, I2=81%), walking speed (SMD=0.46, 95% CI [0.14, 0.77], P=.005, I2=49%), and walking endurance (SMD=0.43, 95% CI [0.02, 0.85], P=.04, I2=24%).

CONCLUSIONS

WBVT may be an effective intervention to improve lower limb muscle strength and physical performance in older adults. Tinetti total score remains controversial and warrants assessment in future high-quality randomized controlled trials.

Effect of whole-body vibration training on the recovery of lower limb function in people with stroke: a systematic review and meta-analysis

PURPOSE

The purpose of this meta-analysis was to systematically evaluate the effects of whole-body vibration training (WBVT) on the recovery of lower limb function in people with stroke.

METHODS

The literature search was made in the electronic databases PubMed, Web of Science, Scopus and Embase electronic databases. Only randomized controlled trials were included. Data extraction, quality assessment and meta-analysis were performed. The search was conducted on September 01, 2022. The data analysis software was RevMan 5.3.

RESULTS

A total of 13 RCTs were included, including 687 patients. The results showed that compared with the control group, the overall difference in balance function was statistically significant [MD = 4.23, 95% CI 2.21 ∼ 6.26, p < 0.0001]. There was no significant difference in the evaluation indexes of lower limb motor function, including the TUG, 10MWT, 6MWT, and FMA - LE. The overall difference in lower limb muscle spasticity was statistically significant [MD = -0.53, 95% CI -0.81 ∼ 0.26, p = 0.0001].

CONCLUSIONS

Compared with the control group, using WBVT treatment has a more obvious effect on the recovery of lower limb function and muscle spasticity, and there is no obvious advantage in motor function recovery.IMPLICATIONS FOR REHABILITATIONThis Systematic Review and meta-analysis of evidence suggest that whole-body vibration training is effective in the rehabilitation of lower limb function in patients with stroke.Whole body vibration training may be a better choice for improving balance and spasm in people with stroke.Currently it is not known which whole-body vibration training model with vibration intensity, stimulus type and duration is most effective and to design more targeted interventions.

Alterations of Body Composition, Blood Morphology and Fibrinogen Concentration after Vibration Therapy in Older Adult Women: A Randomized Controlled Trial

Vibrotherapy is one of the methods of physical therapy. Vibration, like various forms of physical activity, affects metabolic processes and health. The aim of this study was to assess the influence of thirty vibration sessions on body composition, hematologic and rheological indexes of blood, and protein and fibrinogen concentration in elderly women's blood. The study included 69 women, aged 60-70 years (mean age 64.6 ± 2.9), who were randomly and parallel assigned into: the vibrotherapy group 1 (G1) that took part in vibrotherapy on the Knees module, the vibrotherapy group 2 (G2) that took part in vibrotherapy on the Metabolism module, and the control group (CG) without interventions. In all patients, the following assessments were performed twice-baseline and after thirty vibrotherapy sessions: an assessment of body composition, a complete blood count with a hematology analyzer and erythrocyte aggregation by a laser-optical rotational red cell analyzer; total plasma protein and fibrinogen concentrations were established, respectively, by biuret and spectrophotometric methods. Intergroup (between groups) and intragroup (within each group) changes were statistically evaluated. After applying thirty vibration sessions, a decrease in body composition parameters (BM, body mass G1, p < 0.05; G2, p < 0.001 and FFM, fat free mass G1, p < 0.05; G2, p < 0.05) was confirmed in both intervention groups and BMI, body mass index in G2 (p < 0.05). It was found that, in G2, changes in erythrocyte aggregation indexes (T ½, half time kinetics of aggregation, p < 0.05 and AI, aggregation index, p < 0.05) and decrease of fibrinogen concentration (p < 0.05) took place. A series of thirty vibration sessions did not cause significant alterations in blood morphological parameters; therefore, vibrotherapy did not disturb hematological balance. Vibration sessions had a positive effect on BM, BMI, AG and fibrinogen concentration in the studied women, indicating the usefulness of this form of activation in older adults. Due to a decrease in FFM observed in the study, vibrotherapy should be employed in conjunction with physical exercise and other forms of physical activity in the group of older adults.

Effect of Whole-body Vibration frequency on muscle tensile state during graded plantar flexor isometric contractions

Background

Acute physiological and biomechanical alterations have been reported following whole-body vibration (WBV). Stiffening of muscles has only been anecdotally reported in response to WBV. Accordingly, this study investigated active plantar flexor muscle stiffness in response to a single WBV bout at four mechanical vibration frequencies.

Methods

Thirteen healthy adults (37.1 ± 14.4 years old) randomly received WBV in 4 different frequencies (6, 12, 24, and 0 Hz control) for 5 min. Shear wave speed (SWS) in longitudinal and transverse projections, architecture, and electric muscle activity were recorded in the medial gastrocnemius (MG) and soleus (SOL) muscle during graded plantar flexor contraction. Subjective rating of perceived muscle stiffness was assessed via Likert-scale.

Results

SWS of the MG at rest was enhanced in response to 5 min of 24 Hz WBV (p = 0.025), while a small reduction in SOL SWS was found during contraction (p = 0.005) in the longitudinal view. Subjective stiffness rating was increased following 12 Hz intervention. After 24 Hz WBV, pennation angle for MG was decreased (p = 0.011) during contraction. As a secondary finding, plantar flexor strength was significantly increased with each visit, which, however, did not affect the study's main outcome because of balanced sequence allocation.

Conclusion

SWS effects were solely limited to 24 Hz mechanical vibration and in the longitudinal projection. The observed effects are compatible with an interpretation by post-activation potentiation, warm-up, and force-distribution within the triceps surae muscles following 5 min WBV. The outcome may suggest SWS as a useful tool for assessing acute changes in muscle stiffness.

Effects of whole-body vibration training combined with KAATSU training on lower limb joint muscle strength in older women

Objective: This study aimed to investigate the effect of whole-body vibration training (WBVT) combined with KAATSU training (KT) on lower limb joint muscle strength and to provide a reference for improving muscle strength in older women. Methods: A total of 86 healthy older people was randomly divided into WBVT group (WG, n = 21), KT group (KG, n = 22), combined intervention group (CIG, n = 20) and control group (CG, n = 23). WG and CIG subjects underwent WBVT, and KG and CIG subjects underwent 150 mmHg and lower limb joint and local compression intervention for 16 weeks (three times per week, about 15 min/time). The peak torque (PT) and endurance ratio (ER) of joint flexion or extension were tested for all subjects. Results: 1) Results at 16 weeks were compared with the baseline data. The knee extension and ankle flexion PT (60°/s) in CIG increased by 14.3% and 15.3%, respectively (p < 0.05). The knee extension PT (180°/s) increased by 16.9, 18.4% and 33.3% in WG, KG and CIG (p < 0.05), respectively, and the ankle extension PT (180°/s) in CIG increased by 31.1% (p < 0.05). The hip, knee extension and ankle flexion ER increased by 10.0, 10.9% and 5.7% in CIG (p < 0.05), respectively. 2) Results were compared among groups at 16 weeks. The relative changes were significantly lower in WG, KG and CG compared to CIG in the knee extension and ankle flexion PT (60°/s) (p < 0.05). The relative changes were significantly greater in WG, KG and CIG compared to CG in the knee extension PT (180°/s) (p < 0.05). The relative changes were significantly lower in WG, KG and CG compared to CIG in the ankle extension PT (180°/s) (p < 0.05). The relative changes were significantly lower in WG, KG and CG compared to CIG in the hip extension ER (p < 0.05). The relative changes were significantly lower in CG compared to CIG in the knee extension ER (p < 0.05). Conclusion: Sixteen-week WBVT and KT increased the knee extensor strength in older women. Compared with a single intervention, the combined intervention had better improvements in the knee extensor and ankle flexor and extensor strength and hip extension muscle endurance. Appears to be some additional benefit from combined intervention above those derived from single-interventions.

Adding mechanical vibration to a half squat with different ballasts and rhythms increases movement variability

The aim of this study was to determine whether whole body vibration increases movement variability while performing a half squat with different ballasts and rhythms through entropy. A total of 12 male athletes (age: 21.24 ± 2.35 years, height: 176.83 ± 5.80 cm, body mass: 70.63 ± 8.58 kg) performed a half squat with weighted vest, dumbbells and bar with weights suspended with elastic bands, with and without vibration at the squat rhythm of 40 and 60 bpm. Each ballast corresponded to 15% of the body mass. The movement variability was analysed by calculating the sample entropy of the acceleration signal, recorded at the waist using an accelerometer. With vibration, differences were found between weighted vest and dumbbells (t(121) = -8.81, p < 0.001 at 40 bpm; t(121) = -8.18, p < 0.001 at 60 bpm) and between weighted vest and bar at both rhythms (t(121) = -8.96, p < 0.001 at 40 bpm; t(121) = -8.83, p < 0.001 at 60 bpm). Furthermore, a higher sample entropy was obtained at 40 bpm with all ballasts (t(121) = 5.65, p < 0.001 with weighted vest; t(121) = 6.27, p < 0.001 with dumbbells; t(121) = 5.78, p < 0.001 with bar). No differences were found without vibration. These findings reveal that adding mechanical vibration to a half squat produces a non-proportional increase in movement variability, being larger when the ballast is placed on the upper limbs and when performed at a slow rhythm.

Effects of whole-body vibration on sensorimotor deficits and brain plasticity among people with chronic ankle instability: a study protocol for a single-blind randomized controlled trial

BACKGROUND

Chronic ankle instability (CAI) is a form of musculoskeletal disease that can occur after a lateral ankle sprain, and it is characterized by pain, recurrent ankle sprains, a feeling of "giving way" at the ankle joint, and sensorimotor deficits. There has been increasing evidence to suggest that plastic changes in the brain after the initial injury play an important role in CAI. As one modality to treat CAI, whole-body vibration (WBV) has been found to be beneficial for treating the sensorimotor deficits accompanying CAI, but whether these benefits are associated with brain plasticity remains unknown. Therefore, the current study aims to investigate the effect of WBV on sensorimotor deficits and determine its correlation with plastic changes in the brain.

METHODS

The present study is a single-blind randomized controlled trial. A total of 80 participants with CAI recruited from the university and local communities will be divided into 4 groups: whole-body vibration and balance training (WBVBT), balance training (BT), whole-body vibration (WBV), and control group. Participants will be given the WBV intervention (25-38 Hz, 1.3-2 mm, 3-time per week, 6-week) supervised by a professional therapist. Primary outcome measures are sensorimotor function including strength, balance, proprioception and functional performance. Brain plasticity will be evaluated by corticomotor excitability, inhibition, and representation of muscles, as measured by transcranial magnetic stimulation. Activation of brain areas will be assessed through functional near-infrared spectroscopy. Secondary outcome measures are self-reported functional outcomes involving the Cumberland Ankle Instability Tool and the Foot and Ankle Ability Measure. All tests will be conducted before and after the WBV intervention, and at 2-week follow-up. Per‑protocol and intention-to-treat analysis will be applied if any participants withdraw.

DISCUSSION

This is the first trial to investigate the role of brain plasticity in sensorimotor changes brought by WBV for individuals with CAI. As plastic changes in the brain have been an increasingly important aspect in CAI, the results of the current study can provide insight into the treatment of CAI from the perspective of brain plasticity.

TRIAL REGISTRATION

Chinese Clinical Trial Registry (ChiCTR2300068972); registered on 02 March 2023.

Effects of a proprioceptive focal stimulation (Equistasi®) on reducing the biomechanical risk factors associated with ACL injury in female footballers

Introduction

Football presents a high rate of lower limb injuries and high incidence of Anterior Cruciate Ligament (ACL) rupture, especially in women. Due to this there is the need to optimize current prevention programs. This study aims to verify the possibility to reduce the biomechanical risk factors associated with ACL injury, through the application of proprioceptive stimulation by means of the Equistasi® device.

Methods

Ten elite female footballers were enrolled and received the device for 4 weeks (5 days/week, 1h/day). Athletes were assessed directly on-field at four time points: T0 and T1 (evaluation without and with the device), T2 (after 2 weeks), T4 (after 4 weeks) while performing two different tasks: Romberg Test, and four sidestep cutting maneuvers bilaterally. Seven video cameras synchronized with a plantar pressure system were used, thirty double colored tapes were applied on anatomical landmarks, and three dimensional coordinates reconstructed. Vertical ground reaction forces and center of pressure data were extracted from the plantar pressure insoles. Hip, knee, and ankle flexion-extension angles and moments were computed as well as abd-adduction joint torques. From the Romberg Test both center of pressure descriptive variables and frequency analysis parameters were extracted. Each variable was compared among the different time frames, T1, T2 and T4, through Friedman Test for non-parametric repeated measures (p<0.05); Wilcoxon Signed Rank Test was used for comparing variables between T0 and T1 (p<0.05) and across the different time frames as follows: T1-T2, T2-T4 and T1-T4.

Results

Statistically significant differences in both posturographic and biomechanical variables between the assessment at T0 and T1 were detected. Reduced hip and knee abduction torques were revealed in association with reduced both ground reaction forces and ankle dorsiflexion torque from T1 up to T4.

Discussion

The proprioceptive stimuli showed to have the potential to improve cutting biomechanics mainly with respect to the ligament and quadriceps dominance theories. Results of the present study, even if preliminary and on a small sample size, could be considered promising towards the inclusion of proprioceptive training in injury prevention programs.

Effects of a Single Session of Systemic Vibratory Therapy on Flexibility, Perception of Exertion and Handgrip Strength in Chronic Obstructive Pulmonary Disease Individuals: A Quasi-Experimental Clinical Trial

BACKGROUND

Whole-body vibration exercises (WBVE), that are generated in systemic vibratory therapy (SVT), may benefit individuals with chronic obstructive pulmonary disease (COPD). This study evaluated acute effects of SVT on the flexibility, on the perception of exertion to perform the anterior trunk flexion (ATF), and on the handgrip strength (HG).

METHODS

Thirty-eight individuals, separated into two groups, performed a single session of SVT (five bouts, 25 Hz, 2.5 of amplitude) on a side-alternating vibrating platform (SAVP), in two postures: sitting (Sitting group-SitG, n = 21) or standing (Stand group-StandG, n = 17). In both positions, the feet were on the base of the SAVP. The HG and the AFT were performed before and after the session, and the perception of effort (RPE) was measured during the ATF.

RESULTS

The ATF in the SitG (p ≤ 0.05) and in the StandG (p ≤ 0.05) was significantly improved, but in the comparison between both groups, no significant reduction was found (p = 0.14). The RPE was not influenced by the session. A significant increase of the HG in StandG post session (33.49 ± 10.30 kgf) p = 0.03 was found, but not in the SitG (p = 0.12) or between the two groups (p = 0.55).

CONCLUSIONS

SVT, in a single acute session, would be capable of promoting some functional benefits for the COPD individuals without altering the perception of exertion to perform the ATF.

TRIAL REGISTRATION

49219115.3.0000.5259, RBR-72dqtm.

Long-term human spaceflight and inflammaging: Does it promote aging?

Spaceflight and its associated stressors, such as microgravity, radiation exposure, confinement, circadian derailment and disruptive workloads represent an unprecedented type of exposome that is entirely novel from an evolutionary stand point. Within this perspective, we aimed to review the effects of prolonged spaceflight on immune-neuroendocrine systems, brain and brain-gut axis, cardiovascular system and musculoskeletal apparatus, highlighting in particular the similarities with an accelerated aging process. In particular, spaceflight-induced muscle atrophy/sarcopenia and bone loss, vascular and metabolic changes, hyper and hypo reaction of innate and adaptive immune system appear to be modifications shared with the aging process. Most of these modifications are mediated by molecular events that include oxidative and mitochondrial stress, autophagy, DNA damage repair and telomere length alteration, among others, which directly or indirectly converge on the activation of an inflammatory response. According to the inflammaging theory of aging, such an inflammatory response could be a driver of an acceleration of the normal, physiological rate of aging and it is likely that all the systemic modifications in turn lead to an increase of inflammaging in a sort of vicious cycle. The most updated countermeasures to fight these modifications will be also discussed in the light of their possible application not only for astronauts' benefit, but also for older adults on the ground.

Therapeutic Approach of Whole-Body Vibration Exercise on Wound Healing in Animal Models: A Systematic Review

Human skin wounds pose a gathering threat to the public health, carrying an immense epidemiologic and financial burden. Pharmacological and non-pharmacological (NP) treatments have been proposed to the management of wound healing. Physical exercise is a strong NP intervention considered for patients in wound healing. Particularly, a type of exercise intervention known as whole-body vibration (WBV) exercise has gained increasing interest. WBV exercise is generated due to the transmission of mechanical vibrations, produced by a vibrating platform, to the body. The aim of this review was to summarize studies in experimental animal models using WBV exercise in wound healing. Searches were performed in EMBASE, PubMed, Scopus and Web of Science including publications on 21 November 2022 using the string "whole body vibration" AND "wound healing" (animal or mice or mouse or rat or rodent). The SYRCLE tool was used to assess the risk of bias (RoB). From 48 studies, five studies met the inclusion criteria. RoB indicated that none of the studies fulfilled all methodological analyzed criteria, resulting in possible biases. The studies were homogeneous, and results suggest beneficial effects of WBV exercise in wound healing, mainly related to enhancing angiogenesis, granulation tissue formation, reducing the blood glucose level and enhancing blood microcirculation, by increasing myofiber growth and rapid re-epithelialization. In conclusion, the various biological effects of the response to the WBV exercise indicate the relevance of this intervention in wound healing in animals. Moreover, considering the translation approach, it is possible to speculate that the beneficial effects of this non-pharmacological therapy might justify clinical trials for wound healing also in humans, after criterion evaluation.

Vibration Therapy as an Early Intervention for Children Aged 2-4 Years with Cerebral Palsy: A Feasibility Study

Aims: To evaluate the feasibility and acceptability of vibration therapy (VT) in preschool children with cerebral palsy (CP) and obtain preliminary data on its potential effectiveness.Methods: Nine children aged 2.5-4.8 years (4 boys) with CP GMFCS levels I-III participated in a single-group feasibility study, undergoing a 12-week control period without intervention, followed by 12 weeks of home-based VT (four times/week, 9 min/day, frequency 20 Hz). We assessed adherence to VT protocol, adverse events, and family acceptability of VT. Clinical assessments included motor function (GMFM-66), body composition (DXA), mobility (10-meter walk/run test), and health-related quality of life (PedsQL).Results: VT was well tolerated and acceptable to families, with high adherence levels reported (mean = 93%). There were no observed between-period differences (ΔControl vs ΔVT) except for an improvement in the PedsQL "Movement & Balance" dimension with VT (p = 0.044). Nonetheless, changes after the VT but not the Control period were suggestive of potential treatment benefits for mobility, gross motor function, and body composition (lean mass and legs bone mineral density).Conclusion: Home-based VT is feasible and acceptable for preschool children with CP. Our preliminary data suggest potential health benefits from VT for these children, supporting larger randomized trials to assess its effectiveness properly. Clinical trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12618002027291).

Effects of Whole-Body Vibration Exercise on Athletes with Ankle Instability: A Systematic Review

OBJECTIVE

Chronic Ankle Instability (CAI) or Functional Ankle Instability (FAI) is a condition characterized by laxity and mechanical instability in the ankle joint. This instability interferes with the activities and physical-functional parameters of athletes, which leads to repetitive ankle sprains. The current systematic review was carried out to identify the effects of whole-body vibration exercise (WBVE) in athletes with CAI.

METHODS

We conducted electronic searches in Pubmed, the Cochrane Library, Embase, Web of Science, Scopus, Science Direct, Allied Health Literature (CINAHL) and Academic Search Premier (ASP) (EBSCO) databases on 26 February 2022. Registers were identified, and studies were selected for inclusion according to the eligibility criteria. The methodological quality was assessed by the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

Seven studies were included with a mean methodological quality score of 5.85, considered 'regular' quality on the PEDro scale. WBVE interventions in athletes with CAI showed that this exercise contributes to a better response on parameters of neuromuscular performance, muscle strength and consequently in balance and postural control, variables that are for the management of CAI.

CONCLUSION

WBVE interventions in sports modalities promote physiological responses that may lead to positive effects in several parameters. The protocols proposed in each modality can be carried out in practice and are considered effective additional exercise and training methods beyond traditional types of training for athletes. However, more studies are needed on athletes with this condition, with specific protocols, to highlight the possible physiological and physical-functional responses. Protocol study registration: PROSPERO (CRD42020204434).

Effects of Mechanical Vibration Stimulation of the Larynx on Voice Production

INTRODUCTION

Combining mechanical vibration stimulation with resistance training to improve neuromuscular performance is a method that has gained popularity in the field of sports sciences.

PURPOSE

To evaluate the immediate and mid-term effects of mechanical vibration stimulation (G-Life NL3000) of the larynx associated to vocal exercises.

METHOD

Fourteen professional voice users divided into: Experimental Group - Seven participants who performed a 20-minute exercise protocol with humming applying mechanical vibration stimulation (G-Life NL3000) of the larynx once a day for 30 days; Control Group - Seven participants who performed only the 20-minute exercise protocol with humming. For comparison purposes, the evaluation was carried out pre-stimulation, immediately after simulation (post) and 30 days after stimulation (late-post).

RESULTS

The Experimental Group showed a statistically significant progress in the post-immediate evaluation and in the post-treatment evaluation for maximum phonation time (*P = < 0.001), Jitter (*P = 0.008), Shimmer (*P = 0.005), noise-to-harmonics ratio (*P = 0.005). In the GRBASI scale, the Experimental Group showed significant results in the post-treatment evaluation for Grade (*P = 0.005), Roughness (*P = 0.008), Breathiness (*P = 0.018) and Instability (*P = 0.018). A self-perception voice questionnaire showed better voice quality (*P= 0.031) and easier phonation (*P = 0.005) in the Experimental Group.

CONCLUSION

Mechanical vibration stimulation of the larynx associated to humming produced positive changes in the vocal pattern and significantly improvement in short and mid-term vocal quality for participants in this study.

High-frequency whole-body vibration activates tonic vibration reflex

Objectives

The aim of this research was to examine whether high-frequency whole-body vibration activates the tonic vibration reflex (TVR).

Patients and methods

The experimental study was conducted with seven volunteers (mean age: 30.8±3.3 years; range, 26 to 35 years) between December 2021 and January 2022. To elicit soleus TVR, high-frequency (100-150 Hz) vibration was applied to the Achilles tendon. High-frequency (100-150 Hz) whole-body vibration and low-frequency (30-40 Hz) whole-body vibration were applied in quiet standing. Whole-body vibration-induced reflexes were recorded from the soleus muscle using surface electromyography. The cumulative average method was used to determine the reflex latencies.

Results

Soleus TVR latency was 35.6±5.9 msec, the latency of the reflex activated by high-frequency whole-body vibration was 34.8±6.2 msec, and the latency of the reflex activated by low-frequency whole-body vibration was 42.8±3.4 msec (F_{(2, 12)}=40.07, p=0.0001, ƞ² =0.87). The low-frequency whole-body vibration-induced reflex latency was significantly longer than high-frequency whole-body vibration-induced reflex latency and TVR latency (p=0.002 and p=0.001, respectively). High-frequency whole-body vibration-induced reflex latency and TVR latency were found to be similar (p=0.526).

Conclusion

This study showed that high-frequency whole-body vibration activates TVR.

Whole-Body Vibration Training on Oxidative Stress Markers, Irisin Levels, and Body Composition in Women with Fibromyalgia: A Randomized Controlled Trial

(1) Background: Mitochondrial dysfunction and redox imbalance seem to be involved in fibromyalgia (FM) pathogenesis. The results of our previous studies suggest that whole-body vibration training (WBVT) would improve redox status markers, increase blood irisin levels, and ameliorate the body composition of women with FM. (2) Objective: The current study aimed to investigate WBVT on oxidative stress markers, plasma irisin levels, and body composition in women with FM. (3) Methods: Forty women with FM were randomized into WBVT or untrained (UN) groups. Before and after 6 weeks of WBVT, body composition was assessed by dual-energy radiological absorptiometry (DXA), and inflammatory marker activities were measured by enzymatic assay. (4) Results: Body composition, blood irisin levels, and oxidative stress markers were similar between UN and WBVT groups before the intervention. After 6 weeks of intervention, the WBVT group presented higher irisin levels (WBVT: 316.98 ± 109.24 mg·dL³, WBVT: 477.61 ± 267.92 mg·dL³, p = 0.01) and lower TBARS levels (UN: 0.39 ± 0.02 nmol MDA/mg protein, WBVT: 0.24 ± 0.06 nmol MDA/mg protein, p = 0.001) and visceral adipose tissue mass (UN: 1.37 ± 0.49 kg, WBVT: 0.69 ± 0.54 kg, p = 0.001) compared to the UN group. (5) Conclusions: Six weeks of WBVT improves blood redox status markers, increases irisin levels, and reduces visceral adipose tissue mass, favoring less cell damage and more outstanding oxidative balance in women with FM.

Vibration training reducing falls in community-living older adults: a pilot randomized controlled trial

BACKGROUND

Although vibration training has been applied in older adults, it remains unclear if it can reduce falls.

AIMS

This pilot randomized-controlled trial aimed to test the effects of an 8-week vibration training program on reducing falls among community-dwelling adults.

METHODS

Forty-eight older adults were randomized to two groups: training and control. The training group received three weekly training sessions over eight weeks while the control group maintained their normal lifestyle over the 8-week period. Immediately before (or baseline), following (post-training), and three months after (retest) the 8-week training course, a group of fall risk factors were assessed for all participants. Each participant was also exposed to an unexpected gait-slip on a treadmill during post-training and retest sessions. Their daily-living fall incidence was collected for 12 months after the baseline test. The slip fall was the primary outcome, prospective all-cause falls were the secondary outcome, and fall risk factors acted as the tertiary ones.

RESULTS

The vibration training program significantly reduced the risk of slip-falls and improved all fall risk factors immediately after the training course. The training effect may be carried over for three months. The 8-week training program could also lower the number of falls between the baseline test and retest and reduce the recurrent faller rate across the 12 months after the baseline test.

DISCUSSION

This study indicates that vibration training might have some effects on fall-related measures in older adults.

CONCLUSIONS

An 8-week vibration training program could be effective to reduce falls in older adults.

CLINICALTRIALS

GOV REGISTRATION NUMBER

NCT02694666.

Effects of whole-body vibration exercise in patients with chronic kidney disease: a systematic review

PURPOSE

Chronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial. This systematic review was conducted to assess effects of whole-body vibration exercise (WBVE) in individuals with CKD.

MATERIALS AND METHODS

It was conducted electronic searches in Pubmed, Embase, Scopus, Web of Science databases on May 2021. Records were identified and irrelevant studies were excluded based in eligibility criteria.

RESULTS

Five studies were included with a mean methodological quality score of 9, considered high quality in PEDRo scale. The studies have shown that the WBVE intervention, when applied low intensity was well tolerated, and no adverse effects; was able to improve the motor performance and strength in frail people, which could benefit the prevention of falls events. However, did not improve the quality of life, and the heart rate variability; and not altered cardiorespiratory parameters.

CONCLUSIONS

WBVE intervention promotes a better response in parameters of the motor performance and muscular strength, and interaction bone-muscle. Nevertheless, more studies are needed with this intervention to improve physiological responses, and to understand your recommendation to prevent and reduce the complications and symptoms of the CKD, promoting an active life to these patients.

PROTOCOL STUDY REGISTRATION

PROSPERO (CRD42020203295).IMPLICATIONS FOR REHABILITATIONChronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial.WBVE program possibility, of good acceptance, efficient as well tolerated by physically deconditioned patients who present difficulty to perform any type of exercise.WBVE protocol can promote changes in the patient with CKD lifestyle and benefits for this population because is an exercise without fatigue, impact, stress, or discomfort.

Adding Intermittent Vibration to Varied-intensity Work Intervals: No Extra Benefit

Varied-intensity work intervals have been shown to induce higher fractions of maximal oxygen uptake during high-intensity interval training compared with constant-intensity work intervals. We assessed whether varied-intensity work intervals combined with intermittent vibration could further increase cyclists' fraction of maximal oxygen uptake to potentially optimise adaptive stimulus. Thirteen cyclists (V̇O_2max: 69.7±7.1 ml·kg^-1·min^-1) underwent a performance assessment and two high-intensity interval training sessions. Both comprised six 5-minute varied-intensity work intervals within which the work rate was alternated between 100% (3×30-second blocks, with or without vibration) and 77% of maximal aerobic power (always without vibration). Adding vibration to varied-intensity work intervals did not elicit a longer time above ninety percent of maximal oxygen uptake (415±221 versus 399±209 seconds, P=0.69). Heart rate- and perceptual-based training-load metrics were also not affected (all P≥0.59). When considering individual work intervals, no between-condition differences were found (fraction of maximal oxygen uptake, P=0.34; total oxygen uptake, P=0.053; mean minute ventilation, P=0.079; mean heart rate, P=0.88; blood lactate concentration, P=0.53; ratings of perceived exertion, P=0.29). Adding intermittent vibration to varied-intensity work intervals does not increase the fraction of maximal oxygen uptake elicited. Whether intermittent exposure to vibration can enhance cyclists' adaptive stimulus triggered by high-intensity interval training remains to be determined.

Efficacy and safety of whole-body vibration therapy for post-stroke spasticity: A systematic review and meta-analysis

BACKGROUND

One of the main objectives of stroke rehabilitation is to alleviate post-stroke spasticity. Over the recent years, many studies have explored the potential benefits of whole-body vibration (WBV) treatment for post-stroke spasticity, but it is still controversial.

OBJECTIVE

The current study aims to assess the efficacy and safety of WBV for post-stroke spasticity and determine the appropriate application situation.

METHODS

From their establishment until August 2022, the following databases were searched: PubMed, Web of Science, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, China National Knowledge Infrastructure (CNKI), and Wanfang. Only randomized controlled trials (RCTs) that were published in either English or Chinese were taken into consideration. We independently filtered the research, gathered the data from the studies, and evaluated the research quality (Cochrane RoB tool) and the overall evidence quality (GRADE). Rev Man 5.4 software was utilized to conduct statistical analysis.

RESULTS

In this analysis, 11 RCTs with 475 patients that reported on the effectiveness of WBV therapy for post-stroke spasticity were taken into account. Compared to the control groups, the results revealed that WBV combined with conventional rehabilitation at a vibration frequency lower than 20 Hz (SMD = -0.58, 95% CI: -0.98 to -0.19, P = 0.004) was more effective in relieving upper (SMD = -0.53, 95% CI: -1.04 to 0.03, P = 0.03) and lower limb spasticity (SMD = -0.21, 95% CI: -0.40 to -0.01, P = 0.04); similarly, it was superior for patients aged under 60 years (SMD = -0.41, 95% CI: -0.66 to -0.17, P = 0.0008) with acute and subacute stroke (SMD = -0.39, 95% CI: -0.68 to -0.09, P = 0.01). The valid vibration for reducing spasticity was found to last for 10 min (SMD = -0.41, 95% CI: -0.75 to -0.07, P = 0.02). None of the included studies revealed any serious adverse impact.

CONCLUSION

Moderate-quality evidence demonstrated when WBV was used as an adjuvant, vibration <20 Hz for 10 min was effective and secure in treating upper and lower limb spasticity in patients with acute and subacute stroke under the age of 60 years.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022293951.