Use of whole body vibration in individuals with chronic stroke: Transmissibility and signal purity

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.

Biodynamic Responses to Whole-Body Vibration Training: A Systematic Review

In recent years, whole-body vibration (WBV) training has received an increasing interest in the sports and medical fields. However, there has been inconsistency among several studies regarding the effect of WBV training on the human body, which is partly due to the lack of the existence of guidelines for using WBV training machines. To understand the effect of WBV training on the human body and build the needed regulations, it is essential first to understand the biodynamic responses to vibration which represent how vibration is transmitted to and through the human body. The purpose of this study is to systematically review previous studies that measured biodynamic responses when using WBV training machines to highlight inconsistencies in their results and provide possible reasons for them. An extensive literature search was performed on the SCOPUS database to obtain relevant studies. One hundred and fifty-six potentially relevant studies were obtained but after further screening, 23 papers from 2007 to 2020 met inclusion criteria and were included in the study. The papers were analysed with respect to acceleration, transmissibility, interface force, and apparent mass during different vibration settings, body posture, age, and sex. Results and conflicts among studies were highlighted and possible explanations for the inconsistency were provided.

Effects of different vibration frequencies on muscle strength, bone turnover and walking endurance in chronic stroke

This randomized controlled trial aimed to evaluate the effects of different whole body vibration (WBV) frequencies on concentric and eccentric leg muscle strength, bone turnover and walking endurance after stroke. The study involved eighty-four individuals with chronic stroke (mean age = 59.7 years, SD = 6.5) with mild to moderate motor impairment (Fugl-Meyer Assessment lower limb motor score: mean = 24.0, SD = 3.5) randomly assigned to either a 20 Hz or 30 Hz WBV intervention program. Both programs involved 3 training sessions per week for 8 weeks. Isokinetic knee concentric and eccentric extension strength, serum level of cross-linked N-telopeptides of type I collagen (NTx), and walking endurance (6-min walk test; 6MWT) were assessed at baseline and post-intervention. An intention-to-treat analysis revealed a significant time effect for all muscle strength outcomes and NTx, but not for 6MWT. The time-by-group interaction was only significant for the paretic eccentric knee extensor work, with a medium effect size (0.44; 95% CI: 0.01, 0.87). Both WBV protocols were effective in improving leg muscle strength and reducing bone resorption. Comparatively greater improvement in paretic eccentric leg strength was observed for the 30 Hz protocol.

Effects of whole body vibration exercise on lumbar-abdominal muscles activation for patients with chronic low back pain

Background

Whole body vibration (WBV) training as an intervention method can cure chronic low back pain (CLBP). Different WBV parameters exert different effects on lumbar-abdominal muscle performance. Currently, there is a lack of study researched the influence of WBV training on patients with CLBP by lumbar–abdominal muscle activity. Therefore, this study aimed to investigate how WBV and exercise and their interactions influence lumbar-abdominal muscle activity in patients with CLBP.

Methods

a group of ambulatory patients with chronic low back pain. Muscle activities of the multifidus (MF), erector spinae (ES), abdominal oblique externus muscle (AOE) and the rectus abdominis muscle (RA) were measured by surface electromyography, whereas participants performed 4 different exercises (single bridge, plank, side stay and V crunch) during three whole body vibration conditions and a no-vibration condition in a single experimental session.

Results

Compared with the same exercises without whole body vibration, muscle activity increased when whole body vibration was added to the exercises. MF; the WBV frequency (P = 0.002,) and exercise (P < 0.001) presented significant effects on the root mean square of MF, whereas exercise * frequency (P = 0.044) also resulted in significant interaction effects. ES: the significant differences were detected at WBV frequency (P < 0.001), exercise (P < 0.001), the interaction effect of exercise and frequency (P = 0.225) was no significant. RA: the significant difference was detected at WBV frequency (P = 0.018), the effect of exercise (P = 0.590) and the exercise * frequency interaction (P = 0.572) were no significant. AOE: the significant difference was detected at WBV frequency (P < 0.001), the effect of exercise (P = 0.152) and the exercise * frequency interaction (P = 0.380) were no significant.

Conclusion

Adding whole body vibration to exercise could increase muscle activation of lumbar–abdominal muscle in patients with CLBP. The optimum frequency for lumbar–abdominal muscles is 15 Hz. The best exercises include plank for multifidus and erector spinae, V crunch for rectus abdominis and single bridge for abdominal oblique externus.

Clinical registration

Trial registration: ChiCTR-TRC-13003708. Registered 19 October 2013.

The code of ethical approval

2014008.

Whole-body vibration modulates leg muscle reflex and blood perfusion among people with chronic stroke: a randomized controlled crossover trial

This study aimed to investigate the acute effect of whole-body vibration (WBV) on the reflex and non-reflex components of spastic hypertonia and intramuscular blood perfusion among individuals with chronic stroke. Thirty-six people with chronic stroke (age: 61.4 ± 6.9 years) participated in this randomized controlled cross-over study. Each participant underwent two testing conditions: static standing for 5 minutes with WBV (30 Hz, 1.5 mm) or no-vibration. We assessed the soleus H-reflex, shear modulus (ultrasound elastography) and vascular index (color power Doppler ultrasound) of the medial gastrocnemius (MG) muscle on either paretic or non-paretic side at baseline and every 1-min post-intervention up to 5 minutes. The results revealed a significant inhibition of the H/M ratio bilaterally for the WBV condition (absolute change on paretic side: 0.61 ± 0.35, p = 0.001; non-paretic side: 0.34 ± 0.23, p = 0.001), but not the control condition. The inhibition of H-reflex was sustained up to 4 minutes and 3 minutes on the paretic and non-paretic side, respectively. The vascular index of MG muscle was significantly increased only for the WBV condition [paretic: from 0.55 ± 0.07 to 1.08 ± 0.18 (p = 0.001); non-paretic: from 0.82 ± 0.09 to 1.01 ± 0.13 (p < 0.001)], which lasted for 3 minutes and 5 minutes, respectively. No significant change of the shear modulus in the MG muscle was observed, regardless of the testing condition. Based on our results, WBV had an acute effect on modulating spastic hypertonia dominated by hyperreflexia in people with chronic stroke and facilitating greater intramuscular blood perfusion. No acute effect on passive muscle stiffness was observed.

Effect of gender on the biodynamic responses to vibration induced by a whole-body vibration training machine

Whole-body vibration training machines are used by both male and female users. However, studies investigating the biodynamic responses to vibration during training have used either mixed-gender subjects or male subjects. No study has investigated the effect of gender on the biodynamic responses under vibration training conditions. The objective of this study is to investigate the effect of gender on the apparent mass and the vibration of the head of standing people during exposure to vibration. A total of 40 subjects (20 females and 20 males) were exposed to vertical vibration at six frequencies in the range 20-45 Hz and vibration acceleration in the range 10.8-20.9 m/s² (peak). The subjects stood on a force platform mounted on the vibrating plate of the machine adopting an upright standing posture with their knees unlocked and their arms straight along their bodies. The vertical acceleration and force at the interface between the vibrating plate and the feet were measured and used to calculate the apparent mass. The accelerations of the head in the x-, y- and z-directions were also measured and used to calculate the transmissibility to the head. The apparent mass of males was found higher than that of females. The transmissibility to the head in all directions was found higher in females than males. The differences in the biodynamic responses between males and females were attributed to the differences in body properties and structure of the two genders. The results of this study imply the need for gender-specific vibration training programmes.

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

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

Effects of Stochastic Resonance Whole-Body Vibration in Individuals with Unilateral Brain Lesion: A Single-Blind Randomized Controlled Trial: Whole-Body Vibration and Neuromuscular Function

Introduction

Stochastic resonance whole-body vibration (SR-WBV) devices are promising sensorimotor interventions to address muscle weakness and to improve balance and mobility particularly in the elderly. However, it remains inconclusive whether individuals with stroke or traumatic brain injury (TBI) can profit from this method. The aim of this prospective single-blind randomized controlled trial was to investigate the effects of SR-WBV on muscle strength as well as gait and balance performance in this population.

Methods

Forty-eight individuals with stroke or TBI were randomly allocated to an experimental and a sham group. Participants were exposed daily to 5 consecutives 1-minute SR-WBV sessions, whereas the experimental group trained in a standing position with 5 Hz and the sham group in a seated position with 1 Hz. Isometric muscle strength properties of the paretic knee extensor muscles as well as balance and gait performance were measured at baseline, after the first session and after two weeks of SR-WBV.

Results

Both groups showed short- and long-term effects in gait performance. However, no between-group effects could be found at the three measurement points.

Discussion

Complementary SR-WBV showed no beneficial effects immediately after the intervention and after two weeks of conventional rehabilitation therapy. Future research is needed to identify the potential efficacy of SR-WBV in individuals with stroke and TBI using shorter and less exhausting test procedures and a generally prolonged intervention time.