Effects of whole body vibration with exercise therapy versus exercise therapy alone on flexibility, vertical jump height, agility and pain in athletes with patellofemoral pain: a randomized clinical trial

Vertical whole body vibration for treatment of knee osteoarthritis: a pilote monocentric prospective, randomized trial

INTRODUCTION

Osteoarthritis of the knee (KOA) is a leading cause of disability in the aging population. The treatment of choice in most stages is a conservative multimodal approach. Previous studies were able to prove the efficiency of physical therapy for improvement. Therefore physical therapy, besides pain medication, is one of the most common used forms of therapy for KOA. This study aims to evaluate the possible efficiency of whole-body vibration (WBV) compared to physical therapy. This might benefit patients to whom physical therapy is not accessible.

MATERIALS AND METHODS

Patients with primary Gonarthrosis grade II or III were recruited. Included patients were randomly allocated to two groups. One group was treated by physical therapy and the other one with WBV. Treatment duration was six weeks. An Intention-to-Treat analysis was performed. Effectiveness was evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Outcome Measures in Rheumatology Committee (OMERACT) and Short-Form-Health-Survey 12 (SF-12) at seven, twelve and 26 weeks.

RESULTS

Of 51 patients recruited, 39 patients were finally included. Overall, both treatments were able to show improvements. The SF-12 Score was improved in both groups without significant difference (p = 0.487). The conventional group showed insignificant vaster pain reduction (p = 0.926). Whereas WBV resulted in insignificant improved function (p = 0.144), reduced stiffness (p = 0.931) and improved total score (p = 0.295). Response to therapy reduced over time in both groups. Although more patients of the WBV group reported improvement of their general health status, average improvement was better at the conventional group.

CONCLUSIONS

This study was able to show that, for the conservative treatment of knee osteoarthritis grade II and III, WBV is a non-inferior therapy compared to conventional physiotherapy. Both were able to improve the status of the patients and may be used based on the accessibility and preferences of affected patients.

Effects of whole-body vibration training as an adjunct to conventional rehabilitation exercise on pain, physical function and disability in knee osteoarthritis: A systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is a prevalent degenerative joint condition that impairs mobility and quality of life. While whole-body vibration training (WBVT) shows promise as an adjunct to conventional KOA rehabilitation, its efficacy remains unclear due to inconsistent clinical evidence.

OBJECTIVE

To elucidate the combined effects of WBVT and rehabilitation exercise on pain, physical function, and disability in KOA management through a systematic review and meta-analysis.

METHODS

A comprehensive search was conducted across eight electronic databases (PubMed, Web of Science, Embase, PEDro, SPORTDiscus, Scopus, ScienceDirect, and China National Knowledge Infrastructure) up to February 2024. Inclusion criteria were (i) randomized controlled trials comparing combined WBVT and rehabilitation exercise versus rehabilitation alone in KOA (ii) reported clinical outcomes (iii) human studies, and (iv) publications in English or Chinese. Trial quality was assessed using the PEDro scale and Cochrane risk-of-bias tool. The meta-analysis employed random-effects models in Review Manager 5.3 to account for heterogeneity, supported by sensitivity analyses for robustness and subgroup analyses on WBVT frequency effects.

RESULTS

Sixteen RCTs comprising 589 participants were included. The systematic review found that WBVT combined with conventional rehabilitation significantly reduced pain and improved physical function in KOA patients. The meta-analysis quantified these effects, showing that WBVT significantly (i) reduced knee pain (MD = -0.43, 95% CI [-0.70, -0.16], p = 0.002), with greater reductions observed from high-frequency WBVT, and (ii) increased isokinetic knee peak torque compared to rehabilitation exercise alone. No significant differences were found in balance, functional mobility, and disability outcomes. Sensitivity analysis of high-quality trials supported these results. However, the heterogeneity among studies and variations in control group interventions warrant cautious interpretation.

CONCLUSION

WBVT seems to be effective in reducing pain and enhancing muscle strength in KOA patients when used in conjunction with conventional rehabilitation. Future high-quality RCTs must standardize WBVT protocols, emphasize long-term follow-up, and refine dosage for clinically meaningful outcomes. Systematic review registration: International prospective register of systematic reviews (PROSPERO CRD42024508386).

Effects of 6-Week Whole-Body Vibration Training on Isokinetic Trunk Muscle Strength, Postural Stability, and Jump Performance in Female Adults - A Randomized Controlled Trial

Current evidence regarding the benefits of Whole-Body Vibration (WBV) on postural stability and jump performance remains inconsistent and to the best of our knowledge, there is no study comparing the effectiveness of different vibration frequencies on trunk muscle strength. This study was conducted to determine the effect of whole-body vibration training with different vibration frequency on isokinetic trunk muscle strength, postural stability and jump performance in physically inactive and minimally active healthy female adults. Forty-five females were randomly assigned to 45 hz WBV group (n = 15), 25 hz WBV (n = 15) group and control exercise group without WBV (0 hz group, n = 15). Individuals in each group completed a 6-week trunk-based exercise program at the specified vibration frequency. Concentric and eccentric strength of trunk flexor and extensor muscles, postural stability and jump performance were assessed before and after the training period. There were significant group by time interactions in concentric and eccentric trunk muscle strength. Interaction effects showed no significant differences in postural stability and vertical jump performance. However, post hoc analyses revealed that all three groups significantly improved vertical jump height. These findings suggest that WBV combined with exercise training were effective to enhance the strength of trunk muscles in physically inactive and minimally active women. Nevertheless, WBV exercise training performed in this study had no significant impact on postural stability and jump performance.Clinical Trials Number: NCT05014958 (Pre-registired).

Are adjunct treatments effective in improving pain and function when added to exercise therapy in people with patellofemoral pain? A systematic review with meta-analysis and appraisal of the quality of interventions

OBJECTIVE

To compare the effectiveness of adjunct treatments combined with exercise to exercise alone in people with patellofemoral pain (PFP) and explore the quality of intervention descriptions in randomised controlled trials (RCTs).

DESIGN

Systematic review.

DATA SOURCES

Seven databases were searched in November 2023.

ELIGIBILITY

RCTs that evaluated the effectiveness of any adjunct treatment combined with exercise to exercise alone on self-reported pain and function in people with PFP.

RESULTS

We included 45 RCTs (2023 participants), with 25 RCTs (1050 participants) contributing to meta-analyses. Pooled analysis indicated very low-certainty evidence that neuromuscular electrical stimulation or monopolar dielectric diathermy combined with exercise leads to small and large improvements in self-reported pain when compared with exercise alone (standardised mean difference (95% CI)=-0.27 (-0.53 to -0.02) and -2.58 (-4.59 to -0.57), respectively) in the short-term. For self-reported pain and function, very low-certainty evidence indicates that knee taping, whole-body vibration, electromyographic biofeedback and knee brace combined with exercise do not differ from exercise alone. Interventions are poorly described in most RCTs, adjunct treatments scored on average 14/24 and exercise therapy 12/24 in the Template for Intervention Description and Replication checklist.

CONCLUSION

Neuromuscular electrical stimulation and monopolar dielectric diathermy combined with exercise seem to improve self-reported pain in people with PFP compared with exercise alone. Knee taping, whole-body vibration, electromyographic biofeedback and knee brace do not offer additional benefits to exercise alone. Most interventions are poorly described, which is detrimental to translating research knowledge into clinical practice.

PROSPERO REGISTRATION NUMBER

CRD42020197081.

The influence of vibratory massage after physical exertion on selected psychological processes

Good mental preparation of an athlete plays an important role in achieving optimal sports results. An athlete who enters a competition should not feel fatigue resulting from intense physical exercise. Therefore, new and effective methods are being sought that could help accelerate the process of both physical and mental regeneration. Vibrotherapy is one of them. The aim of the study was to determine the optimal frequency of vibration, its duration and the position in which the subjects were placed during the treatments, in relation to the reduction of subjectively perceived exertion muscle pain, mental discomfort, emotional states and the level of cognitive processes that were disturbed by intense physical activity. Sixteen healthy male volunteers were involved in this study. The participants were assessed for their aerobic and anaerobic capacity. Each of the subjects performed a set of intensive physical exercises and then underwent vibrotherapy treatment. In random order, each of the men tested the effectiveness of eight combinations of frequency, duration, and body position. Psychological tests were conducted for each combination: frequency, duration of treatment, and position during treatment, in four stages: (1) before the start of the experiment (baseline POMS measurements), (2) immediately after the exercise (VAS scale, scale examining psychological discomfort and STROOP test), (3) immediately after the vibration treatment (POMS measurements, VAS scale, scale examining psychological discomfort and STROOP test), (4) 24 h after the vibration treatment (VAS scale examining subjective assessment of perceived pain and psychological discomfort). Based on the results, it was concluded that all the studied variables improved significantly over time (after the vibration treatment and 24 h after training). In addition, a statistically significant interaction measurement × frequency was noted for vigor scale (52HZ favored greater improvement in this state), and a statistically significant interaction was found for measurement × time for the VAS scale (p < 0.05) - the lower pain value was indicated 24 h after the 10-min vibration treatment. The type of frequency used, position, and duration of the treatment did not play a statistically significant role in changing STROOP test results and severity of psychological discomfort (p > 0.05).

The Effect Of Percussive Therapy On Musculoskeletal Performance And Experiences Of Pain: A Systematic Literature Review

Background

There is a lack of specific research on the effect of percussive therapy (PT) delivered by massage guns on physiological adaptations. This systematic literature review investigates research conducted on the effects of PT interventions on performance in strength and conditioning settings, and on experiences of musculoskeletal pain.

Purpose

To determine the effect of PT delivered by massage guns on physiological adaptations: muscle strength, explosive muscle strength and flexibility, and experiences of musculoskeletal pain.

Study Design

Systematic literature review.

Methods

Data sources (CINAHL, Cochrane Library, Psychinfo, PubMed, SportDISCUS and OpenGrey) were searched from January 2006 onwards for full text literature in any language involving adult populations receiving PT delivered by massage guns, directly to any muscle belly or tendon, with comparisons to an alternative treatment, placebo or no treatment. Literature with outcomes relating to acute or chronic physiological adaptations in muscle strength, explosive muscle strength, flexibility or experiences of musculoskeletal pain were included. Articles were assessed for quality using the Critical Appraisal Skills Programme and PEDro scores.

Results

Thirteen studies met the inclusion criteria. All studies had limitations in methodological quality or reporting of findings but still included contextually-rich details that contributed to the overall narrative synthesis. A significant relationship was found between a single application of PT delivered by massage guns and an acute increase in muscle strength, explosive muscle strength and flexibility, with multiple treatments eliciting a reduction in experiences of musculoskeletal pain.

Conclusion

PT delivered by massage guns can help improve acute muscle strength, explosive muscle strength and flexibility, and reduce experiences of musculoskeletal pain. These devices may provide a portable and cost-effective alternative to other forms of vibration and interventions.

Beyond physiology: Acute effects of side-alternating whole-body vibration on well-being, flexibility, balance, and cognition using a light and portable platform A randomized controlled trial

A good body-balance helps to prevent slips, trips and falls. New body-balance interventions must be explored, because effective methods to implement daily training are sparse. The purpose of the current study was to investigate acute effects of side-alternating whole-body vibration (SS-WBV) training on musculoskeletal well-being, flexibility, body balance, and cognition. In this randomized controlled trial, participants were randomly allocated into a verum (8.5 Hz, SS-WBV, N = 28) or sham (6 Hz, SS-WBV, N = 27) condition. The training consisted of three SS-WBV series that lasted one-minute each with two one-minute breaks in between. During the SS-WBV series, participants stood in the middle of the platform with slightly bent knees. During the breaks in between, participants could loosen up. Flexibility (modified fingertip-to-floor method), balance (modified Star Excursion Balance Test), and cognitive interference (Stroop Color Word Test) were tested before and after the exercise. Also, musculoskeletal well-being, muscle relaxation, sense of flexibility, sense of balance, and surefootedness were assessed in a questionnaire before and after the exercise. Musculoskeletal well-being was significantly increased only after verum. Also, muscle relaxation was significantly higher only after verum. The Flexibility-Test showed significant improvement after both conditions. Accordingly, sense of flexibility was significantly increased after both conditions. The Balance-Test showed significant improvement after verum, and after sham. Accordingly, increased sense of balance was significant after both conditions. However, surefootedness was significantly higher only after verum. The Stroop-Test showed significant improvement only after verum. The current study shows that one SS-WBV training session increases musculoskeletal well-being, flexibility, body balance and cognition. The abundance of improvements on a light and portable platform has great influence on the practicability of training in daily life, aiming to prevent slip trips and falls at work.

Effects of acute taurine consumption on single bout of muscular endurance resistance exercise performance and recovery in resistance trained young male adults

Study aim: This study investigated the effect of taurine supplementation on exercise performance and recovery from resistance exercise. The study was conducted with a cross-over design in a double-blind manner.

Material and methods: Ten resistance trained males (age 21.4 ± 2.01 years; BMI: 23.6 ± 2.5 kg/m²) ingested either a taurine (0.1g/kg) supplement or placebo (18 mg aspartame) prior to resistance exercise. Vertical jump, flexibility, balance, systolic blood pressure, diastolic blood pressure, heart rate (HR), maximal voluntary muscle contraction, speed, lactate, glucose and perceived soreness and strain were assessed. The subjects performed two exercise trials with 1 week wash out interval. Blood samples were collected at baseline and before each exercise (chest press, abdominal crunch and leg extension) to analyse plasma levels of lactate and glucose.

Results: Paired-T test results showed statistically significant increment (p < 0.05) in total volume (kg × #repetitions), chest press volume and leg extension volume. Repeated measure ANOVA results demonstrated statistically significant differences (p < 0.05) in lactate and flexibility in trial and time, and in maximal voluntary isometric muscle contraction (MVIC) test in time, trial and trial × time in favour taurine group. No statistically significant differences were found in cardiovascular parameters, glucose, and balance parameters (p > 0.05).

Conclusion: In conclusion, 0.1 g/kg of taurine consumption before resistance exercise could positively affect exercise performance by increasing exercise volume and reducing lactate levels.

EFFECTS OF VIBRATION TRAINING ON THE PHYSICAL FITNESS OF SHORT-DISTANCE SWIMMERS

ABSTRACT Introduction Vibration training is a widespread exercise. Existing experimental results show that using vibration strength exercises under the same loading conditions can improve the muscular strength of swimmers’ lower limbs. Objective This paper especially studies the effect of vibration exercise on the physical quality of swimmers under various conditions. Methods The athletes were randomly divided into two groups: the experimental group and the control group. The experimental group used a vibrometer to exercise the lower limb muscles. The control group engaged only in routine training. After eight weeks of practice, the runners tested in the 100m, 150m, 200m, and 400m. The present article also explores the relationship between swimmers of different ages. Results Compared to the control group, there was a significant difference in maximum hip extensor volume between the experimental and control groups. There was also a significant difference between the two groups (P<0.05). The most significant increase in maximal exercise capacity between the two groups was in the ankle. The change in maximum load between the two groups was also significant (P<0.01). Conclusion The vibration training method can improve the swimmer’s knee flexor group. Swimmers can improve their body coordination by performing vibration exercises. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Whole Body Vibration: A Valid Alternative Strategy to Exercise?

Several studies agree that mechanical vibration can induce physiological changes at different levels, improving neuromuscular function through postural control strategies, muscle tuning mechanisms and tonic vibration reflexes. Whole-body vibration has also been reported to increase bone mineral density and muscle mass and strength, as well as to relieve pain and modulate proprioceptive function in patients with osteoarthritis or lower back pain. Furthermore, vibratory training was found to be an effective strategy for improving the physical performance of healthy athletes in terms of muscle strength, agility, flexibility, and vertical jump height. Notably, several benefits have also been observed at the brain level, proving to be an important factor in protecting and/or preventing the development of age-related cognitive disorders. Although research in this field is still debated, certain molecular mechanisms responsible for the response to whole-body vibration also appear to be involved in physiological adaptations to exercise, suggesting the possibility of using it as an alternative or reinforcing strategy to canonical training. Understanding these mechanisms is crucial for the development of whole body vibration protocols appropriately designed based on individual needs to optimize these effects. Therefore, we performed a narrative review of the literature, consulting the bibliographic databases MEDLINE and Google Scholar, to i) summarize the most recent scientific evidence on the effects of whole-body vibration and the molecular mechanisms proposed so far to provide a useful state of the art and ii) assess the potential of whole-body vibration as a form of passive training in place of or in association with exercise.

The influence of an 8-week therapeutic exercise program on the patient experience of patellofemoral pain: a qualitative descriptive study

OBJECTIVE

The aim of this study was to explore patients' experience of patellofemoral pain (PFP), in order to help improve the mutual understanding between the patient and the physiotherapist and consequently enhance the efficacy of treatment.

METHODS

A qualitative study design with focus groups was used to explore patient experience prior to the implementation of the therapeutic exercise program, during its duration, and up to twelve months after its conclusion.

RESULTS

Patients provided a detailed description of their lifestyle prior to the enrollment in the therapeutic exercise program, their experience of the therapeutic exercise program and the behavioral changes that remained after its conclusion. Three main themes emerged from our data: 1) PFP characteristics and the impact of PFP on daily life; 2) experience with the therapeutic exercise program; and 3) changes in PFP and daily behaviors following the therapeutic exercise program.

CONCLUSION

Our findings suggest that a targeted therapeutic exercise program effectively reduces short- and long-term PFP and enhance overall well-being. Further research is needed to investigate the effects of different therapeutic exercise programs with a focus on the role of self-motivation.

The reflex mechanism underlying the neuromuscular effects of whole-body vibration: Is it the tonic vibration reflex?

OBJECTIVES

Whole-body vibration (WBV) is applied to the sole of the foot, whereas local mechanical vibration (LMV) is applied directly to the muscle or tendon. The time required for the mechanical stimulus to reach the muscle belly is longer for WBV. Therefore, the WBV-induced muscular reflex (WBV-IMR) latency may be longer than the tonic vibration reflex (TVR) latency. The aim of this study was to determine whether the difference between WBV-IMR and TVR latencies is due to the distance between the vibration application point and the target muscle.

METHODS

Eight volunteers participated in this study. The soleus reflex response was recorded during WBV, LMVs, and tendon tap. LMVs were applied to the Achilles tendon and sole of the foot. The latencies were calculated using the cumulative averaging technique.

RESULTS

The latency (33.4±2.8 ms) of the soleus reflex induced by the local foot vibration was similar to the soleus TVR latency (30.9±3.2 ms) and T-reflex (32.0±2.4 ms) but significantly shorter than the latency of the soleus WBV-IMR (42.3±3.4 ms) (F_(3,21)=27.46, p=0.0001, partial η²=0.797).

CONCLUSIONS

The present study points out that the neuronal circuitries of TVR and WBV-IMR are different.

Whole-body vibration exercise and training increase regional CBF in mild cognitive impairment with enhanced cognitive function

OBJECTIVES

Preclinical and non-medicinal interventions are essential for preventing and treating cognitive decline in patients with mild cognitive impairment (MCI). Whole-body vibration (WBV) exercise is conducted on a platform that generates vertical sinusoidal vibrations, and WBV training may improve regional cerebral blood flow (rCBF) and cognitive function, however, the underlying mechanism remains unclear. The aim of the present study was to investigate whether WBV exercise and a 24-week WBV training protocol increased rCBF and enhanced cognitive function in patients with amnestic MCI (aMCI).

METHODS

[99mTc]-ECD and SPECT studies were performed on 16 aMCI patients at baseline, during WBV exercise, and on 6 of the 16 patients after 24-week WBV training. To diagnose SPECT images and select the patients, a Z-score mapping approach was used, which revealed pathological hypoperfusion in the parietal association cortex, precuneus and/or posterior cingulate gyrus for MCI at baseline. rCBF was semi-quantitatively measured and underestimation in the high flow range was corrected. Since it is difficult to quantitatively measure rCBF during WBV exercise, the rCBFratio was obtained by standardizing with the average of individual mean SPECT counts with correcting underestimation in the high flow range. The rCBFratios at baseline and after WBV training were also obtained in a similar manner. Since the changes in rCBF were regarded as corresponding to the changes in rCBFratio, the ratios were compared. Cognitive function was also evaluated and compared.

RESULTS

We found that the rCBFratio changed with an average range of 11.5% during WBV exercise, and similar changes were observed after 24-week WBV training with a 13.0% change, resulting in improved cognitive function (MoCA-J, P = 0.028). The rCBFratio increased in the parietal association cortex and occipital lobes, including the precuneus and posterior cingulate gyrus, at which hypoperfusion was detected at baseline, but decreased in the frontal lobe and anterior cingulate gyrus. The rCBFratio increased on the right side of several motion-suppressive nuclei by WBV exercise; the bilateral red nuclei and right medial globus pallidus by WBV training.

CONCLUSION

WBV exercise and training increase rCBF in aMCI patients, and WBV training enhances cognitive function and may increase the cognitive reserve. Further investigation is necessary.

The effects of virtual reality training on clinical indices and brain mapping of women with patellofemoral pain: a randomized clinical trial

Background

Virtual reality training (VRT) is a new method for the rehabilitation of musculoskeletal impairments. However, the clinical and central effects of VRT have not been investigated in patients with patellofemoral pain (PFP). To comprehensively assess the effects of VRT on clinical indices and brain function, we used a randomized clinical trial based on clinical and brain mapping assessment.

Methods

Twenty-six women with PFP for more than 6 months were randomly allocated to 2 groups: intervention and control. The intervention consisted of lifestyle education + 8 weeks VRT, in 24 sessions each lasting 40 min of training, whereas the control group just received lifestyle education. The balance was the primary outcome and was measured by the modified star excursion balance test. Secondary outcomes included pain, function, quality of life, and brain function which were assessed by visual analogue scale, step down test and Kujala questionnaire, SF-36, and EEG, respectively. Pre-intervention, post-intervention and follow-up (1 month after the end of the intervention) measurements were taken for all outcome measures except EEG, which was evaluated only at pre-intervention and post-intervention). Analyses of variance was used to compare the clinical outcomes between the two groups. The independent t-test also was used for between group EEG analyses.

Results

Balance score (P < 0.001), function (P < 0.001), and quality of life (P = 0.001) improved significantly at post-intervention and 1 month follow-up in the VRT group compared with the control group. VRT group showed a significantly decreased pain score (P = 0.004). Alpha (P < 0.05) and theta (P = 0.01) power activity also increased in the brain of the VRT group.

Conclusion

This study demonstrated that long term VRT was capable of improving both clinical impairments and brain function in patients with PFP. Therefore, therapists and clinicians can use this method as a more holistic approach in the rehabilitation of PFP.

Trial registration

IRCT, IRCT20090831002391N40. Registered 23 / 10 / 2019.