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High-frequency whole-body vibration improves balancing ability in elderly women.

Cheung WH, Mok HW, Qin L, Sze PC, Lee KM, Leung KS.

Department of Orthopaedics and Traumatology, Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.

OBJECTIVE: To investigate the efficacy of high-frequency whole-body vibration (WBV) on balancing ability in elderly women. DESIGN: Randomized controlled trial. Subjects were randomized to either the WBV intervention or the no-treatment control group. SETTING: Community-living elderly women. PARTICIPANTS: Sixty-nine elderly women aged 60 or above without habitual exercise. INTERVENTION: Side alternating WBV at 20Hz with 3 minutes a day and 3 days a week for 3 months in the WBV intervention group. Those in control group remained sedentary with normal daily life for the whole study period. MAIN OUTCOME MEASURES: Limits of stability in terms of reaction time, movement velocity, directional control, endpoint excursion, maximum excursion, and the functional reach test were performed at baseline and endpoint. RESULTS: Significant enhancement of stability was detected in movement velocity (P<.01), maximum point excursion (P<.01), in directional control (P<.05). CONCLUSIONS: WBV was effective in improving the balancing ability in elderly women. This also provides evidence to support our user-friendly WBV treatment protocol of 3 minutes a day for the elderly to maintain their balancing ability and reduce risks of fall.

Cheung W.H., Mok H.W., Qin L., Sze P.C., Lee K.M. & Leung K.S. (2007). High-frequency whole-body vibration improves balancing ability in elderly women. Archives of Physical Medicine and Rehabilitation. 88(7). 852-857.

A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction.

Moezy A, Olavaei G, Hadian M, Razi M, Faghihzadeh S.

School of Rehabilitation, Medical Sciences/Tehran University, Tehran, Iran.

OBJECTIVE: To compare the effect of a whole body vibration training (WBVT) programme with a conventional training (CT) programme on knee proprioception and postural stability after anterior cruciate ligament (ACL) reconstruction. METHODS: Twenty athletes with unilateral ACL reconstruction were randomly assigned to the WBVT or CT group; all participants received 12 sessions of WBVT or conventional training. Absolute error in joint repositioning for two target angles (30 degrees and 60 degrees ) was measured with the Biodex dynamometer; bilateral dynamic postural stability (anteroposterior, mediolateral and overall stability indices) was measured with the Biodex Stability System pre-intervention and post-intervention. RESULTS: The improvement in postural stability in the WBVT group was significantly greater than that in the CT group (p< or =0.05). The p values of the changing scores of open overall, open anteroposterior, open mediolateral, closed overall, closed anteroposterior and closed mediolateral stability indices were 0.002, 0.010, 0.0001, 0.001, 0.0001 and 0.046, respectively. In addition, there were significant differences in all averages of absolute angular error at 60 degrees and 30 degrees between the WBVT and CT groups in both knees (p = 0.001 in healthy knees and p = 0.001 and p = 0.0001 in reconstructed knees), apart from the healthy knees at the 30 degrees target position, which was not significant (p = 0.131). CONCLUSIONS: Whole body vibration training improved proprioception and balance in athletes with reconstructed ACL.

Moezy A., Olavaei G., Hadian M., Razi M. & Faghihzadeh S. (2008). A comparative study of whole body vibration training and conventional training on knee proprioception and postural stability after anterior cruciate ligament reconstruction. British Journal of Sports Medicine. 42(5). 373-378.

The feasibility of Whole Body Vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial.

Bautmans I, Van Hees E, Lemper JC, Mets T.

Gerontology, Free University of Brussels (VUB), Laarbeeklaan 103, B-1090 Brussels, Belgium. [email protected]

BACKGROUND: Fatigue or lack of interest can reduce the feasibility of intensive physical exercise in nursing home residents. Low-volume exercise interventions with similar training effects might be an alternative. The aim of this randomised controlled trial was to investigate the feasibility of Whole Body Vibration (WBV) in institutionalised elderly, and its impact on functional capacity and muscle performance. METHODS: Twenty-four nursing home residents (15 female, 9 male; mean age 77.5 +/- 11.0 years) were randomised (stratification for age, gender and ADL-category) to 6 weeks static WBV exercise (WBV+, N = 13) or control (only static exercise; N = 11). Outcome measures were exercise compliance, timed up-and-go, Tinetti-test, back scratch, chair sit-and-reach, handgrip strength and linear isokinetic leg extension. RESULTS: At baseline, WBV+ and control groups were similar for all outcome variables. Twenty-one participants completed the program and attended respectively 96% and 86% of the exercise sessions for the WBV+ and control groups. Training-induced changes in timed up-and-go and Tinetti-test were better for WBV+ compared to control (p = 0.029 for timed up-and-go, p = 0.001 and p = 0.002 for Tinetti body balance and total score respectively). In an alternative analysis (Worst Rank Score & Last Observation Carried Forward) the differences in change remained significant on the Tinetti body balance and total score. No other significant differences in change between both groups were observed. CONCLUSION: In nursing home residents with limited functional dependency, six weeks static WBV exercise is feasible, and is beneficial for balance and mobility. The supplementary benefit of WBV on muscle performance compared to classic exercise remains to be explored further.

Bautmans I.,Van Hees E., Lemper J.C. & Mets T. (2005). The feasibility of whole body vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial. BMC Geriatrics. 22;5:17.

Effect of 4-min vertical whole body vibration on muscle performance and body balance: a randomized cross-over study.

Torvinen S, Sievanen H, Jarvinen TA, Pasanen M, Kontulainen S, Kannus P.

Bone Research Group, UKK Institute, Tampere, Finland. [email protected]

The purpose of this randomized cross-over study was to investigate the effects of a 4-min long, 2-mm vertically-vibrating vibration-exercise on muscle performance and body balance in healthy subjects. Sixteen volunteers (eight men and women aged 18-35 years) underwent both the 4-min vibration- and sham-interventions in a randomized order on different days. Performance- and balance-tests (stability platform, grip strength, extension strength of lower extremities, tandem-walk, vertical jump and shuttle-run) were done 10 minutes before (baseline) and 2 and 60 minutes after the intervention. In addition, the effect of vibration on the surface electromyography (EMG) of soleus, vastus lateralis, gluteus medius, and paravertebralis muscles was investigated during the vibration. The 4-min vibration-loading did not induce any statistically significant change in the performance- or balance-tests at the 2- or 60-min tests. Interestingly, however, the mean power frequency of the EMG in the vastus lateralis and gluteus medius muscles decreased during the vibration-intervention, indicating muscle fatigue, particularly in the hip region. It was concluded that a 4-min long, 2-mm vertically-vibrating vibration-stimulus did not induce changes in the performance and balance tests. Future studies should focus on evaluating the effects of different kinds of vibration-regimens, as well as the long-term effects of vibration-training, on body balance and muscle performance, and, as a broader objective, on bone.

Torvinen S., Sievanen H., Jarvinen T.A., Pasanen M., Kontulainen S. & Kannus P. (2002). Effect of 4-min vertical whole body vibration on muscle performance and body balance: a randomized cross-over study. International Journal of Sports Medicine. 23(5). 374-379.

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

Bogaerts A, Verschueren S, Delecluse C, Claessens AL, Boonen S.

Division of Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Katholieke Universiteit Leuven, Tervuursevest 101, 3001 Leuven, Belgium.

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

Bogaerts A, Verschueren S., Delecluse C., Claessens A.L. & Boonen S. (2007). Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial. Gait & Posture. 26(2). 309-316.

Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study.

Torvinen S, Kannnus P, Sievanen H, Jarvinen TA, Pasanen TA, Kontulainen S, Nenonen A, Jarvinen TL, Paakkala T, Jarvinen M, Vuori I.

Bone Research Group, UKK Institute, Tampere, Finland.

Recent animal studies have given evidence that vibration loading may be an efficient and safe way to improve mass and mechanical competence of bone, thus providing great potential for preventing and treating osteoporosis. Randomized controlled trials on the safety and efficacy of the vibration on human skeleton are, however, lacking. This randomized controlled intervention trial was designed to assess the effects of an 8-month whole body vibration intervention on bone, muscular performance, and body balance in young and healthy adults. Fifty-six volunteers (21 men and 35 women; age, 19-38 years) were randomly assigned to the vibration group or control group. The vibration intervention consisted of an 8-month whole body vibration (4 min/day, 3-5 times per week). During the 4-minute vibration program, the platform oscillated in an ascending order from 25 to 45 Hz, corresponding to estimated maximum vertical accelerations from 2 g to 8 g. Mass, structure, and estimated strength of bone at the distal tibia and tibial shaft were assessed by peripheral quantitative computed tomography (pQCT) at baseline and at 8 months. Bone mineral content was measured at the lumbar spine, femoral neck, trochanter, calcaneus, and distal radius using DXA at baseline and after the 8-month intervention. Serum markers of bone turnover were determined at baseline and 3, 6, and 8 months. Five performance tests (vertical jump, isometric extension strength of the lower extremities, grip strength, shuttle run, and postural sway) were performed at baseline and after the 8-month intervention. The 8-month vibration intervention succeeded well and was safe to perform but had no effect on mass, structure, or estimated strength of bone at any skeletal site. Serum markers of bone turnover did not change during the vibration intervention. However, at 8 months, a 7.8% net benefit in the vertical jump height was observed in the vibration group (95% CI, 2.8-13.1%; p = 0.003). On the other performance and balance tests, the vibration intervention had no effect. In conclusion, the studied whole body vibration program had no effect on bones of young, healthy adults, but instead, increased vertical jump height. Future human studies are needed before clinical recommendations for vibration exercise.

Torvinen S., Kannus P., Sievanen H., Jarvinen T.A., Pasanen T.A., Kontulainen S., Nenonen A., Jarvinen T.L. Paakkala T., Jarvinen M. & Vuori I. (2003). Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study. Journal of Bone and Mineral Research. 18(5). 876-884.

Balance training and exercise in geriatric patients.

Runge M, Rehfeld G, Resnicek E.

Aerpah-Klinik Esslingen, Germany. [email protected]

Objective measures of gait and balance which meet the criteria of reliability and validity are required as a basis for exercise regimens. We established reference values of clinically relevant locomotor and balance performances for geriatric patients. We are using these data for evaluating the effects of different therapeutic approaches to locomotor and balance disorders. Reference values for chair rising. We administered a battery of five tests concerning neuromuscular function, locomotion and balance to a sample of 212 participants without apparent locomotor deficits (139 women, 73 men, mean age 70,5 years, SD 6,78 , median 70 years, range 60 to 90 years, recruited by public announcements). The test battery comprised the 'chair rising test' for measuring lower extremity neuromuscular function (five repetitions of rising from a chair as quickly as possible with arms crossed over the chest). The test has been proven reliable, valid, sensible and predictive for falls and future locomotor status and ADL-status. Chair rising [sec/5x], Range: 5.4-19.4, Mean: 9.1 (women:9.2, men:9.0), SD: 1.97, Median: 8.9. Training of balance and muscle power with Galileo 2000 - preliminary results. Galileo is a device for whole body vibration/oscillatory muscle stimulation. The subject stands with bended knees and hips on a rocking platform with a sagittal axle, which thrusts alternatively the right and left leg 7-14 mm upwards with a frequency of 27 Hz, thereby lengthening the extensor muscles of the lower extremities. The reflexive reaction of the neuromuscular system is a chain of rapid muscle contractions. We conducted a randomized controlled trial, n=34 (age: mean 67y, range 61-85, 11 female), cross-over design, intervention group 2 months training program three times a week (each session 3x2 minutes), performance tests of all participants every two weeks). The first 19 subjects have finished the intervention period. They reached mean performance gains in chair rising of 18%, strikingly different to the constant values of the controls. We interpret the findings as improvements in muscle power by the oscillative muscle stimulation.

Runge M., Rehfeld G. & Resnicek E. (2000). Balannce training and exercise in geriatric patients. Journal of Musculoskeletal and Neuronal Interactions. 1(1). 61-65.

Effects of whole body vibration on postural steadiness in an older population.

Rees SS, Murphy AJ, Watsford ML.

Human Performance Laboratory, School of Leisure, Sport and Tourism, University of Technology, Sydney, Australia.

The aim of this study was to investigate the effects of vibration exercise on postural steadiness performance in a healthy, older population. Forty-three healthy, older participants (23 men and 20 women, aged 73.5+/-4.5yr) were randomly assigned to either a vibration group (VIB), an exercise without vibration group (EX) or a control group (CONT). The VIB and EX groups undertook static and dynamic bodyweight exercises three times per week for eight weeks. Static balance was assessed using a one-legged postural steadiness (OLPS) test. This test was performed prior to and immediately after the training period. OLPS improved significantly for the VIB intervention after eight weeks training (p<0.05) compared to the EX and CONT groups. The improvements in OLPS were significantly affected by the baseline values, with the largest changes evident for VIB participants with a poorer initial score (p<0.01). Vibration exercise can contribute to improved static one-legged balance in a healthy, older population. As improvements in OLPS were related to baseline values, vibration exercise as an intervention would appear to serve the most benefit for those that exhibit diminished postural control.

Rees S.S., Murphy A.J. & Watsford M.L. (2008). Effects of whole body vibration on postural steadiness in an older population. Journal of Science and Medicine in Sport. [Epub ahead of print].

Effect of four-month vertical whole body vibration on performance and balance.

Torvinen S, Kannus P, Sievanen H, Jarvinen TA, Pasanen M, Kontulainen S, Jarvinen M, Oja P, Vuori I.

Bone Research Group, UKK Institute, Kaupinpuistonkatu 1, FIN-33500 Tampere, Finland. [email protected]

PURPOSE: This randomized controlled study was designed to investigate the effects of a 4-month whole body vibration-intervention on muscle performance and body balance in young, healthy, nonathletic adults. METHODS: Fifty-six volunteers (21 men and 35 women, aged 19-38 yr) were randomized to either the vibration group or control group. The vibration-intervention consisted of a 4-month whole body vibration training (4 min.d(-1), 3-5 times a week) employed by standing on a vertically vibrating platform. Five performance tests (vertical jump, isometric extension strength of the lower extremities, grip strength, shuttle run, and postural sway on a stability platform) were performed initially and at 2 and 4 months. RESULTS: Four-month vibration intervention induced an 8.5% (95% CI, 3.7-13.5%, P=0.001) net improvement in the jump height. Lower-limb extension strength increased after the 2-month vibration-intervention resulting in a 3.7% (95% CI, 0.3-7.2%, P=0.034) net benefit for the vibration. This benefit, however, diminished by the end of the 4-month intervention. In the grip strength, shuttle run, or balance tests, the vibration-intervention showed no effect. CONCLUSION: The 4-month whole body vibration-intervention enhanced jumping power in young adults, suggesting neuromuscular adaptation to the vibration stimulus. On the other hand, the vibration-intervention showed no effect on dynamic or static balance of the subjects. Future studies should focus on comparing the performance-enhancing effects of a whole body vibration to those of conventional resistance training and, as a broader objective, on investigating the possible effects of vibration on structure and strength of bones, and perhaps, incidence of falls of elderly people.

Torvinen S., Kannus P., Sievanen H., Jarvinen T.A., Pasanen M., Kontulainen S., Jarvinen M., Oja P. & Vuori I. (2002). Effect of four-month vertical whole body vibration on performance and balance. Medicine and Science in Sports and Exercise. 34(9). 1523-1528.

Effects of random whole-body vibration on postural control in Parkinson's disease

Turbanski S, Haas CT, Schmidtbleicher D, Friedrich A, Duisberg P.

Institute of Sport Sciences, Johann Wolfgang Goetge-University, Frankfurt/Main, Germany

Parkinson's Disease Hospital, Bad Nauheim, Germany

We investigated spontaneous effects of random whole-body vibration (rWBV) on postural control in Parkinsonian subjects. Effects were examined in biomechanical tests from a total of 52 patients divided equally into one experimental and one control group. Postural control was tested pre- and post-treatment in two standardized conditions (narrow standing and tandem standing). The intervention was based on rWBV (y: 3 mm, f: 6 Hz 1 Hz/sec) consisting of 5 series lasting 60 seconds each. The main findings from this study were that (1) rWBV can improve postural stability in Parkinson's disease (PD) spontaneously (2) these effects depend on the test condition. Based on the results of this study, rWBV can be regarded as an additional device in physical therapy in PD.

Turbanski S., Haas C.T., Schmidtbleicher D., Friedrich A. & Duisberg P. (2005). Effects of random whole-body vibration on postural control in parkinson's disease. Research in Sports Medicine. 13(3). 243-256.

Long-term effects of 6-week whole-body vibration on balance recovery and activities of daily living in the postacute phase of stroke: a randomized, controlled trial.

Van Nes IJ, Latour H, Schils F, Meijer R, van Kuijk A, Geurts AC.

Sint Maartenskliniek Research, Development & Education, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands. [email protected]

BACKGROUND AND PURPOSE: The long-term effects of 6-weeks whole-body vibration, as a novel method of somatosensory stimulation, on postural control and activities of daily living were compared with those of 6 weeks of exercise therapy on music of the same intensity in the postacute phase of stroke. METHODS: Fifty-three patients with moderate to severe functional disabilities were randomized within 6 weeks poststroke and within 3 days after admission to a rehabilitation center to either whole-body vibration or exercise therapy on music in addition to a regular inpatient rehabilitation program. The whole-body vibration group received 4x45-second stimulation on the Galileo 900 (30-Hz frontal plane oscillations of 3-mm amplitude) for 5 days per week during 6 weeks. The exercise therapy on music group received the same amount of exercise therapy on music. Outcome variables included the Berg Balance Scale, Trunk Control Test, Rivermead Mobility Index, Barthel Index, Functional Ambulation Categories, Motricity Index, and somatosensory threshold at 0, 6, and 12 weeks follow up. RESULTS: At baseline, both groups were comparable in terms of prognostic factors and outcome measures. Both at 6 and 12 weeks follow up, no clinically relevant or statistical differences in outcome were observed between the groups. No side effects were reported. CONCLUSIONS: Daily sessions of whole-body vibration during 6 weeks are not more effective in terms of recovery of balance and activities of daily living than the same amount of exercise therapy on music in the postacute phase of stroke.

Van Nes I.J., Latour H., Schils F., Meijer R., van Kujik A. & Geurts A.C. (2006). Long-term effects of 6 week whole body vibration on balance recovery and activities of daily living in the postacute phase of stroke: a randomized, controlled trial. Stroke. 37(9). 2331-2335.

Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly.

Kawanabe K, Kawashima A, Sashimoto I, Takeda T, Sato Y, Iwamoto J.

Kawashima Orthopaedic Clinic, Chiba, Japan.

The present study was conducted to determine the beneficial effect of whole-body vibration (WBV) exercise in addition to muscle strengthening, balance, and walking exercises on the walking ability in the elderly. Sixty-seven elderly participants were divided into two groups; the WBV exercise plus routine exercises group (n=40) and the routine exercises alone group (n=27). WBV exercise was performed on a Galileo machine (Novotec, Pforzheim, Germany) at an intensity of 12-20 Hz, for a duration of 4 minutes, once every week. All the participants in both the groups were similarly instructed to undergo routine exercises such as balance and muscle strengthening training, and take walking exercise twice a week. The period of this study was 2 months to evaluate the acute effects of WBV exercise. The mean age of the participants was 72.0 years (range, 59-86 years). At baseline, there were significant negative correlations between age and the walking speed, step length, and maximum standing time on one leg. After the 2-month exercise program, the walking speed, step length, and the maximum standing time on one leg were significantly improved in the WBV exercise plus routine exercises group, while no significant changes in these parameters were observed in the routine exercises alone group. Thus, the present study showed the beneficial effect of WBV exercise in addition to muscle strengthening, balance, and walking exercises in improving the walking ability in the elderly. WBV exercise was safe and well tolerated in the elderly.

Kawanabe K., Kawashima A., Sashimoto I., Takeda T., Sato Y. & Iwamoto J. (2007). Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly. The Keio Journal of Medicine. 56(1). 28-33.

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