Whole-Body Vibration and Lower Limb Motor Output
| Author Year; Country Score Research Design Sample Size |
Methods | Outcomes |
| Bosveld et al. 2015; USA RCT PEDro=8 Level 1 N= 25 |
Population: 25 individuals; chronic SCI; age =49.7 ± 12.5 years; years post injury= >1y Treatment: Participants were randomized into two groups. Group 1 (n = 13) received whole-body vibration treatment (frequency: 50 Hz, amplitude: 2 mm) comprising of four 45-second bouts with 1-minute rest periods after each bout. Group 2 (n = 12) received sham electrical stimulation. Maximal voluntary isometric quadriceps force was measured with a fixed dynamometer. A modified Five-Time-Sit-To-Stand (FTSTS) test was used to assess functional lower extremity strength. Measures were made at pre-test, immediate post-test, and delayed post-test 20 minutes later. Outcome Measures: Maximal voluntary isometric quadriceps force, modified Five-Time-Sit-To-Stand (FTSTS) test. |
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Effect Sizes: Forest plot of standardized mean differences (SMD ± 95%C.I.) as calculated from pre- and post-intervention data |
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Alizadeh-Meghrazi et al. 2015; Canada |
Population: 10 males; 6 healthy, 4 with chronic SCI; 1 AIS A and 3 AIS C; age= 28.83 ± 7.78y; years post injury > 1y Treatment: Testing was performed on 2 days, where the participants were randomly allocated to exposure to either the WAVE® or Juvent™ platform each day. All participants were provided with the same shoes to eliminate footwear variability. In the case of the WAVE® platform, all combinations of the following parameters were used: (1) vibration frequencies of 25, 35, and 45 Hz; (2) two vibration amplitude settings and (3) knee angles of 140°, 160°, and 180°. In the case of the Juvent™ platform, all combinations of the following parameters were used: (1) vibration frequencies of 25, 35, and 45 Hz; (2) constant power setting of 28; and (3) knee angles of 140°, 160°, and 180°. Outcome Measures: EMG |
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Ness & Field-Fote 2009; USA |
Population: 3 women, 14 men; aged 28-65 years; all participants had a motor-incomplete SCI; C3-T8 lesion level; ≥1 year duration. Treatment: WBV 3 days/week for 4 weeks with four 45 second bouts of 50 Hz frequency and 2-4mm intensity each session, while standing on a vibration platform and 1 minute seated rest in between. Outcome Measures: 3-D motion capture system used to measure walking function (walking speed; step length; cadence (steps/min); hip-knee intralimb coordination). |
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Discussion
A recent report demonstrated the potential benefits of WBV administered for 3 minutes a day for 12 sessions over a 4-week period (Ness & Field-Fote 2009). Following this training period, the authors reported a mean improvement in walking speed of 0.062 m/s, which although statistically significant, was considered a small effect size. Training was also associated with an increase in cadence and hip-knee inter-joint coordination. Although whole-body vibration has been introduced for other neurological disorders such as Parkinson’s disease, this is the first report to demonstrate the potential benefits of whole-body vibration in the SCI population. Another study has since shown the potential benefits of WBV through improvements in muscle force output and sit-to-stand function (Bosveld & Field-Fote 2015).
Another study investigated the physiological effects of whole-body vibration in persons with SCI (Herrero et al. 2010), suggesting possible mechanisms of how WBV could be beneficial for lower limb function (not presented in table due to lack of functional or behavioural results). The authors showed that peak blood flow in the femoral artery increased with higher vibration frequencies (20 or 30 Hz), and that muscle activity increased regardless of frequency. This suggests that incorporating whole-body vibration into rehabilitation programs could benefit persons with SCI by promoting circulation in the legs and increasing muscle activation.
Conclusion
There is Level 1 evidence that WBV improves muscle force output and Sit to Stand test scores (Bosveld & Field-Fote 2015) though neither of these differences was significant.
