Acute effects of whole body vibration on balance in persons with and without chronic ankle instability

Influence of whole-body vibration and drop jump on the range of motion in the ankle joint and running parameters-A randomized crossover study

BACKGROUND AND PURPOSE

Warm-up (WU) is a commonly practiced technique aimed at preparing athletes for physical activity. Although coaches and athletes consider WU essential, there is still an ongoing debate about its effectiveness. This might be due to the fact that WU procedures often rely on experiences rather than scientific research. During WU, athletes may pursue intermediate goals such as ensuring proper ranges of motion in joints, which seem crucial particularly for runners' ankle joints. Hence, the aim of this study was to evaluate influence of whole-body vibration (WBV), drop jump (DJ), and a combination of both (WBV + DJ) in terms of ankle dorsiflexion and running parameters among recreational runners.

METHODS

Sixteen runners performed as a WU: five sets of 30 s calf raises without WBV (CTRL), five sets of 30 s calf raises during WBV, five sets of six DJ, five sets of 30 s calf raises during WBV followed by 6 DJ. Range of motion (ROM) of the ankle joint was measured in a prone position using an inclinometer for the soleus and gastrocnemius muscles, separately. Measurements were conducted before and after WU, and after a 3000 m run.

RESULTS

There was no interaction for time and WU for left (p = 0.926) and right (p = 0.738) soleus muscle as well as for left (p = 0.748) and right (p = 0.197) gastrocnemius muscles. No difference (p = 0.914) for the running time was found.

DISCUSSION

WBV, drop jumps, or a combination of both did not affect ankle dorsiflexion and running time.

Effect of whole-body vibration on postural stability in young adults with generalized joint hypermobility: A comparative study

BACKGROUND

Whole-body vibration (WBV) is being used in rehabilitation and sport. Studies confirm its positive impact on muscle strength and power or regulating muscle hypertension. However, there are some uncertainties regarding its influence on postural stability. This issue seems particularly interesting in the case of individuals with generalized joint hypermobility (GJH), for whom proprioceptive training and muscle strengthening exercises are recommended while techniques that decrease muscle tension are not advised.

OBJECTIVE

The aim of the study was to evaluate the acute effect of WBV on postural stability in adults with GJH.

METHODS

60 participants were categorized into the groups: 1) hypermobility with vibration (GJH+WBV), 2) hypermobility without vibration (GJH-WBV), 3) control group with vibration (CTRL+WBV), 4) control group without vibration (CTRL-WBV). The first and the third group completed WBV (frequency: 15 Hz and 30 Hz, amplitude 3 mm, 3 × 3 min). The second and fourth groups participated only in measurement sessions. GJH was assessed using the Beighton test. Postural stability was measured as the overall stability index (OSI) on the Biodex Balance System on the stable and unstable platform with open and closed eyes. Measurements were taken before and after WBV for two weeks.

RESULTS

At a frequency of 15 Hz, a significant time effect was observed for measurements Before and After in CTRL-WBV on the stable platform with open eyes (p= 0.012) and on the unstable platform with closed eyes (p= 0.000) for the GJH+WBV and CTRL+WBV groups. There were no significant interactions (p> 0.05) between factors. At a frequency of 30 Hz, there was a significant time effect Before and After (p= 0.047) on the stable platform with open eyes, but no interaction was found between factors (p= 0.835).

CONCLUSION

There is no positive acute effect of WBV on postural stability in adults with and without GJH.

Immediate effects of local muscle vibration on static and dynamic balance control in individuals with chronic ankle instability

OBJECTIVES

To investigate the immediate effects of local muscle vibration (LMV) on static and dynamic balance control in individuals with and without chronic ankle instability (CAI).

DESIGN

Quasi-experimental study.

SETTING

Research laboratory.

PARTICIPANTS

Twenty-six individuals with CAI and 26 healthy controls.

MAIN OUTCOME MEASURES

Center of pressure variables (mean total velocity and displacement in anteroposterior (AP) and mediolateral (ML) directions) during single-leg standing with eyes open and eyes closed and also reach distances in anterior (ANT), posteromedial (PM), and posterolateral (PL) directions of the modified star excursion balance test (MSEBT) were assessed before and after LMV.

RESULTS

Statistical analyses showed a significant decrease in mean total velocity and displacement in AP direction from before to after LMV in eyes open condition for both individuals with CAI (p = 0.025, p = 0.041, respectively) and healthy controls (p = 0.001, p = 0.003, respectively). Similar results were observed in eyes closed condition for both individuals with CAI (p < 0.001, p < 0.001, respectively) and healthy controls (p = 0.040, p = 0.014, respectively). The results also showed increased reach distances in ANT (p < 0.001), PM (p < 0.001), and PL directions (p < 0.001) in all participants after LMV.

CONCLUSION

Our results suggest that LMV may be a useful tool in rehabilitation of static and dynamic balance deficits in individuals with CAI.

Whole-Body Vibration Impacts on the Degree of Toe Angle and Its Correlation to the Knee Osteoarthritis Index during Level Walking among Female University Students: A Randomized Controlled Trial

Whole-body vibration (WBV) training is used for ankle rehabilitation as it stimulates muscle spindles to excite tonic vibration reflexes, and improves muscle strength, power, joint proprioception, balance, and flexibility. Thus, this study aims to determine the impact of whole-body vibration on the degree of the toe angle and the correlation between the toe angle and knee osteoarthritis index during level walking among female university students. A randomized controlled trial was conducted with 42 participants divided into two groups. The control group performed only home-based exercise (HBE) after education, and the study group received WBV with HBE. The functional status of participants to predict osteoarthritis was evaluated using the Western Ontario and McMaster osteoarthritis index (WOMAC), where the toe angle degree and WOMAC index were assessed before and six weeks after training. The results showed a significant improvement in the toe-in angle of HBE + WBV compared to the HBE group (p = 0.02), and in HBE + WBV, an improvement of the toe angle showed a 43% decrease in the WOMAC index (p = 0.001). In conclusion, WBV for the ankle and foot training program positively affected the degree of the toe angle, that directly affected the subtalar and ankle joint mechanics. Trial registration in the Pan African Clinical Trial Registry PACTR202304816093190 (registered retrospectively, date of registration: 18 April 2023).

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 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).

The Effects of Acute and Long-Term Whole-Body Vibration Training on the Postural Control During Cognitive Task in Patients With Chronic Ankle Instability

CONTEXT

Chronic ankle instability (CAI) is a common problem associated with impaired postural stability. Whole-body vibration (WBV) has been developed to improve muscle function and reportedly improves postural stability. The aim of this study was to evaluate the effect of 12 sessions of WBV on postural control during standing postural task in participants with CAI.

DESIGN

A controlled clinical trial study.

METHODS

Sixteen participants with CAI and 16 healthy participants aged between 20 and 40 years included in this study. They received WBV (30-Hz frequency, 3 series of four 45-s exercises with a 45-s rest) for a total of 12 sessions, 2 session per week for 6 weeks. Postural control was assessed by center of pressure (COP) parameters, including mean and SD in the anterior-posterior and medial-lateral displacement during single-leg standing. Assessments were done before and immediately after the first session and after the 12th session of WBV, with opened and closed eyes associated with easy and difficult cognitive tasks.

RESULTS

The results showed that the SD of COP displacement in the x-axis was significant in eyes opened and SD of COP displacement in the x- and y-axes were significant between groups in the eyes-opened, and eyes-closed conditions (P < .05). Analysis of variance indicated that the effect of WBV training was significant for the mean of COP displacement in the y-axis. Post hoc indicated that the effect of 12 sessions of WBV on the mean of COP displacement was significant in the CAI group (P < .05). However, the acute effect of WBV was not significant on the COP displacement in all axes (P > .05).

CONCLUSION

Higher postural sway associated with postural cognitive interactions might be considered in the rehabilitation of CAI. Twelve sessions of WBV might induce some improvement in postural control with the method of WBV used in this study.

The Effects of Whole Body Vibration on the Limits of Stability in Adults With Subacute Ankle Injury

BACKGROUND

Limited research exists on the effects of both high and low frequency whole body vibration (WBV) on individuals with subacute lateral ankle sprains.

HYPOTHESIS/PURPOSE

To examine the difference in the effects of high and low frequency WBV on limits of stability (LOS) in adults with a subacute ankle sprain. It was hypothesized that WBV would improve effects on outcome variables for LOS as a component of dynamic balance.

STUDY DESIGN

Quasi-experimental, pretest-posttest design.

METHODS

Fifteen participants ages 19-27 years (Mean age 22±2.36) with either a Grade I or Grade II lateral ankle sprain received WBV in bilateral stance under three randomized conditions (high frequency-25 Hz, low frequency-6 Hz, and control, which consisted of bilateral stance with machine off) for six minutes over three sessions (one time per week). The LOS test, consisting of 5 variables, were assessed using the NeuroCom® Balance Manager-SMART EquiTest® (Natus Medical Incorporated, Pleasanton, CA) at baseline and after the intervention period. The participants completed a practice LOS test and then had a six-minute standing rest break. After the rest break, they completed the pre-LOS (baseline) test. Intervention was administered using the Galileo® Med L Chip Research (Novotec Medical GmbH, Pforzheim, Germany) for six minutes for the appropriate condition of either high or low frequency WBV or control. Data analysis was performed using 2-Way (2x3) Repeated Measures ANOVAs with additional post hoc testing as needed.

RESULTS

Significant interactions were found for reaction time (RT), movement velocity (MVL), and maximal excursion (MXE) composite scores with a decrease in RT of 0.117 seconds (p=0.022) between control and high frequency conditions during the post LOS. For composite MVL, an increase of 0.547 degrees/second (p=0.002) between pre- and post-high frequency WBV occurred. For composite MXE, an increase of 2.13% p=0.031 (when comparing pre- and post-high frequency WBV.

CONCLUSION

Findings suggest that a single session of high frequency WBV in individuals with a subacute lateral ankle sprain may result in improvement in several components of postural stability. WBV is a quick intervention that could be implemented in physical therapy clinics, athletic training rooms, and workout facilities to improve an individual's LOS as a component of dynamic balance one to eight weeks post lateral ankle sprain.

LEVEL OF EVIDENCE

2b.

Effects of Whole-Body Vibration and Balance Training on Female Athletes with Chronic Ankle Instability

We explored the effects of 6-week whole-body vibration (WBV) and balance training programs on female athletes with chronic ankle instability (CAI). This randomized controlled study involved female athletes with dominant-leg CAI. The participants were randomly divided into three groups: WBV training (Group A), balance training (Group B), and nontraining (control group; Group C). Groups A and B performed three exercise movements (double-leg stance, one-legged stance, and tandem stance) in 6-week training programs by using a vibration platform and balance ball, respectively. The Star Excursion Balance Test (SEBT), a joint position sense test, and an isokinetic strength test were conducted. In total, 63 female athletes with dominant-leg CAI were divided into three study groups (all n = 21). All of them completed the study. We observed time-by-group interactions in the SEBT (p = 0.001) and isokinetic strength test at 30°/s of concentric contraction (CON) of ankle inversion (p = 0.04). Compared with the control group, participants of the two exercise training programs improved in dynamic balance, active repositioning, and 30°/s of CON and eccentric contraction of the ankle invertor in the SEBT, joint position sense test, and isokinetic strength test, respectively. Furthermore, the effect sizes for the assessed outcomes in Groups A and B ranged from very small to small. Female athletes who participated in 6-week training programs incorporating a vibration platform or balance ball exhibited very small or small effect sizes for CAI in the SEBT, joint position sense test, and isokinetic strength test. No differences were observed in the variables between the two exercise training programs.

Does verbal encouragement change dynamic balance? The effect of verbal encouragement on Star Excursion Balance Test performance in chronic ankle Instability

BACKGROUND

The Star Excursion Balance Test (SEBT) is commonly used for testing dynamic balance in chronic ankle instability (CAI) in both clinical and research settings. However, the effect of verbal encouragement (VE) on the SEBT performance is not known.

OBJECTIVE

To investigate the effects of VE on maximum reach distance performance between CAI and healthy participants on the SEBT.

METHOD

Thirty-four college-aged adults, 17 with CAI and 17 healthy controls, performed the SEBT in the anterior, posteromedial, and posterolateral reach directions. Independent variables (VE versus No-VE) and group (CAI versus healthy) were analyzed using Analysis of Variance (ANOVA) to determine whether VE and group affected reach performance.

RESULTS

There was a significant group-by-condition interaction (p = 0.02) for the anterior as well as for the posteromedial reach (p = 0.04). There was no statistically significant interaction (p = 0.48) for the posterolateral reach. There were moderate to large effect sizes in the reach distances found in the No-VE condition between the CAI and healthy controls, but with VE, the range of effect sizes from No-VE to VE were diminished.

CONCLUSION

There was a significant group by condition interaction for anterior and posteromedial reaches which shows that providing VE resulted in a greater increase in performance for participants with CAI compared to healthy controls. Psychological constraints need to be considered while performing and interpreting the results of the SEBT.

Bilateral spatiotemporal postural control impairments are present in participants with chronic ankle instability

OBJECTIVES

This study evaluated center-of-pressure (COP) and time-to-boundary (TTB) measures of postural control during a Lateral Step-Down Test in participants with chronic ankle instability (CAI).

DESIGN

Cohort study.

SETTING

Biomechanics laboratory.

PARTICIPANTS

Physically active adults with CAI (n = 15) and matched controls (n = 15).

MAIN OUTCOME MEASURES

Traditional COP and TTB measures of postural control were computed in the medial/lateral (ML) and anterior/posterior (AP) directions.

RESULTS

No significant results were found for the traditional COP measures (p > 0.05). The CAI group exhibited a lower TTB ML absolute minimum on their affected limb compared to the matched limb of the control group (p < 0.001). Additionally, on average the CAI group displayed significantly lower TTB ML mean of minima (p = 0.004) and TTB standard deviation of minima in the ML (p < 0.001) and AP directions (p = 0.002) regardless of limb.

CONCLUSIONS

Sensorimotor impairments associated with CAI negatively alter spatiotemporal postural control and may cause a maladaptive reorganization of centrally mediated motor control strategies that results in bilateral postural control deficits during the Lateral Step-Down Test. In addition, traditional COP measures did not reveal any postural control deficits suggesting that a spatiotemporal analysis should be used when assessing postural control in participants with CAI.

Effects of strength exercise on the knee and ankle proprioception of individuals with knee osteoarthritis

This study aims to investigate the effects of 8-week strength exercise on knee and ankle proprioception of individuals with knee osteoarthritis (KOA). Forty participants were randomly divided into control and strength exercise groups. Strength exercise group underwent squat training of three times a week for 8 weeks, while control group received an education programme. Threshold for detection of passive movement of knee and ankle joint was tested using an electrically driven movable frame. Between- and within-group differences were evaluated through repeated-measurement analysis of variance. After intervention, passive motion sense in knee flexion of participants in strength exercise group significantly improved (p = 0.033, 95% confidence interval of mean difference: 0.019-1.478) with significant difference between groups. No significant differences of passive motion senses were found in knee extension and ankle between strength exercise and control groups. Eight-week squat training significantly improves the motion sense of knee flexion in patients with KOA.