Impact of whole-body vibration training versus fitness training on muscle strength and muscle mass in older men: a 1-year randomized controlled trial

Safety and Effectiveness of Acceleration Training as Cardiac Rehabilitation Immediately After Open Heart Surgery - A Pilot Study

BACKGROUND

We examined the safety and efficacy of acceleration training (AT) in patients immediately after cardiac surgery.

METHODS AND RESULTS

This randomized controlled study included patients who underwent open-heart surgery using cardiopulmonary bypass. Of these patients, 31 received regular cardiac rehabilitation (CR) and 39 received AT in addition to regular CR (AT group). AT was provided using a vibration platform (Power Plate®Pro7TMand Power plate®personal; Performance Health System, Chicago, IL, USA). The AT group performed 5 static resistance training sessions: squats, wide stance squats, toe stands, banded squats, and front lunges. Each vibration session lasted 30 s. We evaluated the short physical performance battery, anterior mid-thigh thickness, maximum voluntary isometric contraction of the knee extensors, and serum intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) concentrations as indicators of endothelial function. The observation period was during hospitalization and lasted approximately 20 days. No adverse events occurred during AT. Ultrasound revealed a significantly lower reduction in muscle mass at discharge in the AT group. No significant differences were observed in ICAM-1 and VCAM-1 concentrations between the 2 groups preoperatively, postoperatively, or at discharge.

CONCLUSIONS

AT is considered safe and effective for patients immediately after open-heart surgery. AT, along with regular CR, may prevent skeletal muscle mass loss, muscle weakness, and physical function loss immediately after open-heart surgery.

Evidence of whole-body vibration exercises on body composition changes in older individuals: a systematic review and meta-analysis

Introduction: The aging process is associated with changes in body composition, including fat gain and skeletal muscle loss from middle age onward. Moreover, increased risk of functional decline and the development of chronic diseases are also related to aging. Objective: This systematic review and meta-analysis aimed to evaluate the effects of whole-body vibration exercise (WBVE), as a physical exercise, on body composition in people over 60 years of age. Methods: Searches were performed on PubMed, Scopus, Web of Science, and Embase. Only randomized clinical trials evaluating the effects of WBVE on body composition in older individuals were considered. The methodological quality of the studies involved was assessed using the Physiotherapy Evidence Database (PEDro) scale, recommendations from the Cochrane Collaboration were used to assess risk of bias, and quality of evidence was assessed using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) methodology. RevMan 5.4 was used to calculate standardized mean differences and confidence intervals of 95% (CIs). Results: Eight studies were included in this review with a mean methodological quality score of 7.5, which is considered high quality on the PEDro scale. The included studies suggest that more robust research with protocols and well-designed comparison groups is required to better assess changes in the body composition of older individuals through WBVE. Quantitative results were calculated, with differences in weighted means, differences in standardized means, and 95% confidence intervals (CIs). Conclusion: WBVE evaluated by the studies included in this review did not demonstrate improvements in body composition, and no significant effect of WBVE was found on fat mass with standardized differences (SD = -1.92; 95% CI: -4.81 to -0.98; p = 0.19), lean mass with standardized mean differences (SMD = 0.06 CI 95% [-0.21; -0.33]; p = 0.67), or skeletal muscle mass with standardized differences (SD = 0.10; CI 95% [-1.62; 1.83]; p = 0.91). Therefore, to date, there is lack of adequate evidence to state that WBVE can benefit the body composition of men and women over 60 years of age. However, further studies are required to better understand the physiological impacts of WBVE on body composition. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#myprosperoCRD42021248871, identifier CRD42021248871.

Effects of whole-body vibration training in static and dynamic semi-squat patterns on the lower limb muscle activity

The decline in physical function and the deterioration of the neuromusculoskeletal system in older people can easily lead to reduced muscle strength and slower mobility in the joints of the lower limbs, increasing the incidence of chronic diseases such as muscle wasting disorders, osteoporosis, debilitation and fall and fracture. It may also affect the quality of life and functional independence of older people, and in serious cases, even directly threaten their health. This study was conducted to determine the differences in lower limb muscle activation characteristics between static semi-squat (SSS) and dynamic semi-squat (DSS) training in middle-aged and old women at different frequencies and amplitudes and to explore a personalized whole-body vibration (WBV) training instruction program suitable for them. Fifteen healthy middle-aged and old women (60.8 ± 4.18 years old) were recruited for SSS and DSS WBV training. Their muscle activity of the rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF) and gastrocnemius (GS) were calculated using the BTS FreeEMG300 wireless surface electromyography (EMG), which participants were completed that the two different contraction patterns of squats on WBV training. The knee flexion was maintained at 45° while the subjects were performing the SSS training, while during the DSS training, the knee flexion fluctuates between 10° and 45°. The SSS exercise requires the subject to remain stationary in the squatting position and the DSS to be performed at a rhythm of 4 s/repetition, with 2 s of squatting, 1 s of standing up, and 1 s intervals. The vibration frequencies and amplitudes were changed to the WBV training intensity, and the vibration frequencies were set to 0 Hz, 30 Hz and 40 Hz, and the amplitudes were set to 0 mm, 2 mm and 4 mm. Each subject is randomised to participate in WBV training with 5 combinations of frequency and amplitude in both static and dynamic semi-squat patterns. These were 0 Hz 0 mm, 30 Hz 2 mm, 30 Hz 4 mm, 40 Hz 2 mm, 40 Hz 4 mm for the static and dynamic demi-squat patterns of WBV training. A two-way repeated measures ANOVA was applied to compare the changes in surface EMG of the lower limb muscles in different modes of SSS and DSS with WBV training. (1) Our results showed significantly interaction effects in the frequency × amplitude of root mean square (EMGrms) in GS (P < 0.05), while no significant differences were observed in the interaction effects of SSS/DSS patterns, frequencies and amplitude of RF, VM, VL and BF (P > 0.05). (2) Comparisons between groups showed that the EMGrms of the RF were significantly higher for the DSS than the SSS (P < 0.05). Additionally, the EMGrms of VL and BF at 30 Hz and 40 Hz were greater than 0 Hz (P < 0.05). Also, The EMGrms at 4 mm for the VM, VL and BF were significantly higher than 0 mm, the EMGrms at 4 mm for the VM and VL were significantly higher than 2 mm (P < 0.05), and the EMGrms at 2 mm of VL and BF were significantly higher than 0 mm (P < 0.05). (3) The results showed that WBV stimulation significantly increased the EMGrms of the GS in the SSS compared with the vibration free semi-squat alone (P < 0.05). However, there were no significant differences between WBV training protocols for SSS patterns with different frequencies and amplitudes (frequencies and amplitudes not were 0 Hz and 0 mm) (P > 0.05). Comparison of EMGrms for WBV training of the GS in DSS patterns showed that 40 Hz/4 mm was significantly higher than 0 Hz/0 mm (P < 0.05), but there was no significant difference between the remaining vibration conditions (P > 0.05). WBV training for DSS can significantly improve the activation of the RF compared to SSS pattern. Compared with no vibration, WBV could significantly improv the activity of the lower limb muscles. Additionally, an increase in amplitude from 2 to 4 mm could significantly improve VM and VL activation, while no significant improvement on lower limb muscle activation was observed for increasing vibration frequency from 30 to 40 Hz.

Impacts of Whole-Body Vibration on Muscle Strength, Power, and Endurance in Older Adults: A Systematic Review and Meta-Analysis

BACKGROUND

Randomized clinical trials (RCTs) were conducted to identify the effectiveness of whole-body vibration (WBV) on strength, power, and muscular endurance in older adults. However, the results of different studies are contradictory.

OBJECTIVE

To verify the impacts of the WBV on strength, power, and muscular endurance in older adults.

METHODS

The search was carried out in PubMed, Embase, CENTRAL, CINAHL, SPORTDiscus, Web of Science, LILACS and PEDro databases. Methodological quality was assessed using the PEdro scale. Meta-analysis calculations were performed using the standardized mean difference, comparing WBV with control groups and WBV with other types of exercise.

RESULTS

Thirty-four studies were included in the current systematic review. Most studies (56%) had low methodological quality (PEDro score < 6). WBV, compared with control groups, has significant effects on muscle strength of knee extensors and flexors, lower limb extensors, and ankle plantar flexors. There were no differences between WBV and other types of exercise. Subgroup analyzes demonstrated that, in general, the significant results observed in the primary analyzes were not dependent on body position during vibration, kind of vibration, cumulative dose or magnitude of WBV.

CONCLUSION

WBV was effective in increasing lower limb muscle strength. However, no significant results were observed for upper limb strength, lower limb power, and lower and upper limb muscle endurance in older adults. However, more studies are needed to better understand the physiological impacts of WBV in older.

Assessments of early patellofemoral joint osteoarthritis features after anterior cruciate ligament reconstruction: a cross-sectional study

BACKGROUND

Persistent anterior knee pain and subsequent patellofemoral joint (PFJ) osteoarthritis (OA) are common symptoms after anterior cruciate ligament reconstruction (ACLR). Quadriceps weakness and atrophy is also common after ACLR. This can be contributed by arthrogenic muscle inhibition and disuse, caused by joint swelling, pain, and inflammation after surgery. With quadriceps atrophy and weakness are associated with PFJ pain, this can cause further disuse exacerbating muscle atrophy. Herein, this study aims to identify early changes in musculoskeletal, functional and quality of health parameters for knee OA after 5 years of ACLR.

METHODS

Patients treated with arthroscopically assisted single-bundle ACLR using hamstrings graft for more than 5 years were identified and recruited from our clinic registry. Those with persistent anterior knee pain were invited back for our follow-up study. For all participants, basic clinical demography and standard knee X-ray were taken. Likewise, clinical history, symptomatology, and physical examination were performed to confirm isolated PFJ pain. Outcome measures including leg quadriceps quality using ultrasound, functional performance using pressure mat and pain using self-reported questionnaires (KOOS, Kujala and IKDC) were assessed. Interobserver reproducibility was assessed by two reviewers.

RESULTS

A total of 19 patients with unilateral injury who had undergone ACLR 5-years ago with persistent anterior knee pain participated in this present study. Toward the muscle quality, thinner vastus medialis and more stiffness in vastus lateralis were found in post-ACLR knees (p < 0.05). Functionally, patients with more anterior knee pain tended to shift more of their body weight towards the non-injured limb with increasing knee flexion. In accordance, rectus femoris muscle stiffness in the ACLR knee was significantly correlated with pain (p < 0.05).

CONCLUSION

In this study, it was found that patients having higher degree of anterior knee pain were associated with higher vastus medialis muscle stiffness and thinner vastus lateralis muscle thickness. Similarly, patients with more anterior knee pain tended to shift more of their body weight towards the non-injured limb leading to an abnormal PFJ loading. Taken together, this current study helped to indicate that persistent quadriceps muscle weakness is potential contributing factor to the early development of PFJ pain.

Effects of the Whole-Body Vibration Exercise on Sleep Disorders, Body Temperature, Body Composition, Tone, and Clinical Parameters in a Child with Down Syndrome Who Underwent Total Atrioventricular Septal Defect Surgery: A Case-Report

BACKGROUND

The health and developmental issues of people with Down syndrome (DS) are complex and are associated with many medical, psychological, and social problems from childhood through into adulthood. DS children have an increased risk of multiorgan comorbidities, including congenital heart disease. Atrioventricular septal defect (AVSD) is a congenital heart malformation that often occurs in DS people.

AIM

Physical activity and exercise are recommended for patients with cardiovascular disease and are considered to be the gold standard of cardiac rehabilitation. Whole-body vibration exercise (WBVE) is considered a form of exercises. The aim of this case report is to show the effects of WBVE on sleep disturbances, body temperature, body composition, tone, and clinical parameters in a child with DS with corrected total AVSD. The subject is a 10-year-old girl, with free-type DS, who underwent surgery to correct a total AVSD at 6 months. She underwent periodic cardiological monitoring and was released to perform any type of physical exercise, including WBVE. WBVE improved sleep quality and body composition.

CONCLUSION

WBVE leads to physiological effects that benefit the DS child.

Effects of whole-body vibration training with different frequencies on the balance ability of the older adults: a network meta-analysis

Purpose: To compare the effects of whole-body vibration training (WBVT) with different frequencies on the balance ability of older adults. Methods: Randomized controlled trials (RCTs) on the WBVT interventions on balance ability in older adults were searched through PubMed, Web of Science, The Cochrane Library, ProQuest, Embase, Opengrey, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (CSTJ) databases from the establishment of the database to August 2022, and all literature that met the PICOS (Participants, Intervention, Comparison, Outcomes, Study design) criteria were enrolled. Two reviewers screened and assessed the methodological quality of the included literature according to the physiotherapy evidence database (PEDro) scale criteria. Statistical analysis was performed using Stata 14.0 software after data extraction. Results: Twenty-five RCTs with a total of 1267 subjects were finally included. The results of the pairwise comparison of the Network Meta-analysis showed that the Timed Up and Go Test (TUGT) values of Low-frequency whole-body vibration training (LF-WBVT) was lower than the placebo and traditional rehabilitation groups, and the difference was statistically significant [WMD = -1.37, 95% CI (-2.53, -0.20)] [WMD = -1.84, 95% CI(-3.17,-0.51)]. The Five-repetition Sit-to-Stand Test (5STS) values of LF-WBVT, Medium-frequency whole-body vibration training (MF-WBVT), and High-frequency whole-body vibration training (HF-WBVT) were lower than the placebo and traditional rehabilitation groups, but none of them were statistically significant. In addition, the TUGT and 5STS values of HF-WBVT had a tendency to be lower than those of LF-WBVT and MF-WBVT, but neither of them was statistically different. The cumulative probability ranking results of both TUGT and 5STS showed that HF-WBVT was the best protocol. Conclusion: Current evidence shows that HF-WBVT may be the best protocol for improving balance in older adults. Due to the study's limitations, the conclusion obtained in this study still needs to be further confirmed by more high-quality studies. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42021250405].

Analysis of Vibration Frequency and Direction for Facilitating Upper-Limb Muscle Activity

We aimed to determine the effect of vibration frequency and direction on upper-limb muscle activation using a handheld vibrator. We recruited 19 healthy participants who were instructed to hold a handheld vibrator in their dominant hand and maintain the elbow at 90° flexion, while vertical and horizontal vibrations were applied with frequencies of 15, 30, 45, and 60 Hz for 60 s each. Surface electromyography (EMG) measured the activities of the flexor digitorum superficialis (FDS), flexor carpi radialis (FCR), extensor carpi ulnaris (ECU), extensor carpi radialis (ECR), biceps, triceps, and deltoid anterior muscles. EMG changes were evaluated as the difference in muscle activity between vibration and no-vibration (0 Hz) conditions. Muscle activity was induced under vibration conditions in both vertical and horizontal (p < 0.05) directions. At 45 Hz, FDS and FCR activities increased during horizontal vibrations, compared with those during vertical vibrations. ECU activity significantly increased under 15-Hz vertical vibrations compared with that during horizontal vibrations. Vibrations from the handheld vibrator significantly induced upper-limb muscle activity. The maximum muscle activations for FDS, ECR, ECU, biceps, and triceps were induced by 45-Hz horizontal vibration. The 60-Hz vertical and 30-Hz horizontal vibrations facilitated maximum muscle activations for the FCR and deltoid anterior, respectively.

Impact of Two Whole-Body Vibration Exercise Protocols on Body Composition of Patients with Metabolic Syndrome: A Randomized Controlled Trial

(1) Background: This study investigated the effects of two 6-week whole-body vibration exercise (WBVE) protocols on body composition in patients with metabolic syndrome (MSy). Thirty-three patients were allocated to either the Fixed Frequency WBVE Group (FFG-WBVE) or the Variable Frequency WBVE Group (VFG-WBVE). (2) Methods: A side-alternating vibration platform was used and the patients remained in the semi-squat position on this platform. In the FFG-WBVE (n = 12; median age = 50.50 years) and (body mass index BMI = 31.95 kg/m²), patients were exposed to 10 s of mechanical vibration at a fixed frequency of 5 Hz, followed by 50 s without vibration. In the VFG-WBVE (n = 10; median age = 57.50 years) and (BMI = 32.50 kg/m²), the patients performed 60 s of mechanical vibration at different frequencies from 5 to 16 Hz). Body composition evaluated through (bioelectrical impedance analysis and anthropometric measurements) were was evaluated before and after the all the interventions in each group. (3) Results: The VFG-WBVE decreased waist circumference, p = 0.01 and segmental fat mass [left arm, p = 0.01; right arm, p = 0.02 and trunk, p = 0.03]. Bone content increased, p = 0.01. No significant changes were observed in the FFG- WBVE. (4) Conclusions: In conclusion, this study demonstrated that 6 weeks of WBVE with a protocol with variable frequency can positively modify the body composition of MSY patients. These findings might contribute to improvements in the metabolic health of these patients.

Validation of Vibration Exercises on Enhancing Muscle Strength and Upper Limb Functionality among Pre-Frail Community-Dwelling Older Adults

Pre-frail older adults require appropriate exercise to enhance muscle strength as well as upper limb functionality. We developed a handheld vibrator and evaluated its effectiveness in enhancing muscle strength compared to conventional exercises among pre-frail community-dwelling older adults. Thirty-one pre-frail older adults (aged 75.5 ± 5.1 years) were recruited and randomly allocated to a vibration group (VG) and control group (CG). The VG underwent 20 minutes of vibration (frequency: 30 Hz, amplitude: 5 mm, horizontal vibration) using a handheld vibrator as well as 40 minutes of conventional exercise. The CG received 60 minutes of conventional exercise only. The primary outcome was muscle strength assessment (kg), and the secondary outcome included activities of daily living and instrumental activities of daily living scores. The comparisons between the outcome measures revealed no significant differences at the baseline level. Muscle strength of the dominant (ß = 2.49, p = 0.002) and non-dominant (ß = 1.89, p = 0.02) wrist flexion, brachioradialis (ß = 3.8, p = 0.01), and biceps brachii (ß = 3.02, p = 0.02) in the dominant upper limbs was significantly increased among the VG. The vibration intervention can enhance muscle strength in the upper limbs among pre-frail older adults.

Sarcopenia in urologic oncology: Identification and strategies to improve patient outcomes

Sarcopenia is the loss of muscle mass and function related to aging, undereating, disease conditions, or inactivity. Pre-existing sarcopenia diminishes the functional reserve of patients with cancer which increases their risk for frailty, cancer cachexia, and worse outcomes from treatments. The pathogenesis of sarcopenia is multi-factorial: opening opportunities for clinicians to work across disciplines to improve patient outcomes and quality of life. The purpose of this essay is to describe sarcopenia, discuss clinical screening and assessment for sarcopenia, and highlight potential interventions to manage sarcopenia in the urologic oncology population.

The top 100 most-cited articles on exercise therapy for sarcopenia: A bibliometric analysis

Objective

Vast quantities of literature regarding the applications of exercise therapy for sarcopenia have been published. The main objective of this study is to determine the top 100 most-cited articles and analyze their bibliometric characteristics.

Design

This study reports a bibliometric analysis via a systematic search of the academic literature regarding the applications of exercise therapy for sarcopenia.

Methods

All databases in the Web of Science were searched with the following strategy: term search (TS) = (exercise^* OR training OR “physical activit^*”) AND TS = (sarcopenia) on 25 February 2022. The results were presented in descending order by their total citations. The list of the top 100 articles was finally determined by negotiation of two independent researchers.

Results

The top 100 articles were published between 1993 and 2020. More than half of the articles (n = 54) were published during the decade 2006–2015. Total citations of the top 100 articles ranged from 155 to 1,131 with a median of 211.5. The average of annual citations was constantly increasing with year (P < 0.05). The most studied exercise therapy is strength/resistance training, with about 71% articles had discussed about it. The top 100 articles were from 54 different journals, and the Journal of Applied Physiology was the journal that contributed the most articles (n = 8). A total of 75 different first corresponding authors from 15 countries made contributions to the top 100 list. Luc J.C. van Loon from the Maastricht University in the Netherlands published the most articles (n = 5) as the first corresponding author. Most articles (87%) were from North America (58%) and Europe (29%), while the United States as a country contributed over half of the articles (51%).

Conclusion

Our study determined the top 100 most-cited articles on exercise therapy for sarcopenia and analyzed their bibliometric characteristics, which may provide a recommended list for researchers in this field and pave the way for further research.

Effects of Whole-Body Vibration Training with Different Body Positions and Amplitudes on Lower Limb Muscle Activity in Middle-Aged and Older Women

Purpose

The present study was designed to investigate the electromyographic (EMG) response in leg muscles to whole-body vibration while using different body positions and vibration amplitudes.

Methods:

An experimental study with repeated measures design involved a group of community-dwelling middle-aged and older women (n = 15; mean age=60.8 ± 4.18 years). Muscle activity of the gluteus maximus (GM), rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and gastrocnemius (GS) was measured by surface electromyography, which participants were performing three different body positions during three WBV amplitudes. The body positions included static semi-squat, static semi-squat with elastic band loading, and dynamic semi-squat. Vibration stimuli tested were 0 mm, 2 mm, and 4 mm amplitude and 30 Hz frequencies. And the maximum accelerations produced by vibration stimuli with amplitudes of 2 mm and 4 mm are approximately 1.83 g and 3.17 g.

Results:

Significantly greater muscle activity was recorded in VL, BF, and GS. When WBV was applied to training, compared with the same training without WBV (P < .05). There were significant main effects of body positions on EMGrms for the GM, RF, and VM (P < .05). Compared to static semi-squat, static semi-squat with elastic band significantly increased the EMGrms of GM, and dynamic semi-squat significantly increased the EMGrms of GM, RF and VM (P < .05). And there were significant main effects of amplitudes on EMGrms for the GM, RF, and VM (P < .05). The EMGrms of the VL, BF, and GS at 4 mm were significantly higher than 0 mm, and the EMGrms of the VL and BF at 4 mm were significantly higher than 2 mm. There was no significant body interaction between body positions and amplitudes (P > .05).

Conclusions:

The EMG amplitudes of most leg muscles tested were significantly greater during WBV exposure than in the no-WBV condition. The dynamic semi-squat 4 mm whole-body vibration training is recommended for middle-aged and older women to improve lower limb muscle strength and function.

Persistent quadriceps muscle atrophy after anterior cruciate ligament reconstruction is associated with alterations in exercise-induced myokine production

Purpose

Persistent quadriceps muscle atrophy is observed in a subset of patients following anterior cruciate ligament reconstruction (ACLR) despite the completion of comprehensive rehabilitation. Critically, quadriceps muscle atrophy correlates with muscle weakness and quadriceps strength deficits. The aim of this study was to examine the effect of resistance exercise on myokine levels and muscle atrophy status in ACLR patients with persistent quadriceps muscle atrophy.

Methods

Sixteen participants between the ages of 18–39 with a Tegner score of >6 and who had undergone ACLR with hamstring graft were recruited for the study. Quadriceps muscle thicknesses were ascertained by ultrasonography and isokinetic strength assessments were made prior to commencing a single bout of resistance exercise training (RET). Blood samples were taken before and after RET and assayed for myokine expression. Self-reported activity level and knee function questionnaires were completed and recorded.

Results

Clustering by quadriceps muscle size measurements created a non-atrophy group of 9 subjects and an atrophy group of 7 subjects. There were no significant between-group differences in anthropometric measurements, time post operation and knee function questionnaires, but the atrophic group comprised of patients with lower pre-injury sporting levels. The atrophy group exhibited significant lower side-to-side muscle thickness ratios and a decreasing trend in quadriceps strength deficits. Serum brain-derived neurotrophic factor (BDNF) was up-regulated in response to RET in non-atrophy group, but a negative fold change was detected in the atrophy group.

Conclusion

The dysregulation in myokines plays an important role in patients failing to regain muscle mass after ACLR leading to persistent quadriceps muscle atrophy, which may potentiate greater strength deficits and poor functional recovery.

The effect of whole-body vibration in osteopenic patients after total knee arthroplasty: a randomized controlled trial

BACKGROUND

Total knee arthroplasty (TKA) is an important treatment for knee osteoarthritis, but the result of whole-body vibration (WBV) in knee function rehabilitation and bone loss with osteopenia was unknown. Therefore, the purpose of this study is to study whether low-frequency, low-amplitude WBV can improve the clinical outcome of knee osteoarthritis.

METHODS

This study was randomized and included 67 osteopenic patients (55-90 years, 85% women) for TKA surgery (control group N = 32, WBV group N = 35). All selected patients after TKA surgery tested clinical results, such as knee function and bone mass in baseline, 3 months after surgery, and 6 months after surgery.

RESULTS

Compared to the control group, the WBV group improved pain scores, thigh circumference, lower limb muscle strength, joint activity, and joint function in 6 months after surgery. WBV intervention also improves bone density in the spine, the microstructure of the radius and tibia, and the bone turnover marker. At 3 months after TKA surgery, the WBV group had no significant effect on knee function and bone loss.

CONCLUSIONS

Whole-body vibration for osteopenic patients with knee arthroplasty showed good therapeutic results in 6 months after TKA surgery, but the long-term therapeutic effect still needs to be further observed.

Hidden Agenda - The Involvement of Endoplasmic Reticulum Stress and Unfolded Protein Response in Inflammation-Induced Muscle Wasting

Critically ill patients at the intensive care unit (ICU) often develop a generalized weakness, called ICU-acquired weakness (ICUAW). A major contributor to ICUAW is muscle atrophy, a loss of skeletal muscle mass and function. Skeletal muscle assures almost all of the vital functions of our body. It adapts rapidly in response to physiological as well as pathological stress, such as inactivity, immobilization, and inflammation. In response to a reduced workload or inflammation muscle atrophy develops. Recent work suggests that adaptive or maladaptive processes in the endoplasmic reticulum (ER), also known as sarcoplasmic reticulum, contributes to this process. In muscle cells, the ER is a highly specialized cellular organelle that assures calcium homeostasis and therefore muscle contraction. The ER also assures correct folding of proteins that are secreted or localized to the cell membrane. Protein folding is a highly error prone process and accumulation of misfolded or unfolded proteins can cause ER stress, which is counteracted by the activation of a signaling network known as the unfolded protein response (UPR). Three ER membrane residing molecules, protein kinase R-like endoplasmic reticulum kinase (PERK), inositol requiring protein 1a (IRE1a), and activating transcription factor 6 (ATF6) initiate the UPR. The UPR aims to restore ER homeostasis by reducing overall protein synthesis and increasing gene expression of various ER chaperone proteins. If ER stress persists or cannot be resolved cell death pathways are activated. Although, ER stress-induced UPR pathways are known to be important for regulation of skeletal muscle mass and function as well as for inflammation and immune response its function in ICUAW is still elusive. Given recent advances in the development of ER stress modifying molecules for neurodegenerative diseases and cancer, it is important to know whether or not therapeutic interventions in ER stress pathways have favorable effects and these compounds can be used to prevent or treat ICUAW. In this review, we focus on the role of ER stress-induced UPR in skeletal muscle during critical illness and in response to predisposing risk factors such as immobilization, starvation and inflammation as well as ICUAW treatment to foster research for this devastating clinical problem.

The Use of Vibration Training in Men after Myocardial Infarction

The aim of the study was to evaluate the effects of the applied whole-body vibration training (WBV) as additional training to standard rehabilitation programme on exercise tolerance, evaluated through an exercise test, blood lipid profile, and the changes in selected echocardiographic parameters of patients after myocardial infarction. The study involved 63 males. The subjects were divided into two groups: standard—ST (27) and with vibration training—ST + WBV (36). All the subjects had undergone angioplasty with stent implantation. The standard and with vibration training group carried out a 24-day improvement program comprising 22 training units. Each session consisted of endurance, general stamina, and resistance training. Instead of resistance training, the experimental group performed exercises on the vibration platform. Statistically significant changes in both groups were observed in the parameters of the echocardiographic exercise test, such as test duration (p < 0.001), distance covered (p < 0.001), MET (p < 0.001), VO2max (p < 0.001), and HRrest (p < 0.01). The echocardiographic test revealed significant improvement of Left Ventricular Ejection Fraction in both groups (ST + WBV group p = 0.024, ST group p = 0.005). There were no statistically significant changes in blood lipid profile and body mass and composition.

Acute effects of whole body vibration exercise on post-load glucose metabolism in healthy men: a pilot randomized crossover trial

PURPOSE

Exercise on a whole body vibration (WBV) platform, namely WBV exercise (WBVE), has long-term beneficial effects on glucose metabolism, similarly to conventional moderate-intensity exercise. Conventional moderate-intensity exercise reduces post-load plasma glucose levels at the acute phase. This study aimed to reveal acute effects of WBVE on post-load glucose metabolism.

METHODS

This randomized crossover trial enrolled 18 healthy men. They completed the following three interventions in a random order: (1) a 2-hour 75-g oral glucose tolerance test (OGTT) without WBVE (OGTT-alone), (2) 20-minute WBVE before an OGTT (WBVE → OGTT), and (3) 20-minute WBVE during an OGTT (OGTT → WBVE). Post-load glucose metabolism in the WBVE → OGTT and OGTT → WBVE interventions were compared with that in the OGTT-alone intervention.

RESULTS

Plasma glucose levels in the WBVE → OGTT and OGTT → WBVE interventions were not significantly different from those in the OGTT-alone intervention at any time point except 15 min, wherein the WBVE → OGTT intervention had higher glucose levels (111 [interquartile range, 102-122] mg/dL vs 122 [111-134] mg/dL, P = 0.026). Higher plasma glucagon levels were observed at 0 min in the WBVE → OGTT intervention and at 60 min in the OGTT → WBVE intervention (P = 0.010 and 0.015). Cortisol, Growth hormone, and adrenaline levels were significantly increased after WBVE, whereas noradrenaline levels were not. Serum insulin levels in the WBVE → OGTT intervention were significantly higher than those in the OGTT-alone intervention at 0 min (P = 0.008).

CONCLUSIONS

WBVE did not decrease post-load plasma glucose levels at the acute phase. Acute effects of WBVE on post-load glucose metabolism would not be identical to those of conventional exercise. The unique trial number and the name of the registry: UMIN000036520, www.umin.ac.jp , date of registration, June 12, 2019.

An overview of the effects of whole-body vibration on individuals with cerebral palsy

The purpose of this review is to examine how whole-body vibration can be used as a tool in therapy to help improve common physical weaknesses in balance, bone density, gait, spasticity, and strength experienced by individuals with cerebral palsy. Cerebral palsy is the most common movement disorder in children, and whole-body vibration is quickly becoming a potential therapeutic tool with some advantages compared to traditional therapies for individuals with movement disorders. The advantages of whole-body vibration include less strain and risk of injury, more passive training activity, and reduced time to complete an effective therapeutic session, all of which are appealing for populations with physiological impairments that cause physical weakness, including individuals with cerebral palsy. This review involves a brief overview of cerebral palsy, whole-body vibration's influence on physical performance measures, its influence on physical performance in individuals with cerebral palsy, and then discusses the future directions of whole-body vibration therapy in the cerebral palsy population.

Efficacy of Whole-Body Vibration Training on Brain-Derived Neurotrophic Factor, Clinical and Functional Outcomes, and Quality of Life in Women with Fibromyalgia Syndrome: A Randomized Controlled Trial

This study aimed to investigate the efficacy of whole-body vibration training (WBVT) on blood brain-derived neurotrophic factor (BDNF) levels and determine the clinical and functional outcomes in patients with fibromyalgia syndrome (FMS). Thirty-two women with FMS were randomized into an intervention group (IG), receiving 6 weeks of WBVT, or a control group (CG) with no intervention. The outcomes at the baseline and follow-up in both groups included blood BDNF levels, sit-to-stand test (STS), 6-minute walk test (6MWT), Fibromyalgia Impact Questionnaire (FIQ), Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), and visual analogue scale (VAS). WBVT resulted in a group-by-time interaction effect. Thus, after the intervention time, the IG had increased blood BDNF levels (p=0.045), a higher number of repetitions on the STS test (p=0.011), and increased walking distance on the 6MWT (p=0.010), compared to CG. Moreover, there was a reduction in the scores of the FIQ (p=0.001), the PSQI (p=0.001), the BDI (p=0.017), and pain assessed using VAS (p=0.008) in IG. The results demonstrate that WBVT promotes an increase in blood BDNF levels, with concomitant improvement in lower limb muscle strength, aerobic capacity, clinical symptoms, and quality of life in women with FMS. This trial is registered with Brazilian Clinical Trials Registry (REBEC; RBR-38nbbx) (https://ensaiosclinicos.gov.br/rg/RBR-38nbbx).

Ia EPSPs in rat spinal motoneurons are potentiated after a 5-week whole-body vibration

Whole-body vibration (WBV) is often applied as an alternative method for strength training or to prevent muscle force decrease. Previous studies indicated that WBV induced: 1) changes in the contractile parameters predominantly of fast motor units, 2) higher motoneuron excitability, and 3) higher motoneuron firing rates at lower stimulus intensities compared with the control. In this study, we evaluated the influence of WBV on Ia monosynaptic input from muscle spindles because the tonic vibration reflex is responsible for the enhancement of muscle activity observed after WBV. The aim was to answer the question of whether repeated activation of muscle spindles during WBV may result in altered synaptic excitation of motoneurons. WBV was performed on adult male Wistar rats, 5 days per week, for 5 weeks, and each daily session consisted of four 30-s runs of vibration at 50 Hz. Fast-type medial gastrocnemius motoneurons were investigated intracellularly in deeply anesthetized animals in the experimental (n=7, 34 motoneurons) and control (n=7, 32 motoneurons) groups. Monosynaptic Ia EPSPs were evoked by electrical stimulation of afferent fibers from the synergistic lateral gastrocnemius and soleus muscles. Data were analyzed using a mixed linear model. WBV induced an increase of the mean EPSP amplitude by 28% (P=0.025), correlated with the resting membrane potential and input resistance, and a shortening of the mean EPSP rise time by 11% (P=0.012). The potentiation of synaptic excitation of motoneurons indicates that WBV may support rehabilitation or training processes aimed at increasing muscle strength on the basis of increased motoneuronal drive.

Effects of combined whole body vibration and resistance training on lower quadrants electromyographic activity, muscle strength and power in athletes

BACKGROUND

Whole body vibration (WBV) with resistance training is one of the increasing ways of gaining ankle and foot complex muscle strength and power for the rehabilitative and prophylactic purpose in athletes.

OBJECTIVE

The purpose of the study was to compare the effects of combined WBV and resistance training (RVE) with strength training alone (RE) on alteration of gastrocnemius lateralis and vastus medialis obliquus muscle activity and strength, and power performance in athletes.

METHODS

The study was performed on 23 university-level male athletes who were randomized into two groups as RVE (n = 12; age 22.2 ± 1.94 years) and RE (n = 11; age 21.60 ± 1.78 years). The training program was scheduled three times per week for six weeks (18 sessions). Gastrocnemius lateralis (GL) and vastus medialis obliquus (VMO) were measured for muscle activity and isometric strength with surface EMG device and handheld dynamometer respectively. Counter-movement jump (CMJ) was used for measuring power. All the participants were assessed for outcome measures at baseline and then after 6 weeks. Group (RVE vs. RE) by time (pre vs. post) effects were compared through a 2-way interaction utilizing mixed model repeated measure ANOVA.

RESULTS

After training, VMO muscle activity (group effects) increased significantly in the RVE group (p < 0.05). However, both the groups showed statistically significant time and group × time interaction effects for muscle activity of VMO, isometric strength (VMO and GL), and CMJ (p < 0.05).

CONCLUSION

WBV might serve as an adjunct modality for enhancement of the neuromuscular activity of the VMO muscle. However, RVE had no additive effect when compared to RE alone on muscle strength and power in athletes. The long-term impacts of combined WBV and resistance training on other foot and ankles muscle should be investigated in future studies.

Threshold of Relative Muscle Power Required to Rise from a Chair and Mobility Limitations and Disability in Older Adults

PURPOSE

Being able to rise from a chair is paramount for independent living and is strongly influenced by the ability of the lower limbs to exert mechanical power. This study assessed minimal thresholds of lower-limb relative muscle power required to perform the sit-to-stand (STS) task in older adults and its association with mobility limitations and disability.

METHODS

A total of 11,583 older adults (age, 60-103 yr) participated in this investigation. The 5-rep and 30-s versions of the STS test were used to assess chair rising ability. Relative power was calculated by the STS muscle power test. The minimum thresholds of power required to perform the STS tests were derived from the minimum values (i.e., "floor" effect) reported in the power tests through regression analyses. Mobility limitations and disability in activities of daily living (ADL) were recorded.

RESULTS

For the average older man and woman, the thresholds to complete five STS repetitions were 1.1 and 1.0 W·kg-1, respectively, whereas the thresholds to complete one STS repetition were 0.3 W·kg-1 in both sexes. These thresholds increased linearly with height (5- and 1-rep, respectively: +0.13 and +0.03 W·kg-1 per 10-cm increase; both P < 0.001) and did not differ by sex or testing condition (both P ≥ 0.259). All participants with relative power below the 5-rep threshold presented mobility limitations, and 51%-56% of women and 36%-49% of men also showed disability in ADL (all χ2 ≥ 290.4; P < 0.001).

CONCLUSION

A minimum level of relative muscle power is required to rise from a chair independently, which depends on the individual height and is associated with increased mobility limitations and disability. This information will help interpret data yielded by the STS muscle power test and may contribute to the prevention and treatment of mobility limitations in older people.

Psychological Effects of Whole-Body Vibration Training in Frail Older Adults: An Open, Randomized Control Trial

The aim of this study was to identify the psychological effects of whole-body vibration (WBV) exercise in frail older adults. About 117 male and female volunteers (82.5 ± 7.9 years) from residential care facilities were randomized and assigned to control, simulated exercise (SIM), or WBV exercise (WBV) groups. All received regular care, while exercise groups also underwent 16 weeks of training (3 × 20 min/week). WBV exercise began with 5 × 1 min bouts (6 Hz/2 mm, 1:1 min exercise:rest), self-progressing to 10 × 1 min (up to 26 Hz/4 mm), and maintaining knee flexion. SIM training mimicked exercise stance and duration. Pre- and post-measures of falls-confidence, quality of life, and functional independence were completed using validated questionnaires. Functional independence and falls-confidence scores increased by 5.8% and 17.4% respectively with WBV exercise, compared with declines in SIM (p = .074/p = .035, respectively) and control (p = .000/p = .000, respectively) participants. Beneficial effects remained for at least 6-month post-intervention. Further WBV benefits were observed in activity, mobility, and self-care elements of quality of life. Sixteen weeks of low-level WBV exercise is sufficient to enhance frail older adults' falls-related confidence, quality of life, and functional independence.

Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort

BACKGROUND

A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit-to-stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut-off points, and minimal clinically important differences (MCID) for STS power measures in older women and men.

METHODS

A total of 9320 older adults (6161 women and 3159 men) aged 60-103 years and 586 young and middle-aged adults (318 women and 268 men) aged 20-60 years were included in this cross-sectional study. Relative (normalized to body mass), allometric (normalized to height squared), and specific (normalized to legs muscle mass) muscle power values were assessed by the 30 s STS power test. Body composition was evaluated by dual energy X-ray absorptiometry and bioelectrical impedance analysis, and legs skeletal muscle index (SMI; normalized to height squared) was calculated. Habitual and maximal gait speed, timed up-and-go test, and 6 min walking distance were collected as physical performance measures, and participants were classified into two groups: well-functioning and mobility-limited older adults.

RESULTS

Relative STS power was found to decrease between 30-50 years (-0.05 W·kg-1 ·year-1 ; P > 0.05), 50-80 years (-0.10 to -0.13 W·kg-1 ·year-1 ; P < 0.001), and above 80 years (-0.07 to -0.08 W·kg-1 ·year-1 ; P < 0.001). A total of 1129 older women (18%) and 510 older men (16%) presented mobility limitations. Mobility-limited older adults were older and exhibited lower relative, allometric, and specific power; higher body mass index (BMI) and legs SMI (both only in women); and lower legs SMI (only in men) than their well-functioning counterparts (all P < 0.05). Normative data and cut-off points for relative, allometric, and specific STS power and for BMI and legs SMI were reported. Low relative STS power occurred below 2.1 W·kg-1 in women (area under the curve, AUC, [95% confidence interval, CI] = 0.85 [0.84-0.87]) and below 2.6 W·kg-1 in men (AUC [95% CI] = 0.89 [0.87-0.91]). The age-adjusted odds ratios [95% CI] for mobility limitations in older women and men with low relative STS power were 10.6 [9.0-12.6] and 14.1 [10.9-18.2], respectively. MCID values for relative STS power were 0.33 W·kg-1 in women and 0.42 W·kg-1 in men.

CONCLUSIONS

Relative STS power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations. Our study provides normative data, functionally relevant cut-off points, and MCID values for STS power for their use in daily clinical practice.

Effects of physical exercise in sarcopenia. A systematic review

From the third decade of life and due to multiple causes, muscle mass and strength are gradually lost, which affects the function of the musculoskeletal system. This combined loss of muscle mass and strength with aging is called sarcopenia, and is associated with greater morbidity and mortality in the elderly. Early treatment is therefore essential, and physical exercise is the therapeutic approach that has given the best results. This literature review intended to analyze the effect of physical exercise, excluding the role that other treatments proposed, including the nutritional approach, could play in the treatment of sarcopenia, refers to 12 articles. In studies including high intensity strength exercises in isolation, either alone or combined with aerobic exercise, improvements were seen in muscle mass, muscle strength, and functional test times. There is also a significant increase in fat-free mass in individuals who exercised more frequently (more than two sessions per week). Current evidence shows that strength-resistance training and its combination in multimodal programs with aerobic exercise show significantly beneficial effects on anthropometric and muscle function parameters. Programs of prescribed exercises including strength exercises adequate to the characteristics should therefore be adapted to the characteristics of each individual and replace the usual practice of prescribing aerobic exercises (walking) only.

Low Vibrational Training as an Additional Intervention for Postural Balance, Balance Confidence and Functional Mobility in Type 2 Diabetic Patients with Lower Limb Burn Injury: A Randomized Clinical Trial

PURPOSE

Burn injury with pre-existing diabetes has poorer outcomes and complications. Balance and functional mobility are disturbed in diabetic patients with burn injury which increase the risk of total morbidity. The aim of the current study was to evaluate the impact of vibrational training as an additional intervention on postural balance, balance confidence and functional mobility in type 2 diabetic patients with lower limb burn injury.

PATIENTS AND METHODS

Thirty-eight type 2 diabetic patients of both sexes with healed lower limb burn were randomly assigned into two equal groups: the vibration group and the control group. The vibration group received whole body vibration (WBV), 3 sessions a week for 8 weeks, in addition to the selected exercise program (balance exercises and resisted exercises), while the control group only received the selected exercise program. Biodex Balance System was used to assess the dynamic balance score, the Activities-specific Balance Scale to assess balance confidence and the timed up and go test to assess the functional mobility. All measurements were obtained before and at the end of the study after 8 weeks of treatment.

RESULTS

Marked improvement in all dynamic balance indices; overall stability index, antero-posterior stability index and medio-lateral stability index, balance confidence and the functional mobility were obtained in both the vibration and the control groups (P< 0.05), whereas post-treatment comparison between groups revealed a statistically significant difference in favor of the vibration group in all measured variables.

CONCLUSION

Based on the results of the current study, it is possible to conclude that adding WBV training for an 8-week duration to a selected exercise program (balancing and resisted exercises) seems to be effective; in improving postural balance, balance confidence, as well as improving the functional mobility in type 2 diabetic patients with lower limb burn injury.

Effects of whole-body vibration on muscle strength, quadriceps muscle thickness and functional capacity in kidney transplant recipients: A randomized controlled trial

BACKGROUND

Whole-body vibration (WBV) may be an alternative of physical training for kidney transplant recipients.

OBJECTIVE

To evaluate the effect of a training program on quadriceps muscle strength and thickness, distance walked in the 6-min walking test (6MWT), respiratory muscle strength and quality of life in adult kidney transplant recipients.

DESIGN

Randomized controlled clinical trial.

METHOD

Twelve kidney transplant recipients of both genders who underwent WBV training (35 Hz) twice a week for 12 weeks on alternate days (WBVG), and training with a Sham Group (SG) were evaluated before and after intervention.

RESULTS

No difference was observed in quadriceps muscle strength and thickness between groups, however a large (d = 0.81) and a small (d = 0.44) effect size were observed after the training, respectively. Both groups improved the execution time of Sit-to-Stand Test before and after analysis, but this effect did not show superiority between them, however there was a large effect size provided by training (d = 1.11). No changes were observed between groups in relation to inspiratory muscle strength, but training effects could be observed by the effect size after the study period (d = 0.59). No changes were observed regarding the distance walked in the 6MWT and the effect size was small (d = 0.31).

CONCLUSION

WBV program would induce physiological responses that must be taken into consideration in adults' kidney transplant recipients. Our results show considerable effect sizes were observed for muscle strength and quadriceps thickness, inspiratory muscle strength, and 6MWT walking distance, although no difference was observed between groups at the end of the study.

Effects of vibration therapy on muscle mass, muscle strength and physical function in older adults with sarcopenia: a systematic review and meta-analysis

Background

Sarcopenia, a progressive loss of muscle mass and function with advancing age, is a prevalent condition among older adults. As most older people are too frail to do intensive exercise and vibration therapy has low risk and ease of participation, it may be more readily accepted by elderly individuals. However, it remains unclear whether vibration therapy would be effective among older adults with sarcopenia. This systematic review and meta-analysis examined the effect of vibration therapy including local vibration therapy and whole-body vibration therapy, for enhancing muscle mass, muscle strength and physical function in older people with sarcopenia.

Methods

A systematic literature search was conducted in March 2019 in the following 5 electronic databases: PubMed, CINAHL, Embase, PEDro, and the Cochrane Central Register of Controlled Trials, with no restriction of language or the year of publication. Randomized controlled trials and quasi-experimental studies examining effects of vibration therapy on muscle mass, muscle strength or physical function in older adults with sarcopenia were included in this systematic review. Two reviewers independently assessed the methodological quality of the selected studies.

Results

Of the 1972 identified studies, seven publications from six studies involving 223 participants were included in this systematic review. Five of them conducted whole-body vibration therapy, while two conducted local vibration therapy. A meta-analysis of randomized controlled studies indicated that muscle strength significantly increased after whole-body vibration therapy (SMD 0.69, 95% CI 0.28 to 1.11, I² = 0%, P = 0.001) and local vibration therapy (SMD 3.78, 95% CI 2.29 to 5.28, P < 0.001). Physical performance measured by the sit-to-stand test and the timed-up-and-go test were significantly improved after the intervention (SMD -0.79, 95% CI − 1.21 to − 0.37, I² = 0%, P < 0.001) and SMD -0.83, 95% CI − 1.56 to − 0.11, I² = 64%, P = 0.02, respectively).

Conclusion

Vibration therapy could be a prospective strategy for improving muscle strength and physical performance in older adults with sarcopenia. However, due to the limited number of the included studies, caution is needed when interpreting these results. More well-designed, large sample size studies should be conducted to further explore and validate the benefits of vibration therapy for this population.

Effects of Whole-Body Vibration Training and Blood Flow Restriction on Muscle Adaptations in Women: A Randomized Controlled Trial

Centner, C, Ritzmann, R, Gollhofer, A, and König, D. Effects of whole-body vibration training and blood flow restriction on muscle adaptations in women: a randomized controlled trial. J Strength Cond Res 34(3): 603-608, 2020-The purpose of the present randomized controlled trial was to investigate potential synergistic effects of whole-body vibration (WBV) training combined with blood flow restriction (BFR) on muscle mass and strength, and jump performance. Fifty healthy women (26.1 ± 4.6 years) were randomly allocated to one of the following experimental groups: WBV training combined with BFR (WBV + BFR) or WBV only. Before and after the 10-week training intervention, muscle cross-sectional area (CSA) of the vastus lateralis (VL) and gastrocnemius medialis (GM) was evaluated. Additionally, changes in muscle strength and jump performance were assessed before and after the intervention. The level of significance was set to p < 0.05. Vastus lateralis muscle CSA increased in both groups (p < 0.05). The increase in CSA was less pronounced after WBV than WBV + BFR, although the difference was not significant (p = 0.30). Likewise, GM CSA demonstrated comparable increases in both groups with a significant main effect of time (p < 0.05) but no interaction effect (p = 0.89). Assessment of muscular strength (p = 0.70) and jump performance (p = 0.40) did not reveal significant differences between the groups. The results of the present study indicate that the combination of WBV training with BFR shows a noticeable trend toward higher increases in muscle CSA compared with WBV alone. Despite the lack of significance, the results imply clinical relevance particularly in populations showing contraindications toward high training loads. This, however, needs to be confirmed in future research.

Resistance Exercise, Electrical Muscle Stimulation, and Whole-Body Vibration in Older Adults: Systematic Review and Meta-Analysis of Randomized Controlled Trials

It has been shown that resistance exercise (RT) is one of the most effective approaches to counteract the physical and functional changes associated with aging. This systematic review with meta-analysis compared the effects of RT, whole-body vibration (WBV), and electrical muscle stimulation (EMS) on muscle strength, body composition, and functional performance in older adults. A thorough literature review was conducted, and the analyses were limited to randomized controlled trials. In total, 63 studies were included in the meta-analysis (48 RT, 11 WBV, and 4 EMS). The results showed that RT and WBV are comparably effective for improving muscle strength, while the effects of EMS remains debated. RT interventions also improved some outcome measures related to functional performance, as well as the cross-sectional area of the quadriceps. Muscle mass was not significantly affected by RT. A limitation of the review is the smaller number of WBV and particularly EMS studies. For this reason, the effects of WBV and EMS could not be comprehensively compared to the effect of RT for all outcome measures. For the moment, RT or combinations of RT and WBV or EMS, is probably the most reliable way to improve muscle strength and functional performance, while the best approach to increase muscle mass in older adults remains open to further studies.

High-impact Routines to Ameliorate Trunk and Lower Limbs Flexibility in Women

Several types of routines and methods have been experimented to gain neuro/muscular advantages, in terms of overall range of motion, in athletes and fitness enthusiasts. The aim of the present study was to evaluate the impact of different routines on trunk- and lower limbs flexibility in a sample of young women. In a randomized-crossover fashion, eleven subjects underwent to: hamstrings stretching [S]; hamstrings stretching plus whole-body vibration [S+WBV]; partial-body cryotherapy [Cryo]; rest [Control]. Standing hamstrings stretch performance and sit-and-reach amplitude resulted to be improved with [S+WBV] compared to all other protocols (p<0.05). [Cryo] ameliorated the active knee extension performance with respect to all other interventions (p<0.05). These flexibility improvements were obtained without a loss in the trunk position sense proprioception. These results represent the first evidence that a single session of either vibration or cryotherapy can ameliorate flexibility without losing the trunk position sense proprioception in young women.

Effects of physical exercise in sarcopenia. A systematic review

From the third decade of life and due to multiple causes, muscle mass and strength are gradually lost, which affects the function of the musculoskeletal system. This combined loss of muscle mass and strength with aging is called sarcopenia, and is associated with greater morbidity and mortality in the elderly. Early treatment is therefore essential, and physical exercise is the therapeutic approach that has given the best results. This literature review intended to analyze the effect of physical exercise, excluding the role that other treatments proposed, including the nutritional approach, could play in the treatment of sarcopenia, refers to 12 articles. In studies including high intensity strength exercises in isolation, either alone or combined with aerobic exercise, improvements were seen in muscle mass, muscle strength, and functional test times. There is also a significant increase in fat-free mass in individuals who exercised more frequently (more than two sessions per week). Current evidence shows that strength-resistance training and its combination in multimodal programs with aerobic exercise show significantly beneficial effects on anthropometric and muscle function parameters. Programs of prescribed exercises including strength exercises adequate to the characteristics should therefore be adapted to the characteristics of each individual and replace the usual practice of prescribing aerobic exercises (walking) only.

Pain After Whole-Body Vibration Exposure Is Frequency Dependent and Independent of the Resonant Frequency: Lessons From an In Vivo Rat Model

Occupational whole-body vibration (WBV) increases the risk of developing low back and neck pain; yet, there has also been an increased use of therapeutic WBV in recent years. Although the resonant frequency (fr) of the spine decreases as the exposure acceleration increases, effects of varying the vibration profile, including peak-to-peak displacement (sptp), root-mean-squared acceleration (arms), and frequency (f), on pain onset are not known. An established in vivo rat model of WBV was used to characterize the resonance of the spine using sinusoidal sweeps. The relationship between arms and fr was defined and implemented to assess behavioral sensitivity-a proxy for pain. Five groups were subjected to a single 30-min exposure, each with a different vibration profile, and a sham group underwent only anesthesia exposure. The behavioral sensitivity was assessed at baseline and for 7 days following WBV-exposure. Only WBV at 8 Hz induced behavioral sensitivity, and the higher arms exposure at 8 Hz led to a more robust pain response. These results suggest that the development of pain is frequency-dependent, but further research into the mechanisms leading to pain is warranted to fully understand which WBV profiles may be detrimental or beneficial.

Is whole body vibration an alternative physical training method for renal transplant recipients?

OBJECTIVE

To evaluate the effect of a 12-week whole-body vibration (WBV) training program on quadriceps muscle strength, quadriceps thickness, the 6-min walk test (6MWT), respiratory muscle strength and quality of life in adults with a kidney transplant.

METHOD

Five renal transplant recipients (age: 43-52 years; body mass: 67.1 kg; height: 1.60 m) were examined individually before and after a 12-week WBV program (two weekly sessions, 35 Hz frequency, 2-4 mm amplitude) using quadriceps strength, quadriceps thickness, 6-min walking test, inspiratory muscle strength and quality of life.

RESULTS

There were no complications during WBV protocol, and the program was considered safe. Two of the participants changed quadriceps muscle strength, and one increased muscle thickness. Inspiratory muscle strength improved in one participant. The distance covered on 6MWT increased for two participants. Most of the subjects (P3, P4 and P5) reported improved quality of life, mainly regarding pain and social aspects.

CONCLUSION

The protocol improved the physical function and quality of life in some of the patients. However, WBV training prescription should be adjusted according to individual needs. Thus, studying the use of WBV in this patient group is necessary to understand and apply the benefits for this population.

Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial

OBJECTIVE

To investigate the feasibility and benefits of whole-body vibration (WBV) exercise as a safe and effective training tool for countering sarcopenia and age-related declines in mobility and function in the frail elderly.

DESIGN

An open, randomized controlled trial.

SETTING

Residential care facilities.

PARTICIPANTS

Male and female volunteers (N=117; 82.5±7.9y).

INTERVENTIONS

After prescreening for contraindications, participants were randomly allocated to a control, simulated WBV (SIM), or WBV exercise group. All participants received regular care, whereas WBV and SIM participants also underwent thrice-weekly exercise sessions for 16 weeks. Delivered by overload principle, WBV training began with 5 × 1-minute bouts at 6 Hz/2 mm (1:1 min exercise:rest), progressing to 10 × 1 minute at up to 26 Hz/4 mm, maintaining knee flexion. Training for SIM participants mimicked WBV exercise stance and duration only.

MAIN OUTCOME MEASURES

The timed Up and Go, Parallel Walk, and 10-m Timed Walk (10mTW) tests performance were assessed, in addition to the Barthel Index Questionnaire, at baseline, 8, and 16 weeks of exercise, and 3, 6, and 12 months postexercise.

RESULTS

High levels of compliance were reported in SIM (89%) and WBV training (93%), with ease of use and no adverse effects. In comparison to baseline levels, WBV training elicited clinically important treatment effects in all parameters compared to SIM and control groups. Treatment effects remained apparent up to 12 months postintervention for Parallel Walk Test and 6 months for 10mTW Test. Functional test performance declined during and postintervention in non-WBV groups.

CONCLUSIONS

Findings indicate that 16 weeks of low-level WBV exercise provides easily accessible, adequate stimulus for the frail elderly to attain improved levels of physical functionality.

Acute Effects of Whole-Body Vibration Training on Endothelial Function and Cardiovascular Response in Elderly Patients with Cardiovascular Disease

The aim of this single-arm pilot study was to determine the effects of whole-body vibration training (WBVT) on endothelial function in elderly patients with cardiovascular diseases, as well as its safety. A total of 20 elderly patients with stable cardiovascular diseases underwent WBVT, which consisted of five static resistance training exercises (squats, wide stance squats, toe-stands, squats + band, and front lunges). The parameters of WBVT included vertical vibrations, 30 Hz frequency, and a 3-mm peak-to-peak amplitude. Each vibration session lasted 30 seconds, with 120 seconds of rest between sessions. Before and after WBVT, the reactive hyperemia peripheral arterial tonometry index (RH-PAT index) and transcutaneous oxygen pressure (tcPO₂) were recorded as a measure of endothelial function and peripheral blood circulation. Systolic blood pressure, diastolic blood pressure, heart rate, and arterial oxygen saturation of pulse oximetry (SpO₂) were measured at each rest interval as well as before and after WBVT. All patients completed our WBVT protocol without adverse events. The RH-PAT index significantly increased following WBVT (1.42 to 2.06, P < 0.001). There were no significant changes in heart rate (P = 0.777), systolic blood pressure (P = 0.183), diastolic blood pressure (P = 0.925), or SpO₂ (P = 0.248) during WBVT. In conclusion, we demonstrated the acute effects of WBVT on endothelial function, with no reports of adverse events. These findings support the need for further randomized controlled studies to investigate the long-term effects of WBVT.

Whole Body Vibration Training on Muscle Strength and Brain-Derived Neurotrophic Factor Levels in Elderly Woman With Knee Osteoarthritis: A Randomized Clinical Trial Study

Background: Osteoarthritis of the knee (kOA) is a chronic, progressive, degenerative health condition that contributes to the imbalance between the synthesis and destruction of articular cartilage. Recently, whole body vibration (WBV) training has been recommended as an effective alternative for strength training in elderly people, and various physiological effects are obtained in response to exercise performed on a vibratory platform, such as an increase in muscle activation and improved muscle performance. However, the effects of WBV particularly on the strength of the quadriceps muscle and neuronal plasticity are unknown.

Objective: The aim of this study was to evaluate the effects of adding WBV to squat training on the isometric quadriceps muscle strength (IQMS) and the plasma levels of brain-derived neurotrophic factor (BDNF) in elderly woman with kOA.

Methods: Fifteen elderly women ≥65 years of age with kOA were randomized into two interventions: (1) the vibration group (VG), in which participants performed squat exercise training in association with WBV or (2) the exercise group (EG), in which participants performed squat exercise training without vibration, for 12 weeks 3×/week.

Results: Compared to the EG group, the VG group demonstrated a significantly greater delta (Δ) in IQMS values (IC95% 0.43–7.06; p ≤ 0.05) and in Δ BDNF plasma levels (IC95% −32.51 to 4.217; p ≤ 0.05) after the intervention period. There was an association between increase of Δ BDNF plasma levels and increase of Δ IQMS (β = 0.57; R² = 0.32; p = 0.03).

Conclusion: The addition of WBV to squat exercise training improves lower limb muscle performance in elderly women with kOA. These findings suggest that the improvement in muscle performance is related to neuromuscular adaptations induced by WBV.

Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT03918291.

Effects of Whole-Body Vibration Therapy on Distal Tibial Myotendinous Density and Volume: A Randomized Controlled Trial in Postmenopausal Women

Whole‐body vibration (WBV) therapy has been proposed as a therapy to reduce sarcopenia and improve muscle strength. The purpose of this study was to explore whether 12 months of WBV therapy increases myotendinous density and volume of the distal tibia as measured by HR‐pQCT in postmenopausal women in a parallel group, randomized controlled trial with 1:1:1 allocation to three arms. Postmenopausal women (N = 202) with low hip BMD were randomized to 20 min daily of 0.3g 30‐Hz WBV therapy, 0.3g 90‐Hz WBV therapy using the Juvent platform (Juvent, Somerset, NJ, USA), or no WBV. The main outcome measure was myotendinous density (HU) and volume (mm³) at the distal tibia measured at baseline and 12 months with HR‐pQCT. There were no significant effects on myotendinous density or volume at the distal tibia after 12 months of daily 30‐ or 90‐Hz WBV therapy compared with no WBV therapy. Mean change (SD) in myotendinous density from baseline was 4.6 (5.7) HU in the 30‐Hz WBV group, 3.9 (6.1) HU in the 90‐Hz WBV group, and 3.9 (5.4) HU in the control group (p = 0.70). Mean change (SD) in myotendinous volume from baseline was −7 (503) mm³ in the 30‐Hz WBV group, 111 (615) mm³ in the 90‐Hz WBV group, and 35 (615) mm³ in the control group (p = 0.50). In conclusion, WBV therapy at 30‐ or 90‐Hz for 12 months had no significant effects on myotendinous density or volume at the distal tibia as measured by HR‐pQCT in postmenopausal women. © 2018 The Authors. JBMR Plus Published by Wiley Periodicals, Inc. on behalf of the American Society for Bone and Mineral Research.

Whole-body vibration for patients with nonalcoholic fatty liver disease: a 6-month prospective study

Physical exercise has demonstrated benefits for managing nonalcoholic fatty liver disease (NAFLD). However, in daily life maintaining exercise without help may be difficult. A whole-body vibration device (WBV) has been recently introduced as an exercise modality that may be suitable for patients who have difficulty engaging in exercise. We tested WBV in patients with NAFLD and estimated its effectiveness. We studied the effects of a 6-month WBV program on hepatic steatosis and its underlying pathophysiology in 25 patients with NAFLD. Seventeen patients with NAFLD were designated as a control group. After WBV exercise, body weight in the study group decreased by only 2.5% compared with the control group. However, we found significant increases in muscle area (+2.6%) and strength (+20.5%) and decreases in fat mass (-6.8%). The hepatic (-9.9%) and visceral (-6.2%) fat content also significantly decreased (P < 0.05). There was substantial lowering of hepatic stiffness (-15.7%), along with improvements in the levels of inflammatory markers; tumor necrosis factor alpha (-50.9%), adiponectin (+12.0%), ferritin (-33.2%), and high-sensitivity C-reactive protein (-43.0%) (P < 0.05). These results suggest that WBV is an exercise option for patients with NAFLD that is effective, efficient, and convenient.

Evaluation of 18-Week Whole-Body Vibration Training in Normobaric Hypoxia on Lower Extremity Muscle Strength in an Elderly Population

Therapeutic benefits of hypoxic training have been suggested for clinical populations, such as elderly who could suffer loss of lower limb muscle strength and higher risk of falling. This study investigated the effects of 18 weeks of whole-body vibration (WBV) training in normobaric hypoxia on the strength parameters of an elderly population. Thirty-one healthy elderly participants were randomly assigned to a hypoxic whole-body vibration group (HWBV; n = 10), normoxic whole-body vibration group (NWBV; n = 11), or control group (n = 10). The experimental groups received the same vibration treatment in a hypoxia chamber (HWBV: 16.1% fraction of inspired oxygen [FiO₂]; NWBV: 21.0% FiO₂). Isokinetic leg muscle strength was evaluated using a Biodex System-3 isokinetic dynamometer. Body composition was obtained with dual-energy X-ray absorptiometry. There were no significant differences between groups in either strength or body composition parameters. The NWBV group showed statistically significant improvements in the maximal strength of knee extensors, with a small effect size (p = 0.004; d = 0.54). No significant differences were found in any variable of the HWBV group. The combination of WBV training and exposure to normobaric cyclic hypoxia carried out in the present study did not have an effect on strength parameters in healthy elderly subjects.

Blood flow restriction increases myoelectric activity and metabolic accumulation during whole-body vibration

PURPOSE

Whole-body vibration (WBV) training is frequently applied in sports and rehabilitation with the aim of inducing beneficial functional and structural adaptations. In the past decades, blood flow restriction (BFR) training has received increasing attention by enhancing the effectiveness of several low-load exercise regimens. The objective of this study was to evaluate the additional effect of BFR on myoelectric activity and metabolic accumulation during WBV training.

METHODS

Fifteen active men performed three sessions in a counterbalanced order on three different days: whole-body vibration exercise (WBV), whole-body vibration exercise with blood flow restriction (WBV + BFR), and a control session (CON) with neither WBV nor BFR. Electromyographic (EMG) activity was measured in six lower limb muscles throughout each exercise session; lactate and reactive oxygen species (ROS) concentrations were determined prior to, immediately after and 15 min after the exercise sessions.

RESULTS

EMG amplitudes increased from CON (29 ± 13% MVC) to WBV (45 ± 20% MVC) to WBV + BFR (71 ± 37% MVC) conditions (p < 0.05). Likewise, lactate concentrations increased in a similar manner, demonstrating significantly higher increases in the WBV + BFR session compared to WBV and CON. Furthermore, significant correlations between lactate concentration and EMG amplitude were detected. ROS concentration did not change significantly between the conditions.

CONCLUSIONS

The findings of the present study emphasize that the addition of BFR increases the acute effects beyond WBV treatment alone which becomes manifested in both neuromuscular and metabolic adaptations. Further research is needed to identify potential long-term effects of the combination of these two training regimens.

Tai Chi and whole-body vibrating therapy in sarcopenic men in advanced old age: a clinical randomized controlled trial

This study was to investigate the effects of Tai Chi (TC) and whole-body vibration (WBV) exercise in sarcopenic men in advanced old age. Ninety sarcopenic men (mean age 88.6 years; age range 85-101 years) were divided into three groups: TC group, WBV group, and control (CON) group. Patients in the two treatment groups received 8 weeks of training in either TC or WBV, while the control group received reminders not to change their level of physical exercise or lifestyle. Patients in all groups also received health information related to sarcopenia. Muscle mass, muscle strength, and physical performance [balance, gait speed, timed-up-and-go test (TUGT), and five-times-sit-to-stand test (FTSST)] were analyzed and compared among the three groups. Finally, seventy-nine subjects completed the study (TC n = 24; WBV n = 28; and CON 27). Muscle strength was significantly increased in the TC and WBV groups compared to the control group (P < 0.01). Following 8 weeks of exercise, improvements were observed in all physical performance tests for the TC and WBV groups (P < 0.05). The improvement in balance was greater in the TC group than the WBV group. Time × Group effects revealed significant improvements in muscle strength in the lower extremities (P < 0.05) and physical performance (P < 0.01) in both the TC and WBV groups. Changes in muscle mass, as measured by dual-energy X-ray absorptiometry, did not significantly differ between groups. These findings indicate that TC and WBV are effective treatments for improving muscle strength and physical performance in sarcopenic men in advanced old age.

How whole-body vibration can help our COPD patients. Physiological changes at different vibration frequencies

Objective

Evaluate cardiac, metabolic, and ventilatory changes during a training session with whole-body vibration training (WBVT) with 3 different frequencies in patients with chronic obstructive pulmonary disease (COPD).

Methods

This was a prospective, interventional trial in outpatients with severe COPD. Participants performed 3 vertical WBVT sessions once a week using frequencies of 35, 25 Hz and no vibration in squatting position (isometric). Cardiac, metabolic, and ventilator parameters were monitored during the sessions using an ergospirometer. Changes in oxygen pulse response (VO₂/HR) at the different frequencies were the primary outcome of the study.

Results

Thirty-two male patients with a mean forced expiratory volume in 1 second of 39.7% completed the study. Compared to the reference of 35 Hz, VO₂/HR at no vibration was 10.7% lower (P=0.005); however, no statistically significant differences were observed on comparing the frequencies of 35 and 25 Hz. The median oxygen uptake (VO₂) at 25 Hz and no vibration was 9.43% and 13.9% lower, respectively, compared to that obtained at 35 Hz (both comparisons P<0.0001). The median expiratory volume without vibration was 9.43% lower than the VO₂ at the end of the assessment at 35 Hz vibration (P=0.002).

Conclusion

Vertical WBVT training sessions show greater cardiac, metabolic, and respiratory responses compared with the squat position. On comparing the 2 frequencies used, we observed that the frequency of 35 Hz provides higher cardiorespiratory adaptation.

Whole body vibration to attenuate reduction of explosive force in chronic kidney disease patients: a randomized controlled trial

To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~-15% and -51%, P=0.038], RFDr at 30 msec [~-22% and -52%, P=0.044] and RFDr at 50 msec [~-11% and -54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~-8% and -55%, P=0.025), 200 msec (~-3% and -46%, P= 0.025); RFDr 100 msec (~0.01% and -56%, P=0.033), 200 msec (~-5% and -36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.

Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies

The prevalence of obesity in combination with sarcopenia (the age-related loss of muscle mass and strength or physical function) is increasing in adults aged 65 years and older. A major subset of adults over the age of 65 is now classified as having sarcopenic obesity, a high-risk geriatric syndrome predominantly observed in an ageing population that is at risk of synergistic complications from both sarcopenia and obesity. This Review discusses pathways and mechanisms leading to muscle impairment in older adults with obesity. We explore sex-specific hormonal changes, inflammatory pathways and myocellular mechanisms leading to the development of sarcopenic obesity. We discuss the evolution, controversies and challenges in defining sarcopenic obesity and present current body composition modalities used to assess this condition. Epidemiological surveys form the basis of defining its prevalence and consequences beyond comorbidity and mortality. Current treatment strategies, and the evidence supporting them, are outlined, with a focus on calorie restriction, protein supplementation and aerobic and resistance exercises. We also describe weight loss-induced complications in patients with sarcopenic obesity that are relevant to clinical management. Finally, we review novel and potential future therapies including testosterone, selective androgen receptor modulators, myostatin inhibitors, ghrelin analogues, vitamin K and mesenchymal stem cell therapy.