Effect of vibration on muscle perfusion: a systematic review

Effects of local vibration stimulation on muscle recovery and hypertrophy

[Purpose] Optimization of post-training muscle recovery is important in clinical rehabilitation and sports science. In this study, we investigated the effects of local vibration stimulation on post-training muscle recovery and hypertrophy in healthy adults, focusing on the upper extremities. [Participants and Methods] The study included 20 healthy students categorized into the control and vibration stimulation groups. Both groups underwent training, including elbow flexion. The vibration stimulation group received immediate post-training local vibration stimulation. Evaluation included measurement of upper arm circumference, muscle strength, muscle hardness, and ultrasonographic imaging. [Results] Our results showed that local vibration stimulation increased muscle luminosity but had no significant effect on muscle strength, hardness, or thickness. [Conclusion] Post-training vibration stimulation may promote muscle growth and recovery by stimulating blood flow and improving nutrient and oxygen supply to muscles.

Whole Body Vibration Training Has No Effect on Vascular Endothelial and Inflammatory Markers in Young Healthy Women

Background: The aim of the study was to comparatively assess the impact of single and repeated whole body vibration training (WBVT) and training without vibration on changes in the concentration of vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), and high-sensitivity C-reactive protein (hsCRP) in healthy, young, non-training women. Methods: The study involved 46 women (age 20.48 ± 1.72 years), who were divided into three groups: the experimental group participating in WBVT (EVG, n = 17); the comparison group performing the same exercises but without the vibration factor (EXG, n = 12); and the control group, which did not participate in any training (CON, n = 17). The program included participation in 36 training sessions conducted over 12 weeks, with a frequency of 3 times per week. In the EVG and EXG groups, venous blood was collected before and after the first and last training sessions, while in the CON group, blood was collected twice at a 3-month interval. Results: No significant changes were observed in the concentrations of the studied markers either after a single or repeated training session in both experimental groups (p > 0.05). Conclusions: The proposed WBVT protocol appears to be a safe form of exercise that does not induce negative inflammatory reactions. The applied vibration stimulus combined with physical exercises did not initiate pro-angiogenic processes or stimulate eNOS activity in healthy women, suggesting that similar studies should be conducted in individuals with circulatory problems or chronic inflammatory diseases.

The Effects of Massage Guns on Performance and Recovery: A Systematic Review

The use of massage guns has become increasingly popular in recent years. Although their use is more and more common, both in a clinical and sports context, there is still little information to guide the practitioners. This systematic review aimed to determine the effects of massage guns in healthy and unhealthy populations as pre- and post-activity or part of a treatment. Data sources used were PubMed, PEDro, Scopus, SPORTDiscus, Web of Science and Google Scholar, and the study eligibility criteria were based on "healthy and unhealthy individuals", "massage guns", "pre-activity, post-activity or part of a treatment" and "randomized and non-randomized studies" (P.I.C.O.S.). Initially, 281 records were screened, but only 11 could be included. Ten had a moderate risk of bias and one a high risk of bias. Massage guns could be effective in improving iliopsoas, hamstrings, triceps suralis and the posterior chain muscles' flexibility. In strength, balance, acceleration, agility and explosive activities, it either did not have improvements or it even showed a decrease in performance. In the recovery-related outcomes, massage guns were shown to be cost-effective instruments for stiffness reduction, range of motion and strength improvements after a fatigue protocol. No differences were found in contraction time, rating of perceived exertion or lactate concentration. Massage guns can help to improve short-term range of motion, flexibility and recovery-related outcomes, but their use in strength, balance, acceleration, agility and explosive activities is not recommended.

Is it time for doctors to Rx vibrators? A systematic review of pelvic floor outcomes

Introduction

Vibrators and similar devices are an underutilized treatment modality in pelvic and sexual medicine, likely because of the limited knowledge on the health benefits of their use.

Objectives

The aim of this study was to review available data regarding the effect of vibrator use on sexual function, pelvic floor function, and chronic unexplained vulvar pain.

Methods

We performed a systematic literature review of PubMed, Embase, and MEDLINE from inception to March 2021 per the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses). The search was based on the following keywords: sex toy woman, pelvic vibrator, sexual stimulation vibrator, vaginal vibrator, vibrator pelvic floor, vibrator incontinence, and vulvar pain vibrator. An overall 586 articles were identified. Studies that met inclusion criteria were reviewed: original research, sample of women, vibrator use, and application to the pelvic/genital area. Exclusion criteria included case reports, unrelated content, vibrator not applied to the pelvic/genital area, male participants, or conditions of interest not addressed. A total of 17 original studies met the criteria and were reviewed in depth.

Results

After review of the literature and identification of articles appropriate for the study, there were 8 studies surrounding sexual function, 8 on pelvic floor function (muscle strength/urinary incontinence), and 1 on vulvar pain. Among the identified studies, vibrators were considered an accepted modality to enhance a woman’s sexual experience, improve pelvic floor muscle function, and facilitate treatment of vulvar pain.

Conclusions

Vibrators are not well studied, and given the promising benefits demonstrated in the articles identified, future research efforts should be directed toward investigating their utility. Considering the potential pelvic health benefits of vibrators, their recommendation to women could be included in our pelvic floor disorder treatment armamentarium.

Effects of Vibration Resistance Exercises on EMG and Skeletal Muscle Hemodynamics

Objectives: Past studies show that vibration can stimulate muscle activity and improve muscle performance. However, further verification is needed on the effects of different vibration frequencies combined with different muscle strength exercise intensities on EMG activity and skeletal muscle hemodynamics. Methods: We recruited 27 male college athletes for 40%, 60%, and 80% maximum voluntary contraction (MVC) tests at the vibration frequencies of 0 Hz, 10 Hz, 20 Hz, and 30 Hz. We collected EMG activity signals using wireless EMGs and skeletal muscle hemodynamic parameters using a near-infrared spectrometer. Results: At an 80% MVC intensity of the rectus femoris, the mean, peak, and area of EMG at 30 Hz were significantly increased, compared with those at 0 Hz. At a 40% MVC intensity with vibration frequencies of 10 Hz, 20 Hz, and 30 Hz, the HHb of skeletal muscles was significantly increased, while the O2Hb and TSI were significantly decreased, compared with those at 0 Hz. Conclusions: We conclude that high frequency and strongly vibrated muscle strength exercise can improve EMG activity, while vibration and low-intensity muscle strength exercise could increase the oxygen consumption of skeletal muscles.

Changes in Skin Microcirculation Resulting from Vibration Therapy in Women with Cellulite

Background: Cellulite is a cosmetic defect that affects over 80% of post-pubertal women. One of its pathomechanisms involves microvascular dysfunction. It has been suggested that vibration is a physical stimulus that may improve circulation in the skin and muscles. The aim of this study was to evaluate the effect of local vibration on cutaneous microcirculation and on eliminating the symptoms of cellulite in women. Methods: A total of 57 healthy women with at least grade 1 cellulite were recruited and divided into four groups differing by treatment time (30′ or 60′) and position (sitting or lying) during the vibration treatments. Participants took part in 15 vibrotherapy sessions. Body composition, selected circumferences, cellulite grade, and thermographic images of buttocks and thighs were recorded. Results: Significant changes in skin temperature were observed in both studied areas after the first and last treatments in each group. A significant decrease in cellulite grade was observed after a series of treatments. The strongest effects were observed for the sitting position with a treatment time of 60 min. Conclusion: Vibration treatment improves microcirculation in cellulite-affected areas. Over time, no adaptation was observed, and subsequent treatments maintained the beneficial effects. Extending the treatment time increased its influence on the microcirculation in the skin.

Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review

BACKGROUND

Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders.

OBJECTIVES

This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders.

METHODS

PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale.

RESULTS

Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders.

CONCLUSIONS

The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.

Vibration or Transcutaneous Tibial Nerve Stimulation as a Treatment for Sexual Dysfunction in Women with Spinal Cord Injury: Study Protocol for a Randomized Clinical Trial

BACKGROUND

Women with spinal cord injuries usually suffer from sexual dysfunction, such as alterations during arousal and an increase in the time to reach orgasm. However, little evidence has been found on its physiotherapeutic approach, as well as poor adherence to the latter. The aim of this study is to determine the effectiveness of two interventions to improve sexual dysfunction: the application of genital vibration and transcutaneous tibial nerve stimulation.

METHODS

This is a randomized clinical trial that will recruit 54 women who, one year after a spinal cord injury, suffer from sexual dysfunction associated with the latter. The participants will be randomized to three groups: (a) intervention group 1 treated with transcutaneous tibial nerve electrostimulation (n = 18), (b) intervention group 2 treated with genital vibration (n = 18), and (c) a control group (n = 18). The treatment time will be 12 weeks. Adherence to the treatment will be evaluated, as well as the effectiveness of the treatment, through the Female Sexual Function Index, the Sexual Quality of Life-Female questionnaire, quantitative sensory tests, and the improvement reported by the patient in terms of arousal and orgasm. The evaluations will be carried out before the treatment, at the end of the treatment and 3, 6 and 12 months after the end of the treatment.

Local Vibration Reduces Muscle Damage after Prolonged Exercise in Men

Prolonged exercise can lead to muscle damage, with soreness, swelling, and ultimately reduced strength as a consequence. It has been shown that whole-body vibration (WBV) improves recovery by reducing the levels of stress hormones and the activities of creatine kinase (CK) and lactate dehydrogenase (LDH). The aim of the study was to demonstrate the effect of local vibration treatment applied after exercise on the level of selected markers of muscle fiber damage. The study involved 12 untrained men, aged 21.7 ± 1.05 years, with a VO2peak of 46.12 ± 3.67 mL·kg-1·min-1. A maximal intensity test to volitional exhaustion was performed to determine VO2peak and individual exercise loads for prolonged exercise. The subjects were to perform 180 min of physical effort with an intensity of 50 ± 2% VO2peak. After exercise, they underwent a 60 min vibration treatment or placebo therapy using a mattress. Blood samples were taken before, immediately after the recovery procedure, and 24 h after the end of the exercise test. Myoglobin (Mb) levels as well as the activities of CK and LDH were recorded. Immediately after the hour-long recovery procedure (vibration or placebo), the mean concentrations of the determined indices were significantly different from baseline values. In the vibration group, significantly lower values of Mb (p = 0.005), CK (p = 0.030), and LDH (p = 0.005) were seen. Differences were also present 24 h after the end of the exercise test. The results of the vibration group compared to the control group differed in respect to Mb (p = 0.002), CK (p = 0.029), and LDH (p = 0.014). After prolonged physical effort, topical vibration improved post-workout recovery manifested by lower CK and LDH activity and lower Mb concentration compared to a control group.

Design and Simulation of a Soft Robotic Device for Muscle Rehabilitation and Blood Flow Stimulation Therapy

Previous works have shown the efficacy of mechanical stimulation by applying pressure and vibration on muscle rehabilitation. Additionally, a temperature increase can improve both muscle performance and blood circulation during therapies. These modalities of treatment are commonly applied separately in patients with moderate disuse-induced muscle atrophy. In this paper, we propose the design of a novel medical device that synergistically integrates the function of i) elastomeric pneumatic actuators to apply focused orthogonal pressure, ii) vibratory motors to generate localized vibration and iii) carbon fibre heaters for a temperature increase. In particular, computational simulations were performed to characterize the mechanical behaviour of different pneumatic actuator geometries and their predicted advantages in comparison to previous designs. The integration of the three functionalities of the device and preliminary simulations results showcase its potential for improving therapy efficacy, while also being compact, lightweight, and comfortable, which would ease its implementation in rehabilitation programs.Clinical relevance- Disuse-induced muscle atrophy and related cardiovascular problems can lead to physical impairment and significantly affect patient independence. The surge in the number of hospitalized and bedridden patients related to the coronavirus disease (COVID-19) brings about a predicted increase in the incidence of myopathies and muscle weakness. To attend the growing demand, technological aids for more efficient physical therapies will need to be developed.

Spectral analysis of blood flow oscillations to assess the plantar skin blood flow regulation in response to preconditioning local vibrations

BACKGROUND

Local vibration has shown promise in improving skin blood flow and wound healing. However, the underlying mechanism of local vibration as a preconditioning intervention to alter plantar skin blood flow after walking is unclear.

OBJECTIVE

The objective was to use wavelet analysis of skin blood flow oscillations to investigate the effect of preconditioning local vibration on plantar tissues after walking.

METHODS

A double-blind, repeated measures design was tested in 10 healthy participants. The protocol included 10-min baseline, 10-min local vibrations (100 Hz or sham), 10-min walking, and 10-min recovery periods. Skin blood flow was measured over the first metatarsal head of the right foot during the baseline and recovery periods. Wavelet amplitudes after walking were expressed as the ratio of the wavelet amplitude before walking.

RESULTS

The results showed the significant difference in the metabolic (vibration 10.06 ± 1.97, sham 5.78 ± 1.53, p < 0.01) and neurogenic (vibration 7.45 ± 1.54, sham 4.78 ± 1.22, p < 0.01) controls. There were no significant differences in the myogenic, respiratory and cardiac controls between the preconditioning local vibration and sham conditions.

CONCLUSIONS

Our results showed that preconditioning local vibration altered the normalization rates of plantar skin blood flow after walking by stimulating the metabolic and neurogenic controls.

Effect of Resonant Frequency Vibration on Delayed Onset Muscle Soreness and Resulting Stiffness as Measured by Shear-Wave Elastography

This study utilized resonant frequency vibration to the upper body to determine changes in pain, stiffness and isometric strength of the biceps brachii after eccentric damage. Thirty-one participants without recent resistance training were randomized into three groups: a Control (C) group and two eccentric exercise groups (No vibration (NV) and Vibration (V)). After muscle damage, participants in the V group received upper body vibration (UBV) therapy for 5 min on days 1-4. All participants completed a visual analog scale (VAS), maximum voluntary isometric contraction (MVIC), and shear wave elastography (SWE) of the bicep at baseline (pre-exercise), 24 h, 48 h, and 1-week post exercise. There was a significant difference between V and NV at 24 h for VAS (p = 0.0051), at 24 h and 1-week for MVIC (p = 0.0017 and p = 0.0016, respectively). There was a significant decrease in SWE for the V group from 24-48 h (p = 0.0003), while there was no significant change in the NV group (p = 0.9341). The use of UBV resonant vibration decreased MVIC decrement and reduced VAS pain ratings at 24 h post eccentric damage. SWE was strongly negatively correlated with MVIC and may function as a predictor of intrinsic muscle state in the time course of recovery of the biceps brachii.

Acute effects of whole-body vibrations on the fatigue induced by multiple repeated sprint ability test in soccer players

BACKGROUND

We tested the hypothesis that Whole Body Vibration (WBV) positively affects the fatigue process ensuing from repeated bouts of maximal efforts, as induced by repeated sprints ability (RSA). Eleven male soccer players performed three sets of six repeated shuttle sprints (40 metres).

METHODS

Eleven male soccer players (age 23,6±4,5 years) were cross-randomized to perform WBW before RSA and during the recovery between sets (WBV-with) or to warm-up and passive recovery between sets (WBV-without). The effects of WBV were quantified by sprint time (ST) and blood lactate concentration (LA), collected up to 15th min after completion of tests.

RESULTS

ST during RSA showed a better maintenance of performance in the WBV-with compared to WBV-without condition in all three sets, reaching a statistical significance between-groups during the 2nd and 3rd set (P< 0.05). No significant differences in ST over the sets were detected in WBVwith, whereas a significant decrease was observed in the WBV-without condition (P<0.001). LA recovered significantly faster from the 9th to 15th minute of recovery in WBV-with as compared to WBV-without (P<0.05).

CONCLUSIONS

These findings would indicate that WBV performed during recovery between RSA sets is capable of delaying the onset of muscle fatigue resulting in a better maintenance of sprint performance.

The Recovery Benefit on Skin Blood Flow Using Vibrating Foam Rollers for Postexercise Muscle Fatigue in Runners

PURPOSE

To determine the effect of vibrating rollers on skin blood flow after running for recovery from muscle fatigue.

METHOD

23 healthy runners, aged between 20 to 45 years, participated in a crossover trial. Muscle fatigue was induced by running, and recovery using a vibrating roller was determined before and after the intervention. Each subject was measured at three time points (prerun, postrun, and postroller) to compare skin blood flow perfusion and blood flow oscillation at the midpoint of the dominant gastrocnemius muscle. The results show that blood perfusion is greater when a vibrating roller is used than a foam roller, but there is no statistical difference. The analysis of blood flow oscillation shows that vibrating rollers induce 30% greater endothelial activation than a foam roller. Vibrating rollers significantly stimulate the characteristic frequency for myogenic activation (p < 0.05); however, the effect size is conservative.

A mathematical model of skeletal muscle regeneration with upper body vibration

This study investigates the effect that upper body vibration has on the recovery rate of the biceps muscle. A mathematical model that accounts for vibration is developed by adapting three vibration terms into the Stephenson and Kojourahov skeletal muscle regeneration mathematical model. The first term accounts for the increase in the influx rate of type 1 macrophages (P₁). These cells are part of the body's immune response to muscle damage. They control the proliferation rate of satellite cells (S) and phagocytize dead myofiber cells. The second term accounts for the rate of the phenotype change of P₁ to type 2 macrophages (P₂). P₂ are used to support S differentiation and prevent apoptosis of myoblasts (M_b). The final term accounts for the fusion rate of M_b. M_b fuse with each other to create myotubes which align to create myofibers. The addition of these three terms decreases the overall skeletal muscle regeneration time by 47%. The model is validated on the macroscopic scale by subjecting test participants to a muscle damage and recovery protocol involving vibration therapy.

Effects of Preconditioning Local Vibrations on Subsequent Plantar Skin Blood Flow Response to Walking

Weight-bearing exercise such as walking may increase risk of foot ulcers in people with diabetes mellitus (DM) because of plantar ischemia due to repetitive, high plantar pressure. Applications of local vibrations on plantar tissues as a preconditioning intervention before walking may reduce plantar tissue ischemia during walking. The objective of this study was to explore whether preconditioning local vibrations reduce reactive hyperemia after walking. A double-blind, repeated-measures, and crossover design was tested in 10 healthy participants without DM. The protocol included 10-minute baseline, 10-minute local vibrations (100 Hz or sham), 10-minute walking, and 10-minute recovery periods. The order of local vibrations was randomly assigned. Skin blood flow (SBF) was measured over the first metatarsal head during baseline and recovery periods. SBF responses were characterized as peak SBF, total SBF, and recovery time of reactive hyperemia. SBF was expressed as a ratio of recovery to baseline SBF to quantify the changes. Peak SBF in the vibration protocol (6.98 ± 0.87) was significantly lower than the sham control (9.26 ± 1.34, P < .01). Total SBF in the vibration protocol ([33.32 ± 7.98] × 103) was significantly lower than the sham control ([48.09 ± 8.9] × 103, P < .05). The recovery time in the vibration protocol (166.08 ± 32.71 seconds) was not significantly different from the sham control (223.53 ± 38.85 seconds, P = .1). Local vibrations at 100 Hz could reduce walking-induced hyperemic response on the first metatarsal head. Our finding indicates that preconditioning local vibrations could be a potential preventive intervention for people at risk for foot ulcers.

Effects of graduated compression stockings, local vibration and their combination on popliteal venous blood velocity

Objectives

The purpose of this pilot study was to examine and compare the effects of graduated compression stockings, local vibration, and combined graduated compression stockings and local vibration on popliteal venous blood velocity.

Method

Twenty-four healthy subjects received four 15 min interventions (control, graduated compression stockings alone, local vibration alone, and combined graduated compression stockings and local vibration), while resting inactive in the prone position. Popliteal vein blood velocity was investigated before (PRE) and at the end (POST) of each intervention using Doppler ultrasound.

Results

At POST, peak velocity was reported to be 26.3 ± 53.5% ( p <  0.05) greater for local vibration than control (CONT). Peak velocity was 46.2 ± 54.6% ( p <  0.001) and 21.1 ± 37.6% ( p <  0.01) higher for graduated compression stockings than CONT and local vibration, respectively. Graduated compression stockings + local vibration presented 64.1 ± 58.0% ( p <  0.001), 38.4 ± 52.4% ( p <  0.001) and 15.0 ± 31.6% ( p <  0.05) greater values than CONT, local vibration and graduated compression stockings, respectively.

Conclusions

This study demonstrated an increase in popliteal venous blood velocity after graduated compression stockings and local vibration application. Their combination provided the greatest effects.

Whole-body vibration in the reduction of the cellulite

OBJECTIVE

Evaluate the effects of the whole body vibration in improving of cellulite in the women's gluteal region.

METHODS

Controlled clinical trial performed with 42 women, with cellulite in the gluteal region, detected by means of clinical examination. After evaluation, the women were divided into two groups: Whole-Body Vibration (WBV_G) and control (C_G). The evaluations were performed at the beginning and the end of 10 sessions and superficial skin temperature, perimetry in the gluteal region, analysis of body contouring, analysis of improvement by blind reviewers and instrument of satisfaction, by numeric scale were investigated.

RESULTS

In the thermographic analysis, the WBV_G obtained significant increase of superficial skin temperature on the right (p = 0.02) and left (p = 0.02) gluteal region. There was no difference in intra- and intergroups in perimetry and the analysis of body contour. The WBV_G obtained a higher percentage of improvement by assessment of the blind reviewers (p = 0.003) and greater aesthetics satisfaction (p = 0.006), when compared to C_G.

CONCLUSION

WBV provided an improvement in the aspect of the cellulite when assessed by blind reviewers and greater participants' satisfaction, providing a significant increase in the superficial skin temperature in the gluteal region.

Immediate Effects of External Vibration vs Placebo on Vocal Function Therapy in Singers: A Randomized Clinical Trial

Importance

External vibration therapy (EVT) has been widely used in chronic pain conditions, musculoskeletal rehabilitation, and athletic training. Vibration therapy has been suggested to enhance vocal performance and has been popularized in social media. However, there is no evidence to support its effect on vocal function.

Objective

To evaluate the immediate effects of EVT in trained singers using acoustic and self-assessment parameters.

Design, Setting, and Participants

Prospective, randomized, placebo-controlled interventional study at St Michael's Hospital Voice Clinic, affiliated with the University of Toronto. Data collection and analysis were performed by investigators who were blinded to the group assignment of the participants. Study participants were randomized to EVT or a placebo (control) group. The study dates were September 2015 to December 2016.

Interventions

Participants attended the voice laboratory at St Michael's Hospital, where a standardized data collection protocol was performed, including acoustic parameters, voice range profile, and soft voice tasks, followed by subjective rating of vocal effort or discomfort. The EVT group underwent EVT to 5 neck sites bilaterally. The placebo group underwent the same protocol with a modified device. After the intervention, the participants repeated the standardized data collection.

Main Outcomes and Measures

The primary outcome in this study was acoustic analysis (jitter, shimmer, and pitch range) compared before and after treatment. In addition, secondary outcomes included perceived effort or discomfort evaluated by participants after 4 voice tasks proposed to investigate more subtle voice properties. Within and between groups, data sets were statistically analyzed for potential treatment effect.

Results

Among 27 participants (age range, 18-50 years; all female), 14 were randomized to the intervention group and 13 to the placebo group. Comparison of the treatment effect on the vowel token acoustic parameters evaluated showed that, after EVT, participants had a more cohesive change with a restricted 95% CI compared with placebo. The mean change in fundamental frequency after intervention was 5.00 Hz in both groups but the 95% CI was much wider after placebo (-30.30 to 19.20) than after EVT (-18.10 to 7.50). After EVT, the effect size was notable in the vowel (0.83) and SVT3 (0.79) task.

Conclusions and Relevance

In this study, EVT demonstrated a more predictable change in acoustic metrics compared with the placebo treatment. Effort ratings for 6 voice tasks evaluated in this study were not found to be different after EVT compared with the placebo treatment.

Trial Registration

clinicaltrials.gov Identifier: NCT02083341.

Genital vibration for sexual function and enhancement: a review of evidence

Vibration, as provided by a genital vibrator, is commonly regarded as a tool to enhance sexual pleasure and in modern day society falls under the category of a sex toy. However, the vibrator was not originally intended to be a toy, and its benefits reach far beyond that of a plaything. This article is a narrative review of the current evidence regarding the use of vibratory stimulation for the treatment of sexual dysfunction and/or sexual and relationship enhancement. The literature indicates that vibratory stimulation has evidence-based support for the treatment of erectile dysfunction, ejaculatory dysfunction and anorgasmia. Vibratory stimulation is positively correlated with increased sexual desire and overall sexual function. It has also shown benefit for sexual arousal difficulties and pelvic floor dysfunction. Though definitive evidence is lacking, genital vibration is a potential treatment for sexual dysfunction related to a wide variety of sexual health concerns in men and women.

Review of the Mechanisms and Effects of Noninvasive Body Contouring Devices on Cellulite and Subcutaneous Fat

CONTEXT

Today, different kinds of non-invasive body contouring modalities, including cryolipolysis, radiofrequency (RF), low-level laser therapy (LLLT), and high-intensity focused ultrasound (HIFU) are available for reducing the volume of subcutaneous adipose tissue or cellulite. Each procedure has distinct mechanisms for stimulating apoptosis or necrosis adipose tissue. In addition to the mentioned techniques, some investigations are underway for analyzing the efficacy of other techniques such as whole body vibration (WBV) and extracorporeal shockwave therapy (ESWT). In the present review the mechanisms, effects and side effects of the mentioned methods have been discussed. The effect of these devices on cellulite or subcutaneous fat reduction has been assessed.

EVIDENCE ACQUISITION

We searched pubmed, google scholar and the cochrane databases for systemic reviews, review articles, meta-analysis and randomized clinical trials up to February 2015. The keywords were subcutaneous fat, cellulite, obesity, noninvasive body contouring, cryolipolysis, RF, LLLT, HIFU, ESWT and WBV with full names and abbreviations.

RESULTS

We included seven reviews and 66 original articles in the present narrative review. Most of them were applied on normal weight or overweight participants (body mass index < 30 kg/m2) in both genders with broad range of ages (18 to 50 years on average). In the original articles, the numbers of included methods were: 10 HIFU, 13 RF, 22 cryolipolysis, 11 LLLT, 5 ESWT and 4 WBV therapies. Six of the articles evaluated combination therapies and seven compared the effects of different devices.

CONCLUSIONS

Some of the noninvasive body contouring devices in animal and human studies such as cryolipolysis, RF, LLLT and HIFU showed statistical significant effects on body contouring, removing unwanted fat and cellulite in some body areas. However, the clinical effects are mild to moderate, for example 2 - 4 cm circumference reduction as a sign of subcutaneous fat reduction during total treatment sessions. Overall, there is no definitive noninvasive treatment method for cellulite. Additionally, due to the methodological differences in the existing evidence, comparing the techniques is difficult.

Effects of whole-body vibration after eccentric exercise on muscle soreness and muscle strength recovery

[Purpose] The aim of this study was to investigate whether or not a single whole-body vibration treatment after eccentric exercise can reduce muscle soreness and enhance muscle recovery. [Subjects and Methods] Twenty untrained participants were randomly assigned to two groups: a vibration group (n=10) and control group (n=10). Participants performed eccentric quadriceps training of 4 sets of 5 repetitions at 120% 1RM, with 4 min rest between sets. After that, the vibration group received 3 sets of 1 min whole body vibration (12 Hz, 4 mm) with 30 s of passive recovery between sets. Serum creatine kinase, blood urea nitrogen, muscle soreness (visual analog scale) and muscle strength (peak isometric torque) were assessed. [Results] Creatine kinase was lower in the vibration group than in the control group at 24 h (200.2 ± 8.2 vs. 300.5 ± 26.1 U/L) and at 48 h (175.2 ± 12.5 vs. 285.2 ± 19.7 U/L) post-exercise. Muscle soreness decreased in vibration group compared to control group at 48 h post-exercise (34.1 ± 11.4 vs. 65.2 ± 13.2 mm). [Conclusion] Single whole-body vibration treatment after eccentric exercise reduced delayed onset muscle soreness but it did not affect muscle strength recovery.

Acute effects of whole-body vibration with resistance exercise on postexercise blood pressure and oxygen consumption in prehypertensive adults

Background/Objective

Research on the acute health effects of whole-body vibration with resistance exercise (WBV + RE) for clinical populations is limited. This randomized crossover trial evaluated postexercise hypotension and excess postexercise oxygen consumption (EPOC) in response to three conditions: WBV + RE, RE alone, and control (CON) in 11 prehypertensive (systolic/diastolic blood pressure: 120-139/80-89 mmHg) adults.

Methods

Following a 12-hour fast with no exercise for the previous 24 hours, resting VO₂ and blood pressure (BP) were measured. WBV + RE was performed while standing barefoot on a vibration platform (Pneumex Pro-Vibe) and lifting a bar of 10% body weight. Fifteen repetitions of nine exercises were performed using a 1-minute-to-30-second exercise:rest ratio. RE was identical to WBV + RE but without vibration. During CON, participants remained seated for 15 minutes. Following exercise, VO₂ was measured continuously and BP every 15 minutes for 3 hours.

Results

Postexercise hypotension and EPOC were significantly different for WBV + RE compared with RE and CON (p <0.001). Postexercise systolic BP was significantly lower for WBV + RE as compared with RE or CON, while diastolic BP was lower for both WBV + RE and RE compared with CON (p < 0.001; WBV + RE: 124 ± 2/72 ± 6 mmHg; RE: 126 ± 2/71 ± 6 mmHg; CON: 128 ± 2/73 ± 6 mmHg). EPOC was significantly (p < 0.001) higher at 15 minutes postexercise for WBV + RE as compared with RE.

Conclusion

Compared with RE alone, a single bout of WBV + RE resulted in a greater postexercise hypotension response and higher EPOC.

Acute effects of simultaneous electromyostimulation and vibration on leg blood flow in spinal cord injury

STUDY DESIGN

Randomized crossover.

OBJECTIVES

To analyze the acute effects of isolated and simultaneous application of whole-body vibration (WBV) and electromyostimulation (ES) on popliteal artery blood velocity (BV) and skin temperature (ST) of the calf in subjects with spinal cord injury (SCI).

SETTING

Valladolid, Spain.

METHODS

Ten subjects with SCI were assessed in five different sessions. After a familiarization session, four interventions were applied in random order; WBV, ES, simultaneous WBV and ES (WBV+ES), and 30 s of WBV followed by 30 s of ES (WBV30/ES30). Each intervention consisted of 10 sets × 1 min ON+1 min OFF. Subjects were seated on their own wheelchairs with their feet on the vibration platform (10 Hz, 5 mm peak-to-peak), and ES was applied on the gastrocnemius muscle of both legs (8 Hz, 400 μs).

RESULTS

The simultaneous application (WBV+ES) produced the greatest increase in mean BV (MBV; 36% and 42%, respectively) and peak BV (PBV; 30% and 36%, respectively) during the intervention. This intervention produced the greatest mean increases in MBV (21%) and PBV (19%) during the recovery period. Last, this intervention produced the highest increase in ST during the intervention (2.1 °C).

CONCLUSION

The simultaneous application of WBV+ES seems to produce a greater increase in MBV and PBV of the popliteal artery and ST of the calf than the isolated (WBV or ES) or consecutive application of both stimuli (WBV30/ES30). This study provides an efficient therapeutic methodology to improve peripheral arterial properties, which is pivotal in SCI patient's rehabilitation.

Vibration Therapy Is No More Effective Than the Standard Practice of Massage and Stretching for Promoting Recovery From Muscle Damage After Eccentric Exercise

OBJECTIVE

The purpose of this study was to determine if vibration therapy is more effective than the standard treatment of stretching and massage for improving recovery of muscle strength and reducing muscle soreness after muscle damage induced by eccentric exercise.

DESIGN

A randomized, single-blinded parallel intervention trial design was used.

SETTING

Research laboratory.

PARTICIPANTS

Fifty untrained men aged 18 to 30 years completed the study.

INTERVENTIONS

Participants performed 100 maximal eccentric muscle actions (ECCmax) of the right knee extensor muscles. For the next 7 days, 25 participants applied cycloidal vibration therapy to the knee extensors twice daily and 25 participants performed stretching and sports massage (SSM) twice daily.

MAIN OUTCOME MEASURES

Changes in markers of muscle damage [peak isometric torque (PIT), serum creatine kinase (CK), and serum myoglobin (Mb)], muscle soreness (visual analog scale), and inflammation [serum C-reactive protein (CRP)] were assessed.

RESULTS

After ECCmax, there was no difference in recovery of PIT and muscle soreness or serum CK, Mb, and CRP levels between vibration and SSM groups (P > 0.28).

CONCLUSIONS

Cycloidal vibration therapy is no more effective than the standard practice of stretching and massage to promote muscle recovery after the performance of muscle-damaging exercise.

CLINICAL RELEVANCE

Prescription of vibration therapy after maximal exercise involving eccentric muscle damage did not alleviate signs and symptoms of muscle damage faster than the standard prescription of stretching and massage.

Influence of isolated or simultaneous application of electromyostimulation and vibration on leg blood flow

PURPOSE

The aim of this study was to analyze the acute effects of isolated or simultaneously applied whole-body vibration (WBV) and electromyostimulation (ES) on the popliteal arterial blood velocity and skin temperature (ST) of the calf.

METHODS

Thirteen healthy males were assessed in five different sessions. After a familiarization session, four interventions were applied in random order; WBV, ES, simultaneous WBV and ES (WBV+ES), and 30 s of WBV followed by 30 s of ES (WBV30/ES30). Each intervention consisted of 10 sets × 1 min ON + 1 min OFF. The subject was standing on the vibration platform (squat position, 30° knee flexion, 26 Hz, 5 mm peak-to-peak), and ES was applied on the gastrocnemius of both the legs (8 Hz, 400 µs).

RESULTS

The WBV+ES intervention was the only one that maintained the mean blood velocity (MBV) elevated above baseline during the 10 sets, from set-1 (134.6 % p < 0.01) to set-10 (112.6 % p < 0.05). The combined interventions were the only ones that maintained the peak blood velocity (PBV) elevated above baseline during all the sets, from set-1 (113.5 % p < 0.001) to set-10 (88.8 % p < 0.01) and from set-1 (58.4 % p < 0.01) to set-10 (49.1 % p < 0.05) for WBV+ES and WBV30/ES30, respectively.

CONCLUSION

The simultaneous application of WBV and ES produced a general greater increase in MBV and PBV than the application of each method alone or consecutive. This novel methodological proposal could be interesting in different fields such as sports or the rehabilitation process of different pathologies, to achieve an enhanced peripheral blood flow.

A unifying neuro-fasciagenic model of somatic dysfunction - Underlying mechanisms and treatment - Part II

This paper offers an extensive review of the main fascia-mediated mechanisms underlying various therapeutic processes of clinical relevance for manual therapy. The concept of somatic dysfunction is revisited in light of the several fascial influences that may come into play during and after manual treatment. A change in perspective is thus proposed: from a nociceptive model that for decades has viewed somatic dysfunction as a neurologically-mediated phenomenon, to a unifying neuro-fascial model that integrates neural influences into a multifactorial and multidimensional interpretation of manual therapeutic effects as being partially, if not entirely, mediated by the fascia. By taking into consideration a wide spectrum of fascia-related factors - from cell-based mechanisms to cognitive and behavioural influences - a model emerges suggesting, amongst other results, a multidisciplinary-approach to the intervention of somatic dysfunction. Finally, it is proposed that a sixth osteopathic 'meta-model' - the connective tissue-fascial model - be added to the existing five models in osteopathic philosophy as the main interface between all body systems, thus providing a structural and functional framework for the body's homoeostatic potential and its inherent abilities to heal.

In the unloaded lower leg, vibration extrudes venous blood out of the calf muscles probably by direct acceleration and without arterial vasodilation

Purpose

During vibration of the whole unloaded lower leg, effects on capillary blood content and blood oxygenation were measured in the calf muscle. The hypotheses predicted extrusion of venous blood by a tonic reflex contraction and that reactive hyperaemia could be observed after vibration.

Methods

Twelve male subjects sat in front of a vibration platform with their right foot affixed to the platform. In four intervals of 3-min duration vibration was applied with a peak-to-peak displacement of 5 mm at frequencies 15 or 25 Hz, and two foot positions, respectively. Near infrared spectroscopy was used for measuring haemoglobin oxygen saturation (SmO₂) and the concentration of total haemoglobin (tHb) in the medial gastrocnemius muscle.

Results

Within 30 s of vibration SmO₂ increased from 55 ± 1 to 66 ± 1 % (mean ± SE). Within 1.5 min afterwards SmO₂ decreased to a steady state (62 ± 1 %). During the following 3 min of recovery SmO₂ slowly decreased back to base line. THb decreased within the first 30 s of vibration, remained almost constant until the end of vibration, and slowly recovered to baseline afterwards. No significant differences were found for the two vibration frequencies and the two foot positions.

Conclusions

The relaxed and unloaded calf muscles did not respond to vibration with a remarkable reflex contraction. The acceleration by vibration apparently ejected capillary venous blood from the muscle. Subsequent recovery did not match with a reactive hyperaemia indicating that the mere mechanical stress did not cause vasodilation.

A new device to relieve venipuncture pain can affect haematology test results

BACKGROUND

In vitro diagnostic tests play a key role in patients' management (e.g., guiding red blood cell transfusions). The aim of this study was to evaluate the impact of an innovative device (Buzzy®) which is claimed to be able to relieve venipuncture pain by means of cold and vibration. This device was applied during collection of venous blood by venipuncture for conventional haematology testing.

MATERIALS AND METHODS

Blood was drawn from 100 volunteers by a single, expert phlebotomist. A vein was located in the left forearm without applying a tourniquet but using a subcutaneous tissue transilluminator device, so that venous stasis was avoided. Blood samples were collected with a 20G straight needle directly into 4 mL K3EDTA vacuum tubes. In sequence, external cold and vibration was established by Buzzy® on the right forearm -5 cm above the venipuncture site- for 1 minute before venipuncture and continued until the end of the same procedure already performed in the left forearm. Conventional haematological tests were performed using the same instrument (Sysmex® XE-2100D) in all cases.

RESULTS

When Buzzy® was applied before drawing blood, erythrocyte counts and associated parameters (i.e., haemoglobin and haematocrit) were higher, whereas platelet number, leucocyte count and differential were lower. Statistically and clinically significant differences (P<0.001) were observed for erythrocytes, haemoglobin and haematocrit.

DISCUSSION

From a practical perspective, cold-induced haemoconcentration promotes the efflux of water, diffusible ions and low molecular weight molecules from the vessel, thus increasing the concentration of other blood analytes at the puncture site. These variations may influence test results, especially for erythrocytes, haemoglobin and haematocrit. The novel Buzzy® device should, therefore, be used with caution when collecting blood for conventional haematological testing because of the observed bias introduced in some parameters.

Quality impact on diagnostic blood specimen collection using a new device to relieve venipuncture pain

A new device called Buzzy(®) has been recently presented that combines a cooling ice pack and a vibrating motor in order to relieve the venipuncture pain. The aim of this study was to evaluate the impact of Buzzy(®) use during diagnostic blood specimen collection by venipuncture for routine immunochemistry tests. Blood was collected from 100 volunteers by a single, expert phlebotomist. A vein was located on the left forearm without applying tourniquet, in order to prevent any interference from venous stasis, and blood samples were collected using a 20-G straight needle directly into 5 mL vacuum tubes with clot activator and gel separator. In sequence, external cold and vibration by Buzzy(®) was applied on the right forearm-5 cm above the chosen puncture site-for 1 min before venipuncture and continued until the end of the same procedure already done in the left forearm. The panel of tests included the following: glucose, total cholesterol, HDL-cholesterol, triglycerides, total protein, albumin, c-reactive protein, urea, creatinine, uric acid, alkaline phosphatase, amylase, AST, ALT, g-glutamyltransferase, lactate dehydrogenase, creatine kinase, total bilirubin, phosphorus, calcium, magnesium, iron, sodium, potassium, chloride, lipase, cortisol, insulin, thyroid-stimulating hormone, total triiodothyronine, free triiodothyronine, total thyroxine, free thyroxine and haemolysis index. Clinically significant differences between samples were found only for: total protein, albumin and transferrin. The Buzzy(®) can be used during diagnostic blood specimens collection by venipuncture for the majority of the routine immunochemistry tests. We only suggest avoiding this device during blood collection when protein, albumin and transferrin determinations should be performed.