The Clinical Utility of Whole Body Vibration: A Review of the Different Types and Dosing for Application in Metabolic Diseases

Whole body vibration (WBV) is an innovative exercise mimetic that utilizes a vibrating platform to transmit mechanical vibrations throughout the body. WBV has been a popular area of research in recent years due to its potential physiological and therapeutic benefits in both health and disease. The utility of WBV is rooted in the various parameters (i.e., frequency, amplitude, duration) that affect the overall dose of vibration delivered to the body. Each type of WBV, coupled with these aforementioned parameters, should be considered when evaluating the use of WBV in the clinical setting. Thus, the purpose of this review is to provide an overview of recent literature detailing the different types of WBV, the various parameters that contribute to WBV efficacy, and the evidence of WBV in metabolic disease. A systematic search was conducted using Medline, Embase, Cochrane, CINAHL, and PubMed. All types of study designs were considered, with exclusions made for animal studies, duplicates, and study protocols without data. Thirty-four studies were included. In conclusion, as a modern exercise mimetic with therapeutic potential for metabolic diseases, understanding the interplay between the types and dosing of WBV is critical for determining its utility and efficacy. Further studies are certainly needed to elucidate the full therapeutic potential of WBV in metabolic diseases.

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.

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.

Effects of Vibration Training on Weight Loss and Heart Rate Variability in the Obese Female College Students

Objective

The present study examined the effects of a 12-week whole-body vibration training (WBVT) regimen on heart rate variability (HRV) and body composition in the obese female college students.

Methods

Participants were assigned to either the WBVT (n = 17) or obese control group (n = 19). The students in the WBVT group conducted a 12-week (5 times per week and 30 min per time) exercise protocols (30 to 40 Hz of frequency and 4 mm of amplitude), and the obese control group did not perform regular physical training during 12 weeks of study. Then, body composition (body weight, BMI, body fat, body fat percentage; trunk fat mass, muscle mass, MM) and HRV (time domain and frequency domain index) were measured in all subjects before and after WBVT intervention.

Results

(1) After 12-week WBVT intervention, body fat mass, trunk fat mass, and body fat percentage significantly decreased and muscle mass increased in the WBVT group (P < 0.01, respectively); there was no significant change in body weight and BMI (P > 0.05, respectively). (2) After 12-week WBVT intervention, LFn, LF/HF, and HR significantly decreased (P < 0.05, P < 0.01), R-R interval and RMSSD significantly increased (P < 0.01, respectively), and there was no significant difference in HFn (P > 0.05). Nevertheless, there was no significant change before and after the test in body composition and HRV in the obese control group (P > 0.05, respectively). (3) After 12-week WBVT intervention, compared with the obese control group, body fat mass, body fat percentage, trunk fat mass, and LF/HF significantly decreased (P < 0.05, P < 0.01), muscle mass, and RMSSD increased (P < 0.05) in the WBVT group; but there were no significant difference in other indicators (P > 0.05) between the obese control group and WBVT group. (4) The reduction of body fat percentage before and after the WBVT intervention are positively correlated with the reduction in the LFn and LF/HF (r = 0.542, r = 0.504; P < 0.05, respectively) and negatively correlated with the increase in the RMSSD (r = −0.514, P < 0.05), and the reduction of trunk fat mass are positively correlated with the reduction in the LF/HF (r = 0.540, P < 0.05).

Conclusion

The results indicate that WBVT improves HRV and body composition in obese female college students, and the reduction in body fat percentage and trunk fat mass are associated with a shift in cardiac autonomic regulation towards vagal dominance and improve sympathetic-vagus balance after WBVT intervention. In conclusion, WBVT may be a feasible treatment to improve cardiac autonomic function and body composition.

A brief whole-body vibration intervention to avoid weight gain in college students: A randomized controlled pilot trial

ObjectiveOver one-third of college students are overweight or obese and rates are rising. Whole body vibration (WBV) training could prevent weight gain but has not been tested in college students. Methods: Randomized controlled trial comparing thrice weekly WBV for 6 months to controls (CON) in undergraduate students. Feasibility included retention, adherence and safety and outcomes included changes in weight, body mass index (BMI) and fat mass. Results: 77 students enrolled in the trial (WBV: n = 40, CON: n = 37), 81% completed the study. Adherence to WBV averaged 59%. Average group differences were 1% body fat (p = 0.049) and 1 kg fat mass (p < 0.01), favoring WBV. Among students completing >80% of prescribed WBV sessions significant group differences widened, while group differences in BMI (p = 0.026) and weight (p = 0.02) change became significant. Conclusions: WBV may be a feasible, safe and effective approach to weight management in college students, though strategies to optimize adherence should continue.

Effects of Whole-Body Vibration Training on Body Composition, Cardiometabolic Risk, and Strength in the Population Who Are Overweight and Obese: A Systematic Review With Meta-analysis

OBJECTIVES

To assess the effects of whole-body vibration training (WBVT) on body composition, metabolic and cardiovascular risk variables, and lower limb strength in participants who are overweight/obese.

DATA SOURCES

A systematic review with meta-analysis was conducted in 3 databases (PubMed-MEDLINE, Web of Science, and Cochrane Library) from inception through to January 26, 2020.

STUDY SELECTION

Studies analyzing the effect of WBVT on body composition variables, metabolic profile, blood pressure, heart rate, and lower limb strength in the population who are overweight/obese, with interventions of a minimum length of 2 weeks were included.

DATA EXTRACTION

After applying the inclusion and exclusion criteria, 23 studies involving 884 participants who were obese/overweight (experimental group: 543; weight=79.9 kg; body mass index (BMI) =31.3 kg/m², obesity class I according to World Health Organization) were used in the quantitative analysis. The sex of the participants involved in the studies were as follows: (1) 17 studies included only female participants; (2) 1 study included only boys, and (3) 5 studies included both sexes. Meta-analysis, subgroup analysis, and meta-regression methods were used to calculate the mean difference and standardized mean difference (SMD; ± 95% confidence intervals [CIs]) as well as to analyze the effects of pre-post intervention WBVT and differences from control groups.

DATA SYNTHESIS

WBVT led to a significant decrease in fat mass (-1.07 kg, not clinically significant). In addition, WBVT reduced systolic blood pressure (-7.01 mmHg, clinically significant), diastolic blood pressure (-1.83 mmHg), and heart rate (-2.23 bpm), as well as increased the lower extremity strength (SMD=0.63; range, 0.40-0.86). On the other hand, WBVT did not modify the weight, BMI, muscle mass, cholesterol, triglycerides, or glucose.

CONCLUSIONS

WBVT could be an effective training modality to reduce blood pressure (clinically relevant) and resting heart rate. In addition, WBVT led to improved lower limb strength. However, these findings were not consistent with significant improvements on other variables associated with metabolic syndrome (body composition, cholesterol, triglycerides, glucose).

Effects of Acute Whole-Body Vibration Practice on Maximal Fat Oxidation in Adult Obese Males: A Pilot Study

OBJECTIVE

Whole-body vibration (WBV) training has been established as a useful method to improve physical fitness in obese individuals. However, the effects of WBV exercise on maximal fat oxidation (MFO) have not been examined in obese subjects yet.

METHOD

MFO was eval-uated during a cardiopulmonary exercise test (CPET) on a treadmill in 12 adult obese males (BMI = 34.9 ± 3.3 kg/m2) after three different warm-up conditions: static half squat plus WBV (HSV), static half squat without WBV (HSWV), and rest (REST). Cortisol levels were evaluated before and after the warm-up, and 1 min (T1), 10 min (T10), and 30 min (T30) of the recovery phase.

RESULTS

MFO was significantly higher in HSV (p = 0.013; 569.4 ± 117.9 mg/min) and HSWV (p = 0.033; 563.8 ± 142.9 mg/min) than REST (445.5 ± 117.9 mg/min). Cortisol concentrations at T1 were significantly higher in HSV (p = 0.023) and HSWV (p = 0.015) than REST. Moreover, cortisol concentrations were significantly lower at T30 than T1 in HSWV (p = 0.04). No differences were found between T30 and T1 in HSV.

CONCLUSIONS

Active warm-up increases MFO; however, vibration stimulus during half squatting does not increase MFO during a CPET in obese subjects. The lack of significant differences of cortisol concentrations in HSV during the recovery phase might suggest a long-term effect of WBV on the endocrine system.

Does whole body vibration therapy assist in reducing fat mass or treating obesity in healthy overweight and obese adults? A systematic review and meta-analyses

PURPOSE

This review describes the effects of Whole Body Vibration therapy (WBV) for reducing fat mass (%/kg) among healthy (no comorbid disease) overweight and obese adults.

MATERIALS AND METHODS

Systematic literature search was conducted using Medline, Embase, Cochrane, CINAHL, and PubMed databases up to 27^th March 2019. Studies evaluating the effects of WBV therapy on fat mass as a primary or secondary outcome among healthy (no comorbid disease), overweight or obese adults (Body Mass Index ≥25) were included.

RESULTS

Following the search, 2,420 studies were reviewed and 1,603 studies were selected for title and abstract screening. Of 153 studies considered for full-text review, 13 controlled trials were included in the systematic review. Two meta-analyses were performed for five studies. The first random effects (I² = 70%, p-value = 0.02) meta-analysis, revealed a statistically significant mean change for percent fat mass (-2.56, 95% CI: -3.81, -1.31). The second fixed effects meta-analysis, revealed a significant mean change (-1.91, 95% CI: -2.64, -1.18) for fat mass/kg.

CONCLUSION

This systematic review and meta-analyses indicate a positive effect of Whole Body Vibration therapy on reducing fat mass (%/kg), especially when combined with conventional weight loss interventions specifically, diet and exercise.IMPLICATIONS FOR REHABILITATIONWhole Body Vibration therapy may assist obese and bariatric clients with weight loss.Whole Body Vibration therapy with conventional weight loss strategies may augment reductions in fat mass among obese clients in rehabilitation setting.

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 training in obese subjects: A systematic review

OBJECTIVE

(i) to determine the outcomes of whole-body vibration training (WBVT) on obese individuals, and the intervention settings producing such effects; (ii) identify potential improper or harmful use of WBVT.

DESIGN

Systematic review.

DATA SOURCES

Medline, Scopus, Web of Science, PEDro and Scielo until July 2018.

ELIGIBILITY CRITERIA

Full papers evaluating the effect of WBVT on body composition, cardiovascular status and functional performance in obese adults. Papers with PEDro score<4 were excluded.

STUDY APPRAISAL AND SYNTHESIS

Risk of bias and quality of WBVT reporting were assessed with PEDro scale (randomized controlled trials) or TREND checklist (non-randomized studies) and a 14-items checklist, respectively. Weighted acceleration, daily exposure and Hedges' adjusted g were computed.

RESULTS

We included 18 papers published 2010-2017. Typical interventions consisted in three sessions/week of exercises (squats, calf-raises) performed on platforms vibrating at 25-40 Hz (amplitude: 1-2 mm); according to ISO 2631-1:1997, daily exposure was "unsafe" in 7/18 studies. Interventions lasting ≥6 weeks improved cardiac autonomic function and reduced central/peripheral arterial stiffness in obese women; 10 weeks of WBVT produced significant weight/fat mass reduction, leg strength improvements as resistance training, and enhanced glucose regulation when added to hypocaloric diet. No paper evidenced losses of lean mass. Isolated cases of adverse effects were reported.

SUMMARY

To date, WBVT is a promising adjuvant intervention therapy for obese women; long-term studies involving larger cohorts and male participants are required to demonstrate the associated safety and health benefits. The therapeutic use of WBVT in the management of obese patients is still not standardised and should be supported by an extensive knowledge on the causality between vibration parameters and outcomes.