Effects of Whole-Body Vibration on Functional Mobility, Balance, Gait Strength, and Quality of Life in Institutionalized Older People: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Effect of 10-Week Whole-Body Vibration Training on Falls and Physical Performance in Older Adults: A Blinded, Randomized, Controlled Clinical Trial with 1-Year Follow-Up

Whole-body vibration training (WBV) training has shown positive effects on bone strength, muscle strength, and balance, but the evidence on fall prevention is not yet persuasive. This study aimed to evaluate the effectiveness of WBV training in preventing falls and improving physical performance among older adults at fall risk. The study was an assessor- and participant-blinded, randomized, and controlled 10-week training trial with a 10-month follow-up. One hundred and thirty older adults (mean age 78.5 years, 75% women) were randomly allocated into the WBV group (n = 68) and the low-intensity wellness group (n = 62). Falls were prospectively collected using monthly returned and verified diaries. Physical performance was evaluated at baseline before randomization, after the intervention, and follow-up with established methods. The data were analyzed on an intention-to-treat basis. Negative binomial regression was used to estimate the incidence rate ratios for falls, and Cox regression models were used to calculate the hazard ratios for fallers. Between-group differences in physical performance were estimated by generalized linear mixed models. The retention rate was 93%, and the mean adherence to the WBV training was 88% and 86% to the wellness training. Sixty-eight participants fell at least once, and there were 156 falls in total. In the WBV group, the incidence rate of falls was 1.5 (95% confidence interval 0.9 to 2.5) compared to the wellness group (p = 0.11). The hazard ratio for fallers in the WBV group was 1.29 (0.78 to 2.15) (p = 0.32). There was no between-group difference in physical performance after the training period, but by the end of the follow-up, WBV-related benefits appeared. The chair-rising capacity was maintained in the WBV group, while the benefit disappeared in the wellness group (p = 0.004). Also, the 0.5-point difference in short physical performance battery (SPPB) score favored WBV training (p = 0.009). In conclusion, progressive side-alternating WBV training was feasible and well-tolerated among fall-prone older adults. During the one-year follow-up, WBV training was associated with improved physical performance but did not prevent falls compared to chair-based group exercises.

Intervention Hypothesis for Training with Whole-Body Vibration to Improve Physical Fitness Levels: An Umbrella Review

Whole-body vibration (WBV) is a training modality, and it seems to be a safe and efficient exercise especially to improve different aspects of physical fitness in different populations. The protocols for WBV are still not standardized. The difficulty in comparing the data confuses the real efficacy of this instrument. Consequently, the objective of this umbrella review is to analyze the protocols previously adopted and eventually to propose a standard operating procedure for WBV training. Systematic review and meta-analysis of randomized controlled trials on WBV were searched on the electronic databases PubMed, Web of Science, and Scopus until 18 March 2024. A quality assessment of the studies included has been performed. A total of 20 studies were included in this umbrella review and frequency, magnitude, and amplitude intensity data were recorded. Detailed information about the protocols (static or dynamic exercises, barefoot or with shoes, intensity duration, weekly frequency, and vibration characteristics) was also collected. WBV presents widely different protocols. Consequently, a standard operating procedure has not been proposed for WBV training. A hypothesis of intervention was instead written in which parameters for frequency, amplitude, acceleration, and training mode were proposed.

Whole-Body Vibration to Improve Physical Function Parameters in Nursing Home Residents Older Than 80 Years: A Systematic Review With Meta-Analysis

OBJECTIVE

Loss of functional independence is more likely in older adults who reside in an institution as a consequence of a decline in muscle mass and a loss of force production capacity. The aim of this review was to assess the effect of whole-body vibration (WBV) interventions on the strength, balance, and mobility of nursing home residents older than 80 years.

METHODS

An electronic search in MEDLINE, Scopus, and CINAHL databases was conducted. Randomized controlled trials that involved nursing home residents older than 80 years, that investigated WBV interventions compared with nonintervention, usual care, or placebo, and that measured physical function outcomes including strength, balance, gait, and mobility were included. Risk of bias was assessed by 2 reviewers using the Physiotherapy Evidence Database scale. The standardized mean differences (SMD) between the experimental and control groups were calculated with a random-effects model for each outcome, and subgroup analysis was conducted for different outcomes.

RESULTS

In total, 2864 articles were identified; of these, 14 randomized controlled trials met the inclusion criteria. The meta-analysis revealed that WBV significantly increased the lower limb muscle strength (SMD = 0.59; 95% CI = 0.16 to 1.03), mobility (SMD = 0.45; 95% CI = 0.10 to 0.81), gait score (SMD = 0.26; 95% CI = 0.01 to 0.51), balance (SMD = 0.41; 95% CI = 0.01 to 0.81), and physical performance (SMD = 1.33; 95% CI = 0.33 to 2.33).

CONCLUSION

WBV may be an effective intervention to improve the strength, balance, mobility, walking ability, and physical performance of older nursing home residents.

IMPACT

WBV presents a safe, accessible alternative for improving health in this vulnerable population, warranting further research and integration into health care practices.

Effect of Whole-Body Vibration on Balance or Proprioception in Nonspecific Chronic Low Back Pain: A Systematic Review

Objective

This systematic review aimed to investigate the effect of whole-body vibration (WBV) on balance or proprioception for patients with nonspecific chronic low back pain (NSCLBP).

Methods

A comprehensive search was conducted using 5 databases-PubMed, Web of Science, Cochrane Library, Science Direct, and Physiotherapy Evidence Database-from inception to January 2022. Randomized clinical trials that examined the efficacy of WBV on balance or proprioception in patients with NSCLBP were incorporated. The methodological quality of each included study was assessed using the Physiotherapy Evidence Database scale.

Results

Our search strategy yielded 5309 articles, of which 7 published randomized clinical trials (313 patients) met the inclusion criteria. Three of the 4 included studies that investigated balance reported significant improvements after WBV, of which 2 were of high methodological quality. The remaining 3 studies investigating proprioception also showed significant improvements after WBV intervention.

Conclusion

Although some studies seem to provide promising results regarding the efficacy of WBV or WBV combined with exercise in improving balance and proprioception in patients with NSCLBP, at present, no definite conclusions can be drawn due to article heterogeneity and lack of clinical trials.

Effects of Physical Activity on Physical and Mental Health of Older Adults Living in Care Settings: A Systematic Review of Meta-Analyses

Previous studies included in meta-analyses have highlighted the effects of physical activity on the physical and psychological health of older adults living in care settings. We conducted a systematic review of meta-analyses, of institutionalized older adults, to evaluate and conduct a narrative synthesis of the results of these meta-analyses. A literature search was conducted in three databases (PubMed, Web of Science, and Cochrane Library) until 22 March 2023. After screening the identified articles with the PRISMA criteria filters, we included 11 meta-analyses in this systematic review. Higgins' (2013) assessment tool of the meta-analyses demonstrates that the studies were of good quality although future meta-analyses need to provide more information on the treatment of missing data. A summary of the results of these meta-analyses shows that physical activity reduces the rate of falls, mobility issues, functional dependence, and depression, and improves health status. Future studies need to focus on new ways to promote and adapt physical activities to increase the participation of older adults in care settings.

Use of surface electromyography to evaluate effects of whole-body vibration exercises on neuromuscular activation and muscle strength in the elderly: a systematic review

PURPOSE

Reduction of muscle strength and lean mass, increase in the risk of falls, higher mortality, and morbidity are observed in geriatric syndromes. Physical activity is an effective intervention in reducing signs and symptoms of geriatric syndromes. Whole-body vibration exercise (WBVE) is an intervention with low cost and has been effective.

MATERIALS AND METHODS

The aim of this systematic review aimed to determine the effects of WBVE on neuromuscular activation and muscle strength in the elderly. Searches in PubMed, Embase, Science direct, and Scopus databases were conducted. Six studies, that analyzed the use of surface electromyography evaluating effects of WBVE on neuromuscular activation and muscle strength in the elderly, published in English, were included.

RESULTS

Six studies were included. One hundred forty-six individuals participated in the studies and 24 were males (16.43%), with an average age of 74.20 ± 7.66 years. Five publications were defined as "fair" methodological in the PEDro scale, the risk of bias was high and the risk of bias for non-randomized studies was moderate/high. In general, increased strength muscle was reported in the studies.

CONCLUSION

This systematic review suggests that WBVE might promote desirable neuromuscular responses in healthy elderly. However, it is necessary to perform further studies to reinforce the reported findings.IMPLICATIONS FOR REHABILITATIONThe reduction in lean mass and consequent reduction in muscle strength are present in healthy elderly people and the whole-body vibration exercise can reduce or alleviate these symptoms caused by the geriatric syndrome.Whole-body vibration exercise is a training modality that increases neuromuscular activation and muscle strength.Surface electromyography is a useful tool for the evaluation of the neuromuscular activation of the muscle fibers.

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.

Effectiveness of Whole-Body Vibration Training to Improve Muscle Strength and Physical Performance in Older Adults: Prospective, Single-Blinded, Randomized Controlled Trial

Whole-body vibration training (WBVT) is emerging as an alternative exercise method that be easily performed by older adults. This clinical trial investigates the efficacy of WBVT in improving muscle strength and physical performance before resistance exercise, in comparison to conventional resistance exercise after stretching exercise in older adults. The WBVT group (n = 20) performed WBVT using a vibrating platform (SW-VC15™), followed by strengthening exercises. The control group (n = 20) performed stretching instead of WBVT. Both groups underwent a total of 12 sessions (50 min per session). The primary outcome was isokinetic dynamometer. The secondary outcomes were grip strength, short physical performance battery (SPPB), a 36-Item Short Form Survey (SF-36), and body composition analysis. In all results, only the time effect was significant, and the group effect or time x group effect was not. Both groups showed a significant increase in isokinetic dynamometer. Although there was no significant group effect, the increase in mean peak torque was greater in the WBVT group. The only WBVT group showed significant improvement in SPPB. In SF-36, only the control group showed significant improvements. WBVT can be safely performed by older adults and may be an alternative exercise method to boost the effect of strengthening exercise.

Whole-body vibration training versus conventional balance training in patients with severe COPD-a randomized, controlled trial

BACKGROUND

Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training.

METHODS

48 patients with severe COPD (FEV₁: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5-26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses.

RESULTS

Static balance performance improved significantly more (p = 0.032) in favor of WBV (path length during semi-tandem stand: - 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more (p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. - 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s², p = 0.018 vs. 0.01 ± 0.11 m/s², p = 0.71).

CONCLUSIONS

WBV can improve balance performance and muscular power significantly more compared to conventional balance training.

TRIAL REGISTRATION

Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03157986&cntry=&state=&city=&dist  = .

Whole-body vibration promotes lipid mobilization in hypothalamic obesity rat

OBJECTIVES

This study aimed to analyze the effect of whole-body vibration (WBV) on metabolic parameters using the monosodium l-glutamate (MSG) model of obesity.

METHOD

MSG-obese rats that were exposed to WBV on a vibrating platform with 60 Hz frequency, 2 mm amplitude, three times/week, 10 min/day, during eight weeks (from postnatal day (PN) 80 to PN136). Blood glucose, creatine kinases (CK and CK-MB) and lipid profile through plasma and liver levels of lipids and lipoproteins were evaluated. Morphology and oxidative stress of adipose and hepatic tissues were further evaluated.

RESULTS

When performing a WBV exercise, animals showed contrasting metabolic responses. Vibration Control group (CTL-WBV) presented a reduction in CK and liver triacylglycerol, an increase in glucose, lactate, total cholesterol, liver cholesterol, and LDL while MSG Vibration group (MSG-WBV) showed an increase in total triacylglycerol, VLDL, lactate, CK, liver cholesterol, additional liver lipid peroxidation and LDL, total cholesterol and CKMB reduction.

CONCLUSION

Even although the MSG is a model of impacting injury, the metabolic demand of WBV exercise was able to induce mobilization of substrates, highlighting the lipid mobilization in obese animals, it should be used as a metabolic rehabilitation tool in patients with metabolic diseases, such as obesity and diabetes.