Drug therapy is often used to overcome pain and relieve muscle spasms during the acute phase of an injury or illness. The second phase of treatment is rehabilitation and restoration of motor activity. Positive outcomes can be achieved through physiotherapy, therapeutic exercise, manual therapy and massage.
Appropriately selected massage techniques can strengthen the muscles, promote circulation and invigorate the entire body. The same effects can be achieved by employing a vibration platform. Vibratory massage enhances the elasticity of muscle fibers and prevents muscle atrophy. By frequently using a vibration machine such as the Vibra Pro Health over a short period of time, several essential benefits can be achieved. Ligaments are strengthened and circulation is improved. This results in an accelerated resorption of articular effusion and excretion of abnormal deposits in the periarticular tissues. Considering that during daily passive recreation, the blood is not sufficiently cleansed, it is easy to imagine what happens to an individual who has been incapacitated or bedridden for days or weeks. Even after sleeping, the body instinctively wants to stretch, causing the muscles to force the blood which contains toxins out of the veins and intercellular spaces.
Many experts, in particular Academician A.A. Mikulin, recommend vibro-gymnastics as a tool for rehabilitation. The regular shaking of the body increases blood pulsing in the veins and eliminates the accumulation of toxins and blood clots near the venous valves. Consequently, this "shaking of the body" is an effective tool in restoring a normal physical condition. In addition, vibration has a beneficial effect on blood vessel walls, strengthening them and improving elasticity.
While therapeutic vibration massage may be employed to improve blood flow to the affected parts of the body, it will also strengthen the back muscles and help to correct posture, which is necessary for optimal distribution of load on the spine.
Source: US National Library of Medicine National Institutes of Health
Whole-body vibration is the mechanical repetitive movement, or oscillatory motion, around an equilibrium point.38 It is delivered through the use of a vibrating platform on which static poses are held or dynamic exercises can be performed, depending on the type and force of the machine. Whole-body vibration exercise is a forced oscillation that transfers energy from a vibration platform to a human body.33 The vibrations generated by motors underneath the platform are transmitted to the person on the machine. Available vibration exercise platforms produce sinusoidal shaped oscillations described by their frequency, amplitude, and phase angle.33
The International Society of Musculoskeletal and Neuronal Interactions (ISMNI) developed consensus criteria to describe sinusoidal vibrations, the type of vibration currently used in whole-body vibration platforms. Vibration frequency is defined as the repetition rate of the oscillation cycle, and the frequency of oscillations per second is reported in hertz (Hz). The amplitude, which is the maximal displacement from the equilibrium position, is reported in millimeters (mm). Displacement in mm from the lowest to highest point of the vibrating platform position is the peak-to-peak displacement. Peak acceleration, defined as the maximal rate of change in velocity during an oscillation cycle, is a function of the frequency and of peak-to-peak displacement (meters/second*second). Peak acceleration is often expressed as multiples of Earth’s gravity (9.80665 meters/second*second) denoted by the symbol (g).38 While acceleration can be calculated from reported frequency and displacement, the ISMNI recommends reporting acceleration directly for consistency. Vibration acceleration distinguishes the acceptable dose of therapeutic whole-body vibration, as compared to the hazardous dose of vibration defined by the International Organization for Standardization (ISO). Even though available whole-body vibration platforms are meant to produce sinusoidal shaped oscillations, it is important to note that actual oscillations produced by the platforms may diverge from a pure sinusoidal shape, and the vibrations transmitted to human subjects may depend not only on the vibration parameters but also on the position of the individual on the platform and on the rigidity of the platform plates.38 Characteristics of whole-body vibration modalities are an essential part of patent applications. Patent claims for various platforms include direction, amplitude, frequency, and vibration acceleration (patents 20100049105; 20090269728; 20090076421; 20080009776; 20070290632; 20070225622; 20070219052; 20050251068).
Whole-body platforms can be further categorized by acceleration levels and by the way in which they apply vibration. Platforms that provide acceleration of less than 1 g are considered low intensity while those that provide acceleration of greater than 1 g are considered high intensity. Platforms where the left and right feet move up and down simultaneously are described as operating in a synchronous way. Platforms that use a reciprocating vertical displacement on the left and right side of a fulcrum are described as operating in a side-alternating way.38 Platforms that oscillate in three planes are described as tri-planar or elliptical.57 The ISMNI recommends that both the whole-body platform type and intensity be reported.
There are two different theories regarding the optimal settings for a vibration session. One theory proposes using amplitude and frequency settings that do not change during a single vibration session. The other theory proposes using a low amplitude setting along with various frequencies during the vibration session to engage different muscle frequencies.58 It is unclear which theory is best for specific individuals and outcomes.
The FDA has not approved whole-body vibration platforms for medical purposes; therefore, no FDA standards regulate their manufacture, and designs vary widely. An example of a whole-body vibration platform is shown in Appendix D. Some low-intensity platforms are small rectangular devices raised several inches off the ground, resembling a bathroom scale in size and shape, while some high-intensity platforms are larger and resemble typical exercise machines. Some platforms have safety features, such as a handrail for balance.
Low-intensity vibration platforms are currently marketed for home use for about $1,600. Some of these platforms automatically calibrate the treatment to each user’s weight and body mass index. Suggested treatment sessions involve standing on the platform for 10 minutes per day. Manufacturers advise that home use requires no supervision. Newer models are very low height and offer an optional wheelchair mount (e.g., www.livtherapy.com/products/index.html). Technological developments currently underway will allow individuals with mobility problems to use vibration platforms in a seated or supine position (e.g., http://vibetechglobal.com/prototype.aspx).
High-intensity vibration platforms produce a gravitational force greater than 1 g regardless of frequency. High-intensity whole-body platforms marketed as exercise equipment are used in clinical physical therapy or rehabilitation settings, exercise facilities, and in the home. Currently, no organization provides accreditation or training for vibration therapy use in professional settings. Some exercise facilities provide proprietary training to personal trainers (e.g., Powerplate, www.powerplate.com) for proper use in exercise programs, but this training is not specific to osteoporosis prevention or treatment.
Whole-body vibration therapy may offer advantages to individuals who cannot continue or do not want to continue or initiate pharmacological treatment to increase bone density. While bisphosphonates are a first line treatment for osteoporosis, associated adverse effects lead to treatment discontinuation in 10-15 percent of patients.59 Common adverse effects from bisphosphonates include minimal trauma atypical fractures, esophageal irritation, renal toxicity, acute-phase reactions, gastrointestinal toxicity, and osteonecrosis of the jaw.5,12,14-17 The percentage of patients persisting with bisphosphonate therapy for 1 year or more ranged from 17.9 percent to 78.0 percent.60 Therefore, a large percentage of patients receive no pharmacological treatments to prevent fractures. Whole-body vibration may offer an alternative for individuals unable to perform high-impact exercise, and the ease of use may result in better overall compliance. Disadvantages of whole-body vibration therapy include unknown long-term safety and out-of-pocket costs to the consumer.
Vibration exposure, therapeutic and occupational, presents safety concerns. Vibration has been recognized as an occupational hazard associated with low back pain,61,62 musculoskeletal problems,63 cardiovascular disorders,64 neurovestibular disorders65 and Raynaud’s syndrome.66 ISO has defined vibration limits for comfort, performance proficiency, and safety based on the known occupational hazards, and ISO 2631-1 defined high intensity vibrations (those that produce more than 1 g force) as hazardous regardless of frequency (http://www.iso.org/iso/iso_catalogue/catalogue_tc/catalogue_tc_browse.htm?commid=51514). Safety concerns for vibration as a therapeutic intervention include the possibility of an individual losing contact with the vibration platform and becoming air-bound when acceleration exceeds 1 g; the resulting impact as the feet return to the platform may be harmful for individuals with fragile bones.33 Vibration may also be harmful to the soft tissue organs of the head and chest. Further, since vibration transmissibility to the head and trunk can be altered by knee flexion and posture, an individual’s shifting of position on the platform may complicate accurate measurement of vibration in different body parts.33 Additionally, different body parts have their own resonant frequencies, and vibration platform-induced acceleration at frequencies greater than 20 Hz may match a resonant frequency for a particular body part. This would cause the acceleration experienced in that body part to be greater than those set on the platform, and this amplification may be harmful for individuals with fragile bones.67 Nomograms have been developed to estimate the safe length of time, frequency, and acceleration for using different whole-body vibration platforms for exercise based on the ISO standards and known occupational hazards of vibration.68
Key informants indicated that harms from whole-body vibration therapy may include plantar fasciitis, itchy legs, blurred vision, tinny hearing (tinnitus), white-finger disease (a secondary form of Raynaud’s syndrome), orthostatic hypertension, and aggravation of soft-tissue and joint injuries. Dislocation of an intraocular lens after cataract surgery may also be a concern, particularly since the population using whole-body vibration for osteoporosis prevention and treatment is at greater risk for cataract.69 Since various parts of the human body can resonate at different frequencies, and these frequency resonances can be highly individual, unintended injuries could occur without better understanding of the optimal vibration dosage and transmission to different parts of the body. Other concerns expressed by key informants included loss of balance and falls during platform use and lack of clear distinction between platforms intended for powered exercise and those intended for osteoporosis therapy.
NCBI - Comparative Effectiveness Technical Briefs, No. 10. Wysocki A, Butler M, Shamliyan T, et al. Rockville (MD): Agency for Healthcare Research and Quality (US); 2011 Nov.
A new treatment under study by NASA-funded doctors could reverse bone loss experienced by astronauts in space.
The familiar mantra of fitness buffs applies as much in space as it does on Earth -- perhaps more so. The bones and muscles of astronauts, freed from the familiar strains of gravity, can weaken alarmingly. Muscles atrophy relatively quickly, while bones lose mass during prolonged exposures to weightlessness.
Reducing muscle atrophy requires exercise -- and lots of it. Astronauts in space spend about two hours each day working out with the aid of exotic devices that rely on springs, elastic, and harnesses to provide resistance and mimic body weight.
Unfortunately, such "countermeasures" have not solved the problem of muscle or bone loss. It's an ongoing problem for astronauts -- and for researchers!
But now, perhaps, there could be a solution -- at least for bones: NASA-funded scientists suggest that astronauts might prevent bone loss by standing on a lightly vibrating plate for 10 to 20 minutes each day. Held down with the aid of elastic straps, the astronauts could keep working on other tasks while they vibrate.
The same therapy, they say, might eventually be used to treat some of the millions of people who suffer from bone loss, called osteoporosis, here on Earth.
"The vibrations are very slight," notes Stefan Judex, assistant professor of biomedical engineering at the State University of New York at Stony Brook, who worked on the research. The plate vibrates at 90 Hz (1 Hz = 1 cycle per second), with each brief oscillation imparting an acceleration equivalent to one-third of Earth's gravity. "If you touch the plate with your finger, you can feel a very slight vibration," he added. "If you watch the plate, you cannot see any vibration at all."
Although the vibrations are subtle they have had a profound effect on bone loss in laboratory animals such as turkeys, sheep, and rats.
In one study (published in the October 2001 issue of The FASEB Journal), only 10 minutes per day of vibration therapy promoted near-normal rates of bone formation in rats that were prevented from bearing weight on their hind limbs during the rest of the day. Another group of rats that had their hind legs suspended all day exhibited severely depressed bone formation rates -- down by 92% -- while rats that spent 10 minutes per day bearing weight, but without the vibration treatment, still had reduced bone formation -- 61% less.
These results show that the vibration treatment maintained normal bone formation rates, while brief weight bearing did not.
Clinton Rubin, a professor of biomedical engineering at SUNY Stony Brook and principal investigator for the study, cautions that more experiments are required before scientists can be sure that vibration therapy is effective for people. "Animals are different than humans," he notes. And even among humans there are important variables, like nutrition and genetic make-up. What works for post-menopausal women (who often suffer from osteoporosis) might not work for astronauts in space.
"The early results from the research with post-menopausal women are very encouraging -- but they are preliminary. To determine efficacy, we will need a larger scale clinical trial that runs for a longer period of time," Rubin says.
A broader "Phase III" clinical trial is currently being organized, which will provide a strong indication of the treatment's effectiveness for the general population of osteoporosis sufferers.
Whether astronauts would benefit from a vibration-plate regimen is a question that can only be fully answered by conducting experiments in space, Rubin says. Such tests have been proposed, but none are scheduled yet.
Rubin hopes that future experiments will reveal not only whether vibration therapy works, but also why. It's a bit of a puzzle because the treatment doesn't comfortably fit within the framework of conventional wisdom: Currently, most bone researchers believe that the stresses placed on bones by, e.g., bearing weight or strong physical exertion, signal the bone-building cells through some unknown chemical trigger to fortify bones. According to this thinking, the remedy for bone loss in space should be exercises that duplicate stresses on our muscles and skeletons experienced during a daily and active life on Earth.
Unfortunately, without the pull of gravity it is very difficult, if not impossible, to duplicate loads routinely experienced by our muscles and bones on Earth. The regimen of exercise that astronauts perform in space has shown some promise as a countermeasure, but not enough to protect long-voyaging astronauts from injury or bone fracture when they are re-exposed to gravity -- either here on Earth or on some other planet.
Muscles may appear to pull steadily and constantly when flexing -- like the pull of a stretched spring. But muscle contraction is more complex than that. Individual muscle cells in most skeletal muscles can't provide a sustained pull -- they can only apply a quick "twitch." To create a constant pull, the brain activates groups of muscle cells within a muscle (called "motor units") in a rapid, repeating pattern.
Source: Nasa Science News