June/July 2021 Issue

Focus on Fitness: Whole-Body Vibration Training
By Jennifer Van Pelt, MA
Today’s Dietitian
Vol. 23, No. 6, P. 52

The 19th and early 20th centuries introduced many devices promising easy ways to lose weight and/or become fit. Vintage “reducing machines” or “vibrating exercise belts” promised to tone muscles and shake off fat through the use of a large vibrating band around the abdomen that delivered vigorous vibrations to the body.

Fast-forward to the 1990s, as vibration evolved into whole-body vibration (WBV) platforms in athletic training and health club settings, followed by the availability of much less expensive devices for consumers in the 21st century. While its contribution to athletic fitness relative to other training methods is still under debate, WBV for therapeutic use is supported by decades of published evidence. However, its history of healing potential stretches back much farther.

The ancient Greeks and Romans used vibrations from modified tools and musical instruments as well as horse-drawn vehicles to heal wounds and other injuries. The therapeutic use of vibrations also was described in medical texts from various eras, including 16th-century Japan, 17th- and 18th-century France, 19th-century Scotland, and 19th- and early 20th-century America. Medical conditions for which therapeutic vibration has been used include bone fractures, rheumatic disorders, nervous system problems, muscle spasms, physical disabilities, CVDs, and digestive issues.1

WBV remained on the fringes of medical practice until the 1950s and 1960s, when Russian scientists embraced vibration—calling it “rhythmic neuromuscular stimulation”—for muscle and bone strength and recovery applications in astronauts and Olympic athletes. In the mid-1990s, when a Russian astronaut spent more than 400 days in space without the typical large loss of bone density from zero gravity after using WBV, interest from the medical and fitness communities exploded. In the late 1990s, a Dutch Olympic coach developed the most popular commercial WBV device—the Power Plate.1

Since then, smaller, less expensive devices for home use have become available for consumers. These devices also are used by personal trainers, physical therapists, and rehabilitation professionals due to their much lower cost compared with the Power Plate. Power Plate models generally cost more than $10,000; smaller WBV platforms are available for a few hundred dollars.

How Does WBV Work?
A WBV device consists of a vibrating platform with or without a connected handle that produces vibrations; these can be set at various frequencies and amplitudes. Frequency is the number of vibrations per second, measured in Hertz (Hz), while amplitude is the vertical distance the platform moves during vibrations and is measured in millimeters. Frequency can range from 3 to 50-plus Hz (ie, three to 50 vibration cycles per second). Amplitude generally is available as low or high, depending on the model. Higher frequencies and amplitudes deliver a more intense workout for muscles—for example, at a setting of 50 Hz, the muscles are contracting/relaxing 50 times per second.

WBV technology has evolved such that different types of vibration can be included in one device. Oscillating/pivotal, spiral/triplanar, and linear motions are available depending on the model. The different types of vibration are advertised for various uses, such as massage/lymphatic drainage, bone density increase, circulation improvement, muscle strength and balance, and more.

For WBV training, the user can simply stand on the platform set at a certain frequency for a few to several minutes. Alternatively, exercises such as squats, lunges, and weighted strength moves can be done while on the platform or stepping onto the platform. For upper body strengthening, push-ups or planks can be performed with the hands on the platform.

Due to the intensity of vibration delivered to the body during WBV, sessions are short, ranging from a few minutes to 15 minutes depending on the user and the desired results. For example, an older, deconditioned woman with low bone density would require a shorter session at lower frequency and amplitude than a competitive athlete using WBV for muscular strength training.

Published Evidence
Due to its long history, there’s a large body of research on WBV for many therapeutic uses. Enough evidence exists for researchers to perform advanced meta-analyses to determine the benefits of WBV. The strongest evidence is for therapeutic uses, not for fitness and athletic training. Early studies on bone mineral density (BMD) and muscle atrophy in astronauts fueled research on the benefits in older adults with osteoporosis, arthritis, and frailty. Recent studies on WBV for osteoporosis and arthritis include the following:

• A June 2020 meta-analysis of 16 randomized controlled trials (RCTs) evaluating different types of exercise training on bone mineral density in more than 1,600 older postmenopausal women found WBV significantly increased lumbar spine BMD compared with aerobic and resistance training.2
• A May 2020 RCT that included 43 postmenopausal women with osteoporosis found WBV training significantly increased leg muscle work, as well as lumbar and femoral BMD.3
• Another May 2020 RCT that included 58 postmenopausal women found WBV training significantly increased BMD at the femoral neck and lumbar spine compared with high-impact exercise. WBV and high-impact exercise also both improved functional mobility and depression symptoms.4
• A February 2021 RCT comparing WBV training with quadriceps strength training in 81 older adults with knee arthritis found no significant differences in pain and functional tests. However, WBV significantly improved isokinetic muscle strength around the knee joint.5

Recent studies of WBV to improve functioning in frail older adults include the following:

• A July 2020 RCT that included 117 frail participants living in a residential care facility evaluated short sessions of WBV training at 6 to 26 Hz. Researchers found that 16 weeks of low-frequency WBV improved performance on walking and other functional tests, and was easily used and accepted by frail older adults with no adverse effects.6
• A February 2020 study found that twice-weekly WBV for 12 weeks in frail nursing home residents improved knee extension strength and other physical performance measures with no adverse effects.7

Interestingly, WBV also may aid in managing type 2 diabetes and COPD, two conditions common in older adults. An October 2019 meta-analysis of seven studies of 279 older adults with type 2 diabetes compared WBV training with other exercise. WBV was associated with improvements in pain, blood circulation to the legs, glycated hemoglobin levels, and fasting blood glucose levels. It also was found to improve mobility, aerobic capacity, and balance.8 An October 2018 meta-analysis of eight RCTs including 365 patients with COPD found that WBV increased walking distance and functional exercise capacity.9

Research into many other applications of WBV training is vigorous and ongoing and is expected to reveal or confirm additional therapeutic benefits for older adults and other client populations.

— Jennifer Van Pelt, MA, is a certified group fitness instructor and health care researcher in the Lancaster, Pennsylvania, area.


References

1. Kaeding TS. The historical evolution of the therapeutic application of whole body vibrations: any lessons to be learned? Austin Sports Med. 2016;1(1):1003.

2. Mohammad Rahimi GR, Smart NA, Liang MTC, et al. The impact of different modes of exercise training on bone mineral density in older postmenopausal women: a systematic review and meta-analysis research. Calcif Tissue Int. 2020;106(6):577-590.

3. ElDeeb AM, Abdel-Aziem AA. Effect of whole-body vibration exercise on power profile and bone mineral density in postmenopausal women with osteoporosis: a randomized controlled trial. J Manipulative Physiol Ther. 2020;43(4):384-393.

4. Sen EI, Esmaeilzadeh S, Eskiyurt N. Effects of whole-body vibration and high impact exercises on the bone metabolism and functional mobility in postmenopausal women. J Bone Miner Metab. 2020;38(3):392-404.

5. Lai Z, Lee S, Chen Y, Wang L. Comparison of whole-body vibration training and quadriceps strength training on physical function and neuromuscular function of individuals with knee osteoarthritis: a randomised clinical trial. J Exerc Sci Fit. 2021;19(3):150-157.

6. Wadsworth D, Lark S. Effects of whole-body vibration training on the physical function of the frail elderly: an open, randomized controlled trial. Arch Phys Med Rehabil. 2020;101(7):1111-1119. 

7. Grubbs BF, Figueroa A, Kim JS, Contreras RJ, Schmitt K, Panton LB. Whole-body vibration training in frail, skilled nursing home residents. Int J Exerc Sci. 2020;13(3):140-156.

8. Gomes-Neto M, de Sá-Caputo DDC, Paineiras-Domingos LL, et al. Effects of whole-body vibration in older adult patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Can J Diabetes. 2019;43(7):524-529.e2.

9. Zhou J, Pang L, Chen N, et al. Whole-body vibration training - better care for COPD patients: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018;13:3243-3254.