Few people walking into a modern gym today or working with a physical therapist at a clinic know that the sleek modern equipment they’re using actually got its start over 150 years ago when Dr Jonas Gustav Zander, a Swedish doctor and orthopedist, was concerned with developing ways to rehabilitate patients debilitated by disease.
He started designing mechanical therapy machines very similar in purpose (if not in design) to many exercise and therapeutic machines used today—stationary systems that were a hodgepodge of weights, counterweights, cogs, wheels, pulleys and levers designed to create mechanical resistance that would aid in building muscle mass, strength and endurance in the men and women who used them.
Zander even designed a vibrating machine that employed a harness attached to different portions of the body, using it as an aid to increase movement and flexibility.
He called his approach mechanotherapy, and he institutionalized the approach, founding the Zander Therapeutical Institute in Stockholm. Despite initial resistance by doctors (no pun intended), his work soon proved so effective he was elected to the Royal Swedish Academy of Sciences. By 1906, his machines were featured in health spas and health institutes around the world, and mechanotherapy was officially defined as “the employment of mechanical means for the cure of disease.”
Two world wars interrupted growing interest in the field, and mechanotherapy languished until the 1970s, when American inventor and fitness guru Arthur Jones invented the Nautilus machines for high-intensity training. Zander’s vibration-based machine was resurrected even earlier in the 1960s, when scientists and doctors in the Russian cosmonaut program started researching ways to keep their cosmonauts fit in space.
Depending upon the symptom or symptoms to be treated, the therapist will instruct you to stand, sit or even possibly lie on the vibrating platform in one of a variety of positions. For example you could be standing upright (there is handlebar support) or in a partial squat position with knees slightly or more deeply bent.
Some machines use an up-and-down motion considered to be a “linear” motion while others vibrate in a pivoting motion called an oscillating movement. Linear machines mimic a jumping motion in the body (at a minuscule level), stimulating muscles on both sides of the body to contract at the same time. Oscillating movement devices have less vertical impact on the body and trigger muscles to contract alternately (like a regular walking motion).
Again, depending upon the therapeutic effect desired, the therapist adjusts the frequency of vibration (the number of vibrations per second) and the amplitude of the vibrations (the width or depth of the vibration) as well as the duration of the session.
Frequency plays more of a role in comfort, and the amplitude is what drives the force of the vibration that makes it more or less powerful. Sometimes the frequency and amplitude are varied within one session.
“Ultimately we’re trying to stimulate receptors in every area of the body,” says Dr James Bogash, DC. “Oscillating is a little bit easier for the body to adapt to than the straight up-and-down linear motion. Not enough research has been done one way or the other to find out. I think that’s because we haven’t asked the question enough.”
It is those rapid contraction/relaxation movements of the muscles trying to dampen the effects of the vibrational movement that gives the body a workout.
Bogash says treatments vary depending on the fitness and age of the patient. “The plan with seniors will be a lower-frequency session with a lower amplitude. With fit athletes, it’s just the opposite—although most people like a program that bounces between different settings.”
Scientists knew that stimulating circulation and keeping bone density levels high was critical for the cosmonauts’ health in space as well as for making their return to Earth’s gravity a comfortable rather than traumatizing event. Studies with rats were showing that just 10 minutes of mechanical vibratory stimulation plus weight training resulted in bone formation rates roughly equivalent to normal activity.
And so the use of vibrational plates in cosmonaut training was introduced. Although it is not yet being used in NASA training, many decades comparing the space programs of the US and the USSR shows it has been paying off for the Russians. Cosmonauts by far hold the record for the longest times in space over their US counterparts.
For the last 15 years something called whole-body vibrational therapy (WBVT) has been gradually making its way into health fields around the world as a physical therapy treatment.
“Whole-body vibration can be used in a whole range of diagnoses and movement dysfunctions,” says Myla Quiben, Associate Dean at the School of Health Professions at the University of North Texas Health Science Center in Fort Worth, Texas. A board-certified clinical specialist in neurologic physical therapy and geriatric physical therapy, she says it can be used to treat anything from a musculoskeletal diagnosis to more of a movement-based diagnosis for people with movement challenges.
“That includes individuals with cerebral palsy and neurological disorders that include Parkinson’s and stroke. It can be used in a wide range of diagnoses depending upon the outcome that you want from it. There are many potential reasons why people would use vibration therapy, including for treating spasticity from numerous neurological causes.”
As with any relatively new therapy, Quiben is quick to point out that although results from studies and anecdotal accounts of its usefulness are mostly positive, there are also inconclusive studies on WBVT, largely because there are so many variables in treatment methodology.
“How often do people go for this therapy?” she asks. “What about the vibration frequency? What about the treatment itself? Is it a one-time thing versus six weeks or over a year? Is it a 30-minute treatment? Is it 45 minutes? An hour? Are you looking at patients in the acute stage or the subacute or the chronic stage—that is, more than six months after a stroke? There are many factors that feed into the question: ‘Does it work?’”
Research shows there are multiple benefits to using whole-body vibrational therapy (WBVT). WBVT helps to:
Long-term vibrational stresses from driving tractors, trucks and heavy equipment or operating equipment that induces high vibrational effects, like jackhammers, have long been known to cause lumbar injuries, spinal injuries and subsequent back pain.
Unlike these long-term, high-impact occupational situations, whole-body vibrational therapy machines are quite safe to use.
Just be sure to keep your sessions short. Dr James Bogash advises clients to use the machine no more than 10 minutes per session.
If you are dealing with a bone fracture, sprain, torn ligament or other musculoskeletal injury, you should be sure to check with a health professional before using such a device. Dr Bogash advises that for in-home use, be sure not to buy a machine that produces g-forces (gravitational force equivalents) higher than 3 g.
Warning: Do not use a whole-body vibration device if pregnant.
One of the applications for whole-body vibrational therapy that comes to most people’s minds is treating postmenopausal women who are vulnerable to osteoporosis. Bone is a constantly changing tissue that breaks down and rebuilds over and over in a cycle of two separate processes called formation and resorption, which proceeds until and unless something interrupts the cycle, such as long-term bed rest, aging or even space flight. At that point, resorption wins out over formation, and bone density is lost.
Weight/strength training, which involves high-magnitude, low-frequency forces, helps. But even better results are obtained when “micro” training of muscles is introduced, which involves the low-magnitude, high-frequency forces that our bones are subject to during normal daily activities such as walking, standing and even sitting—forces that help the body coordinate movement, balance and posture. Which is exactly what whole-body vibrational therapy does.
“It’s like when you get up in the morning and your body feels stiff and achy, but the more you move around the better you feel,” says Dr James Bogash, DC, a chiropractor in Mesa, Arizona. “Through simple movement the body gets stimulated, and thus the brain is stimulated.
“The reality with whole-body vibration is that the body doesn’t like the vibrations, and all the muscles get involved, moving to dampen the effects. The machine is moving at up to 20 cps [cycles per second], and your muscles are all involved trying to react that fast to dampen that vibration, so you end up getting movement in the muscles that you might not be able to get otherwise.”
In a study reviewing literature on the effects of WBVT on postmenopausal women, seven out of 12 articles showed improvement in bone mineral density.1 The frequency of the machine used in the protocols varied from 12 to 90 Hz, and the duration of treatment, from two to 22 months.
Another study found that vibration therapy reduced chronic back pain and increased bone mineral density in the femoral neck (where the femur connects with the pelvis at the hip joint) and lumbar areas of postmenopausal women with osteoporosis.2
Bogash theorizes on one possibility for why whole-body vibrational training might be effective for bone formation. “Some time ago I learned that the stem cell precursor for bone and fat is the same,” he says. (Stem cells are cells that can transform into various other types of cells that the body requires, such as liver or brain cells.)
“High-frequency vibration such as you get from jogging or from a WBVT machine may be the signal that the stem cells should make bone instead of fat. Maybe exercise is really just the vibration that stem cells recognize as the right time to differentiate into bone, and thus becomes vastly important for bone health.”
One study indeed does show that WBVT increases stem cell levels in the blood.3 WBVT stimulates hormone production and neuromuscular performance in a similar fashion to resistance and explosive power training, by influencing proprioceptive feedback—the mechanism by which muscles, tendons and skin relay information about their position to the brain.4
WBVT can help improve balance and walking after a stroke,5 and many studies have shown that WBVT is effective for increasing physical strength and motor function in children and young adults with cerebral palsy.6
In one study, one aggressive session of vibrational therapy reduced spasticity and coordination difficulties in patients with cerebral palsy, with the researchers concluding that regular vibration treatments could result in “significant improvements in daily living.”7 Whole-body vibration has also been shown to improve balance and muscle strength in children with Down syndrome.8
WBV training reduces pain and improves function for people with knee osteoarthritis,9 and it improves vascular health—specifically arterial stiffness and blood pressure—as well as increasing muscle strength in young overweight and obese women.10
Diabetics show some improvement in neuropathic pain due to the increases in blood flow to the skin.11 And although the optimal number of WBVT treatments and their frequency and duration for treating back pain are unclear, studies show that it can reduce nonspecific low back pain and improve overall function.12
Of course all the studies reported here were done in relative isolation with no other adjunct treatments. Despite all this apparent success, Quiben hastens to advise that WBVT is far from a magic bullet, and the therapy should be part of a larger therapeutic plan with multiple approaches to deal with whatever health issue is being treated.
“It’s not the only thing that you should be doing,” she says. “Whole-body vibrational therapy helps people engage very early on in the rehabilitation process to better understand the types and availability of all the different alternative strategies available to them.”
Over 20 years ago, Jeff Leismer, CEO of VibeTech, was a biomedical engineering student at Michigan Technological University. While taking a class called “Aerospace Physiology and Bone Remodeling,” he became fascinated with the problem of bone density loss in astronauts in space. In microgravity, even using resistance weight training for two hours a day, astronauts lose bone density far faster than people who suffer from osteoporosis—up to 1.6 percent per month.
Under the US National Space Grant College and Fellowship Program, started by NASA in 1989 to fund research into possible space technology applications for the public sector, Leismer launched his graduate thesis research into bone disuse atrophy and the application of vibration to the human body, building a prototype vibration system that could deliver compressive loads similar to the way weight-bearing exercise would to the human body.
In 2010, he launched the company VibeTech, which now has four patents (and several pending) for proprietary therapeutic devices. Although not yet in use by NASA (final-phase tests are still being run in simulated microgravity), today his VibeTech One, a seated/reclining vibration machine, is being used under testing circumstances in several assisted-living communities for orthopedic issues and pain management. It is also being used on a trial basis for its calming effects on Alzheimer’s and dementia patients.
At an independent living condominium in Sheboygan, Wisconsin, the VibeTech One is additionally being used for strengthening the lower body extremities in older adults to help prevent falls and increase general mobility in residents.
“If you can design something for astronauts and keep them strong in space, that’s wonderful,” Leismer said. “But I look at that as a great test bed for developing things here on Earth.”1
Dr Bagash reports the case of a young, extremely fit basketball player who came to him after he had had the anterior cruciate ligament (ACL) repaired in one knee. The ACL is one of four major ligaments in the knee that help stabilize the knee joint.
Without a healthy ACL, the knee joint may become unstable during any sort of strenuous activity. It had been six months since his surgery, and he still didn’t feel stable enough to play. He was frightened that his knee would give out on any sudden turn.
“The receptors around the ACL weren’t firing the way they needed—they weren’t really awake,” says Bogash. “We did a short course of vibrational therapy. He was in really great shape, and he was able to be pretty aggressive with the machine, and that was it.”
After six sessions over the course of a couple weeks, the young man felt like he was ready for the court again. “The therapy woke up the knee. It was nothing more complicated than stimulating the communication between his knee and his brain.”
Another of Bogash’s patients was in his mid-seventies. He’d had a stroke several decades earlier, and at that point in his life, he was reliant on a motorized wheelchair.
“He couldn’t stand,” says Bogash, “so I told him to wheel his chair up to the machine and put his feet on the plate. I figured some stimulation was better than nothing.
“When I came back about three or four minutes later to check on him, he’d managed to tilt his chair enough to support him in standing up, and there he was, standing on the plate with this big smile on his face. His body really liked the sensations.”
James Bogash, DC, has had his whole-body vibrational machine for almost 20 years. In that time, he has found it effective for assisting patients rehabilitate after stroke, as well as for patients dealing with neurological disorders like Parkinson’s and multiple sclerosis. But he says the vast majority of his patients use it either for recovery from a sports injury or as a therapy that can be used to strengthen and improve sports performance in general.
“Over the years of having the machine, it’s utility shows up over and over with knee rehab with patients who had knee replacements and things like ACL [anterior cruciate ligament] tears,” he says. “It’s also a way to avoiding ACL repair in the first place, because it’s a way of exercising the ACL without really stretching it. The more input we have to the body and thus the brain, the better off we are.”
Many studies show the effectiveness of WBVT for sports injuries. Linear vibrational training (vibrations that go up and down instead of side to side) provides something called “anabolic mechanical signals”—a cue to increase metabolic function—to the bones, muscles and tendons.13 WBVT also improves awareness of body position (proprioception) and balance in athletes with reconstructed ACLs,14 and it improves flexibility in gymnasts.15
Studies show WBVT can result in “significant strength gain” comparable to a regular program of cardiovascular and resistance training. It also specifically increases knee-extensor strength16 and has the potential to substantially improve neuromuscular performance.17
It’s hard to imagine that a therapy with such an initially strong track record and roots going as far back as the mid-nineteenth century should still be considered “novel” and in its infancy. But that’s the case. And there are still some therapists who, because of early associations with harmful occupational vibration effects such as low back pain, remain skeptical. But overall, the pro-WBVT team is winning.
“A lot of post-stroke patients and others with neurological problems just can’t move well,” says Bogash. “They need a little help. And that’s what this therapy can provide. I have a lot of Parkinson’s patients who come in, buy a monthly pass package, and after that first month of sessions they disappear. And then it turns out they bought their own units at home. In a perfect world, you would use this therapy daily. And that’s what these people like to do.”
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A space-age therapy
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Milwaukee Business News, Jul 2, 2019. biztimes.com |
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