Advertisement

Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial

Published:March 04, 2020DOI:https://doi.org/10.1016/j.apmr.2020.02.009

      Abstract

      Objective

      To investigate the feasibility and benefits of whole-body vibration (WBV) exercise as a safe and effective training tool for countering sarcopenia and age-related declines in mobility and function in the frail elderly.

      Design

      An open, randomized controlled trial.

      Setting

      Residential care facilities.

      Participants

      Male and female volunteers (N=117; 82.5±7.9y).

      Interventions

      After prescreening for contraindications, participants were randomly allocated to a control, simulated WBV (SIM), or WBV exercise group. All participants received regular care, whereas WBV and SIM participants also underwent thrice-weekly exercise sessions for 16 weeks. Delivered by overload principle, WBV training began with 5 × 1-minute bouts at 6 Hz/2 mm (1:1 min exercise:rest), progressing to 10 × 1 minute at up to 26 Hz/4 mm, maintaining knee flexion. Training for SIM participants mimicked WBV exercise stance and duration only.

      Main Outcome Measures

      The timed Up and Go, Parallel Walk, and 10-m Timed Walk (10mTW) tests performance were assessed, in addition to the Barthel Index Questionnaire, at baseline, 8, and 16 weeks of exercise, and 3, 6, and 12 months postexercise.

      Results

      High levels of compliance were reported in SIM (89%) and WBV training (93%), with ease of use and no adverse effects. In comparison to baseline levels, WBV training elicited clinically important treatment effects in all parameters compared to SIM and control groups. Treatment effects remained apparent up to 12 months postintervention for Parallel Walk Test and 6 months for 10mTW Test. Functional test performance declined during and postintervention in non-WBV groups.

      Conclusions

      Findings indicate that 16 weeks of low-level WBV exercise provides easily accessible, adequate stimulus for the frail elderly to attain improved levels of physical functionality.

      Keywords

      List of abbreviations:

      10mTW (10-m Timed Walk Test), PWT (Parallel Walk Test), SIM (simulated WBV), TUG (timed Up and Go), WBV (whole-body vibration)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Cruz-Jentoft A.J.
        • Baeyens J.P.
        • Bauer J.M.
        • et al.
        Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people.
        Age Ageing. 2010; 39: 412-423
        • Taaffe D.R.
        Sarcopenia: exercise as a treatment strategy.
        Aust Family Physician. 2006; 35: 130
        • Beaudart C.
        • Rizzoli R.
        • Bruyère O.
        • Reginster J.Y.
        • Biver E.
        Sarcopenia: burden and challenges for public health.
        Arch Public Health. 2014; 72: 45
        • Arnold C.M.
        • Gyurcsik N.C.
        Risk factors for falls in older adults with lower extremity arthritis: a conceptual framework of current knowledge and future directions.
        Physiother Can. 2012; 64: 302-314
        • Landi F.
        • Marzetti E.
        • Martone A.M.
        • Bernabei R.
        • Onder G.
        Exercise as a remedy for sarcopenia.
        Curr Opin Clin Nutr Metab Care. 2014; 17: 25-31
        • Rubenstein L.Z.
        Falls in older people: epidemiology, risk factors and strategies for prevention.
        Age Ageing. 2006; 35: ii37-ii41
        • Liu C.J.
        • Latham N.K.
        Progressive resistance strength training for improving physical function in older adults.
        Cochrane Database Syst Rev. 2009; 3: CD002759
        • Frontera W.R.
        • Meredith C.N.
        • O'Reilly K.P.
        • Knuttgen H.G.
        • Evans W.J.
        Strength conditioning in older men: skeletal muscle hypertrophy and improved function.
        J Appl Physiol. 1988; 64: 1038-1044
        • Welle S.
        • Totterman S.
        • Thornton C.
        Effect of age on muscle hypertrophy induced by resistance training.
        J Gerontol A Biol Sci Med Sci. 1996; 51: M270-M275
        • Mayer F.
        • Scharhag-Rosenberger F.
        • Carlsohn A.
        • Cassel M.
        • Müller S.
        • Scharhag J.
        The intensity and effects of strength training in the elderly.
        Dtsch Arztebl Int. 2011; 108: 359
        • Barnett A.
        • Smith B.
        • Lord S.R.
        • Williams M.
        • Baumand A.
        Community-based group exercise improves balance and reduces falls in at-risk older people: a randomised controlled trial.
        Age Ageing. 2003; 32: 407-414
        • Gusi N.
        • Adsuar J.C.
        • Corzo H.
        • del Pozo-Cruz B.
        • Olivares P.R.
        • Parraca J.A.
        Balance training reduces fear of falling and improves dynamic balance and isometric strength in institutionalised older people: a randomised trial.
        J Physiother. 2012; 58: 97-104
        • Elskamp A.B.
        • Hartholt K.A.
        • Patka P.
        • van Beeck E.F.
        • van der Cammen T.J.
        Why older people refuse to participate in falls prevention trials: a qualitative study.
        Exp Gerontol. 2012; 47: 342-345
        • Vind A.B.
        • Andersen H.E.
        • Pedersen K.D.
        • Jørgensen T.
        • Schwarz P.
        Baseline and follow-up characteristics of participants and nonparticipants in a randomized clinical trial of multifactorial fall prevention in Denmark.
        J Am Geriatr Soc. 2009; 57: 1844-1849
        • Gusi N.
        • Raimundo A.
        • Leal A.
        Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial.
        BMC Musculoskelet Disord. 2006; 7: 92
        • Ruan X.Y.
        • Jin F.Y.
        • Liu Y.I.
        • Peng Z.I.
        • Sun Y.G.
        Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis.
        Chin Med J. 2008; 121: 1155-1158
        • Von Stengel S.
        • Kemmler W.
        • Bebenek M.
        • Engelke K.
        • Kalender W.A.
        Effects of whole-body vibration training on different devices on bone mineral density.
        Med Sci Sports Exerc. 2011; 43: 1071-1079
        • Bogaerts A.
        • Delecluse C.
        • Claessens A.L.
        • Coudyzer W.
        • Boonen S.
        • Verschueren S.M.P.
        Impact of whole-body vibration training versus fitness training on muscle strength and muscle mass in older men: a 1-year randomized controlled trial.
        J Gerontol A Biol Sci Med Sci. 2007; 62: 630-635
        • Cheung W.-H.
        • Mok H.-W.
        • Qin L.
        • Sze P.-C.
        • Lee K.-M.
        • Leung K.-S.
        High-frequency whole-body vibration improves balancing ability in elderly women.
        Arch Phys Med Rehabil. 2007; 88: 852-857
        • Kawanabe K.
        • Kawashima A.
        • Sashimoto I.
        • Takeda T.
        • Sato Y.
        • Iwamoto J.
        Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly.
        Keio J Med. 2007; 56: 28-33
        • Furness T.P.
        • Maschette W.E.
        • Lorenzen C.
        • Naughton G.A.
        • Williams M.D.
        Efficacy of a whole-body vibration intervention on functional performance of community-dwelling older adults.
        J Altern Complement Med. 2010; 16: 795-797
        • Iwamoto J.
        • Otaka Y.
        • Kudo K.
        • Takeda T.
        • Uzawa M.
        • Hirabayashi K.
        Efficacy of training program for ambulatory competence in elderly women.
        Keio J Med. 2004; 53: 85-89
        • Merriman H.L.
        • Brahler C.J.
        • Jackson K.
        Systematically controlling for the influence of age, sex, hertz and time post-whole-body vibration exposure on four measures of physical performance in community-dwelling older adults: a randomized cross-over study.
        Curr Gerontol Geriatr Res. 2011; 2011: 747094
        • Mori S.
        • Tuji S.
        • Kawamoto M.
        • et al.
        Six month whole body vibration exercises improves leg muscle strength, balance as well as calcaneal bone mineral density of community dwelled elderly.
        J Bone Miner Res. 2006; 21: S249
        • Bogaerts A.C.
        • Delecluse C.
        • Claessens A.L.
        • Troosters T.
        • Boonen S.
        • Verschueren S.M.P.
        Effects of whole body vibration training on cardiorespiratory fitness and muscle strength in older individuals (a 1-year randomised controlled trial).
        Age Ageing. 2009; 38: 448-454
        • Roelants M.C.
        Whole-body-vibration training increases knee-extension strength and speed of movement in older women.
        J Am Geriatr Soc. 2004; 52: 901-908
        • Verschueren S.M.
        • Roelants M.
        • Delecluse C.
        • Swinnen S.
        • Vanderschueren D.
        • Boonen S.
        Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study.
        J Bone Miner Res. 2004; 19: 352-359
        • Rubin C.
        • Recker R.
        • Cullen D.
        • Ryaby J.
        • McCabe J.
        • McLeod K.
        Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety.
        J Bone Miner Res. 2004; 19: 343-351
        • Bruyere O.
        • Wuidart M.-A.
        • Di Palma E.
        • et al.
        Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents.
        Arch Phys Med Rehabil. 2005; 86: 303-307
        • Bautmans I.
        • Van Hees E.
        • Lemper J.-C.
        • Mets T.
        The feasibility of whole body vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial.
        BMC Geriatr. 2005; 5: 17
        • Bowling A.
        Social networks and social support among older people and implications for emotional well-being and psychiatric morbidity.
        Int Rev Psychiatry. 1994; 6: 41-58
        • Bogaerts A.
        • Delecluse C.
        • Boonen S.
        • Claessens A.L.
        • Milisen K.
        • Verschueren S.M.P.
        Changes in balance, functional performance and fall risk following whole body vibration training and vitamin D supplementation in institutionalized elderly women. A 6 month randomized controlled trial.
        Gait Posture. 2011; 33: 466-472
        • Verschueren S.M.
        • Bogaerts A.
        • Delecluse C.
        • et al.
        The effects of whole-body vibration training and vitamin D supplementation on muscle strength, muscle mass, and bone density in institutionalized elderly women: a 6-month randomized, controlled trial.
        J Bone Miner Res. 2011; 26: 42-49
        • Zhang L.
        • Weng C.
        • Liu M.
        • Wang Q.
        • Liu L.
        • He Y.
        Effect of whole-body vibration exercise on mobility, balance ability and general health status in frail elderly patients: a pilot randomized controlled trial.
        Clin Rehabil. 2014; 28: 59-68
        • Álvarez-Barbosa F.
        • del Pozo-Cruz J.
        • del Pozo-Cruz B.
        • Alfonso-Rosa R.M.
        • Rogers M.E.
        • Zhang Y.
        Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+.
        Maturitas. 2014; 79: 456-463
        • Beaudart C.
        • Maquet D.
        • Mannarino M.
        • et al.
        Effects of 3 months of short sessions of controlled whole body vibrations on the risk of falls among nursing home residents.
        BMC Geriatr. 2013; 13: 42
        • Buckinx F.
        • Beaudart C.
        • Maquet D.
        • et al.
        Evaluation of the impact of 6-month training by whole body vibration on the risk of falls among nursing home residents, observed over a 12-month period: a single blind, randomized controlled trial.
        Aging Clin Exp Res. 2014; 26: 369-376
        • Lark S.D.
        • Wadsworth D.P.
        Physiological, psychological and functional changes with whole body vibration exercise in the elderly: FEVER methodology and protocols.
        Contemp Clin Trials. 2015; 44: 129-133
        • Holden M.K.
        • Gill K.M.
        • Magliozzi M.R.
        • Nathan J.
        • Piehl-Baker L.
        Clinical gait assessment in the neurologically impaired: reliability and meaningfulness.
        Phys Ther. 1984; 64: 35-40
        • Storey J.E.
        • Rowland J.T.J.
        • Conforti D.A.
        • Dickson H.G.
        The Rowland Universal Dementia Assessment Scale (RUDAS): a multicultural cognitive assessment scale.
        Int Psychogeriatr. 2004; 16: 13-31
        • Marín P.J.
        • Santos-Lozano A.
        • Santin-Medeiros F.
        • Robertson R.J.
        • Garatachea N.
        Reliability and validity of the OMNI-vibration exercise scale of perceived exertion.
        J Sports Sci Med. 2012; 11: 438-443
        • Lark S.D.
        • McCarthy P.W.
        • Rowe D.A.
        Reliability of the Parallel Walk Test for the elderly.
        Arch Phys Med Rehabil. 2011; 92: 812-817
        • Lark S.D.
        • Pasupuleti S.
        Validity of a functional dynamic walking test for the elderly.
        Arch Phys Med Rehabil. 2009; 90: 470-474
        • Sipilä S.
        • Multanen J.
        • Kallinen M.
        • Era P.
        • Suominen H.
        Effects of strength and endurance training on isometric muscle strength and walking speed in elderly women.
        Acta Physiol Scand. 1996; 156: 457-464
        • Hardy S.E.
        • Perera S.
        • Roumani Y.F.
        • Chandler J.M.
        • Studenski S.A.
        Improvement in usual gait speed predicts better survival in older adults.
        J Am Geriatr Soc. 2007; 55: 1727-1734
        • Shumway-Cook A.
        • Brauer S.
        • Woollacott M.
        Predicting the probability for falls in community-dwelling older adults using the timed Up & Go test.
        Phys Ther. 2000; 80: 896-903
        • Collin C.
        • Wade D.T.
        • Davies S.
        • Horne V.
        The Barthel ADL Index: a reliability study.
        Int Disabil Stud. 1988; 10: 61-63
        • Mahoney F.
        • Barthel D.
        Functional evaluation: the Barthel Index.
        Md State Med J. 1965; 14: 61-65
        • Shah S.
        • Vanclay F.
        • Cooper B.
        Improving the sensitivity of the Barthel Index for stroke rehabilitation.
        J Clin Epidemiol. 1989; 42: 703-709
        • Sterne J.A.
        • White I.R.
        • Carlin J.B.
        • et al.
        Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls.
        BMJ. 2009; 338: b2393
        • Cohen J.
        Statistical power analysis for the behavioral sciences.
        2nd ed. Lawrence Erlbaum Associates, Hillsdale, NJ1988
        • Page P.
        Beyond statistical significance: clinical interpretation of rehabilitation research literature.
        Int J Sports Phys Ther. 2014; 9: 726-736
        • Gardner M.M.
        • Buchner D.M.
        • Robertson M.C.
        • Campbell A.J.
        Practical implementation of an exercise-based falls prevention programme.
        Age Ageing. 2001; 30: 77-83
        • Robertson M.C.
        • Campbell A.J.
        • Gardner M.M.
        • Devlin N.
        Preventing injuries in older people by preventing falls: a meta-analysis of individual-level data.
        J Am Geriatr Soc. 2002; 50: 905-911
        • Thomas S.
        • Mackintosh S.
        • Halbert J.
        Does the ‘Otago exercise programme’ reduce mortality and falls in older adults?: a systematic review and meta-analysis.
        Age Ageing. 2010; 39: 681-687
        • Machado A.
        • García-López D.
        • González-Gallego J.
        • Garatachea N.
        Whole-body vibration training increases muscle strength and mass in older women: a randomized-controlled trial.
        Scand J Med Sci Sports. 2010; 20: 200-207
        • Rees S.
        • Murphy A.
        • Watsford M.
        Effects of vibration exercise on muscle performance and mobility in an older population.
        J Aging Phys Act. 2007; 15: 367-381
        • von Stengel S.
        • Kemmler W.
        • Engelke K.
        • Kalender W.A.
        Effect of whole-body vibration on neuromuscular performance and body composition for females 65 years and older: a randomized-controlled trial.
        Scand J Med Sci Sports. 2012; 22: 119-127
        • Merriman H.
        • Jackson K.
        The effects of whole-body vibration training in aging adults: a systematic review.
        J Geriatr Phys Ther. 2009; 32: 134-145
        • Marín P.J.
        • Rhea M.R.
        Effects of vibration training on muscle strength: a meta-analysis.
        J Strength Cond Res. 2010; 24: 548-556
        • Pollock R.D.
        • Woledge R.C.
        • Mills K.R.
        • Martin F.C.
        • Newham D.J.
        Muscle activity and acceleration during whole body vibration: effect of frequency and amplitude.
        Clin Biomech. 2010; 25: 840-846
        • Petit P.-D.
        • Pensini M.
        • Tessaro J.
        • Desnuelle C.
        • Legros P.
        • Colson S.S.
        Optimal whole-body vibration settings for muscle strength and power enhancement in human knee extensors.
        J Electromyogr Kinesiol. 2010; 20: 1186-1195
        • Rogan S.
        • Hilfiker R.
        • Herren K.
        • Radlinger L.
        • de Bruin E.D.
        Effects of whole-body vibration on postural control in elderly: a systematic review and meta-analysis.
        BMC Geriatr. 2011; 11: 72
        • Aoyama M.
        • Suzuki Y.
        • Kuzuya M.
        Muscle strength of lower extremities related to incident falls in community-dwelling older adults.
        J Gerontol Geriat Res. 2015; 4: 2
        • Carlucci F.
        • Mazzà C.
        • Cappozzo A.
        Does whole-body vibration training have acute residual effects on postural control ability of elderly women?.
        J Strength Cond Res. 2010; 24: 3363-3368
        • de Zepetnek J.O.
        • Giangregorio L.M.
        • Craven C.
        Whole-body vibration as potential intervention for people with low bone mineral density and osteoporosis: a review.
        J Rehabil Res Dev. 2009; 46: 529-542
        • Mikhael M.
        • Orr R.
        • Amsen F.
        • Greene D.
        • Fiatarone Singh M.
        Effect of standing posture during whole body vibration training on muscle morphology and function in older adults: a randomised controlled trial.
        BMC Geriatr. 2010; 10: 74
        • Cardinale M.
        • Rittweger J.
        Vibration exercise makes your muscles and bones stronger: fact or fiction?.
        J Br Menopause Soc. 2006; 12: 12-18
        • Di Giulio I.
        • Maganaris C.N.
        • Baltzopoulos V.
        • Loram I.D.
        The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture.
        J Physiol. 2009; 587: 2399-2416
        • Liao L.-R.
        • Ng G.Y.F.
        • Jones A.Y.M.
        • Chung R.C.K.
        • Pang M.Y.C.
        Effects of vibration intensity, exercise, and motor impairment on leg muscle activity induced by whole-body vibration in people with stroke.
        Phys Ther. 2015; 95: 1617-1627
        • Abercromby A.F.
        • Amonette W.E.
        • Layne C.S.
        • Mcfarlin B.K.
        • Hinman M.R.
        • Paloski W.H.
        Variation in neuromuscular responses during acute whole-body vibration exercise.
        Med Sci Sports Exer. 2007; 39: 1642-1650
        • Tieland M.
        • Dirks M.L.
        • van der Zwaluw N.
        • et al.
        Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial.
        J Am Med Dir Assoc. 2012; 13: 713-719