Author Archives: Bob

Cellular and Humoral Immunological Parameters.

Cell Mol Immunol, 2015; 12(4): 483-92, PMID: 25382740 external link

Effects of 60-day bed rest with and without exercise on cellular and humoral immunological parameters.

Hoff P, Belavy DL, Huscher D, Lang A, Hahne M, Kuhlmey AK, Maschmeyer P, Armbrecht G, Fitzner R, Perschel FH, Gaber T, Burmester GR, Straub RH, Felsenberg D, Buttgereit F
1] Charite Universitatsmedizin Berlin, Department of Rheumatology and Clinical Immunology, Berlin, Germany [2] Deutsches Rheuma-Forschungszentrum (DRFZ), Berlin, Germany [3] Berlin-Brandenburg Center of Regenerative Therapies (BCRT), Berlin, Germany.


Purpose: Exercise at regular intervals is assumed to have a positive effect on immune functions. Conversely, after spaceflight and under simulated weightlessness (e.g., bed rest), immune functions can be suppressed. We aimed to assess the effects of simulated weightlessness (Second Berlin BedRest Study; BBR2-2) on immunological parameters and to investigate the effect of exercise (resistive exercise with and without vibration) on these changes.

Method: Twenty-four physically and mentally healthy male volunteers (20-45 years) performed resistive vibration exercise (n=7), resistance exercise without vibration (n=8) or no exercise (n=9) within 60 days of bed rest. Blood samples were taken 2 days before bed rest, on days 19 and 60 of bed rest. Composition of immune cells was analyzed by flow cytometry. Cytokines and neuroendocrine parameters were analyzed by Luminex technology and ELISA/RIA in plasma.

General changes over time were identified by paired t-test, and exercise-dependent effects by pairwise repeated measurements (analysis of variance (ANOVA)). With all subjects pooled, the number of granulocytes, natural killer T cells, hematopoietic stem cells and CD45RA and CD25 co-expressing T cells increased and the number of monocytes decreased significantly during the study; the concentration of eotaxin decreased significantly. Different impacts of exercise were seen for lymphocytes, B cells, especially the IgD(+) subpopulation of B cells and the concentrations of IP-10, RANTES and DHEA-S.

Results: We conclude that prolonged bed rest significantly impacts immune cell populations and cytokine concentrations. Exercise was able to specifically influence different immunological parameters.

Conclusion: In summary, our data fit the hypothesis of immunoprotection by exercise and may point toward even superior effects by resistive vibration exercise.

3 Weeks of WBV Improved Ankle JPS & Gait Variables

Physiother Can, 2016; 68(2): 99-105, PMID: 27909356 external link

Effects of Three Weeks of Whole-Body Vibration Training on Joint-Position Sense, Balance, and Gait in Children with Cerebral Palsy: A Randomized Controlled Study.

Ko MS, Sim YJ, Kim DH, Jeon HS
Department of Physical Therapy, The Graduate School, Yonsei University; Department of Occupational Therapy, College of Health and Welfare, Woosong University, Daejeon.


Purpose: To observe the effects of whole-body vibration (WBV) training in conjunction with conventional physical therapy (PT) on joint-position sense (JPS), balance, and gait in children with cerebral palsy (CP).

Methods: In this randomized controlled study, 24 children with CP were randomly selected either to continue their conventional PT or to receive WBV in conjunction with their conventional PT programme. Exposure to the intervention was intermittent (3 min WBV, 3 min rest) for 20 minutes, twice weekly for 3 weeks. JPS, balance, and gait were evaluated before and after treatment.

Results: Ankle JPS was improved after 3 weeks of WBV training (p=0.014). Participants in the WBV group showed greater improvements in speed (F1,21=5.221, p=0.035) and step width (F1,21=4.487, p=0.039) than participants in the conventional PT group.

Conclusion: Three weeks of WBV training was effective in improving ankle JPS and gait variables in children with CP.

Balance and Gait Function after Stroke

J Phys Ther Sci, 2016; 28(11): 3149-3152, PMID: 27942138 external link

The effects of visual control whole body vibration exercise on balance and gait function of stroke patients.

Choi ET, Kim YN, Cho WS, Lee DK
Department of Physical Therapy, Graduate School of Nambu University, Republic of Korea.


Purpose: This study aims to verify the effects of visual control whole body vibration exercise on balance and gait function of stroke patients.

Subjects and Methods: A total of 22 stroke patients were randomly assigned to two groups; 11 to the experimental group and 11 to the control group. Both groups received 30 minutes of Neuro-developmental treatment 5 times per week for 4 weeks. The experimental group additionally performed 10 minutes of visual control whole body vibration exercise 5 times per week during the 4 weeks. Balance was measured using the Functional Reach Test. Gait was measured using the Timed Up and Go Test.

Results: An in-group comparison in the experimental group showed significant differences in the Functional Reach Test and Timed Up and Go Test. In comparing the groups, the Functional Reach Test and Timed Up and Go Test of the experimental group were more significantly different compared to the control group.

Conclusion: These results suggest that visual control whole body vibration exercise has a positive effect on the balance and gait function of stroke patients.

Galileo Improves Exercise Capacity in Pulmonary Arterial Hypertension

Heart, 2017; (): , PMID: 28100544 external link

Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension: a randomised clinical study.

Gerhardt F, Dumitrescu D, Gartner C, Beccard R, Viethen T, Kramer T, Baldus S, Hellmich M, Schonau E, Rosenkranz S
Klinik III fur Innere Medizin, Herzzentrum der Universitat zu Koln, Cologne, Germany.


OBJECTIVE: In patients with pulmonary arterial hypertension (PAH), supportive therapies may be beneficial in addition to targeted medical treatment. Here, we evaluated the effectiveness and safety of oscillatory whole-body vibration (WBV) in patients on stable PAH therapy.

METHODS: Twenty-two patients with PAH (mean PAP>/=25 mm Hg and pulmonary arterial wedge pressure (PAWP)</=15 mm Hg) who were in world health organization (WHO)-Functional Class II or III and on stable PAH therapy for>/=3 months, were randomised to receive WBV (16 sessions of 1-hour duration within 4 weeks) or to a control group, that subsequently received WBV. Follow-up measures included the 6-min walking distance (6MWD), cardiopulmonary exercise testing (CPET), echocardiography, muscle-power, and health-related quality of life (HRQoL; SF-36 and LPH questionnaires).

RESULTS: When compared to the control group, patients receiving WBV exhibited a significant improvement in the primary endpoint, the 6MWD (+35.4+/-10.9 vs -4.4+/-7.6 m), resulting in a net benefit of 39.7+/-7.8 m (p=0.004). WBV was also associated with substantial improvements in CPET variables, muscle power, and HRQoL. The combined analysis of all patients (n=22) indicated significant net improvements versus baseline in the 6MWD (+38.6 m), peakVO2 (+65.7 mL/min), anaerobic threshold (+40.9 mL VO2/min), muscle power (+4.4%), and HRQoL (SF-36 +9.7, LPH -11.5 points) (all p<0.05). WBV was well tolerated in all patients, and no procedure-related severe adverse events (SAEs) occurred.

CONCLUSIONS: WBV substantially improves exercise capacity, physical performance, and HRQoL in patients with PAH who are on stable targeted therapy. This methodology may be utilised in structured training programmes, and may be feasible for continuous long-term physical exercise in these patients. TRIAL REGISTRATION NUMBER: NCT01763112; Results.

Res Gerontol Nurs, 2017; 10(1): 17-24, PMID: 28112354 external link

Muscle Mechanography: A Novel Method to Measure Muscle Function in Older Adults.

Taani MH, Kovach CR, Buehring B


Muscle function decline is a commonly observed process that occurs with aging. Low muscle function, an essential component of sarcopenia, is associated with negative outcomes, including falls, fractures, and dependency. Although many tools have been developed and are used to assess muscle function in older adults, most have important limitations.

Muscle mechanography is a novel method that can quantitatively assess muscle function by performing movements such as heel raises, chair rises, or jumps on a ground reaction force plate. It can also assess balance by measuring sway of the center of pressure.

Muscle mechanography promises to have advantages over currently used tools, appears to have better reproducibility, and can assess a broader range of physical function-from master athletes to frail individuals.

Older adults can safely perform muscle mechanography measurements. Further research is needed to determine whether muscle mechanography can predict outcomes such as falls, fractures, and mortality. [Res Gerontol Nurs. 2017; 10(1):17-24.].

Chemotherapy-related Peripheral Neuropathy

Exp Hematol Oncol, 2017; 6(): 5, PMID: 28194306 external link

A randomized exploratory phase 2 study in patients with chemotherapy-related peripheral neuropathy evaluating whole-body vibration training as adjunct to an integrated program including massage, passive mobilization and physical exercises.

Schonsteiner SS, Bauder Missbach H, Benner A, Mack S, Hamel T, Orth M, Landwehrmeyer B, Sussmuth SD, Geitner C, Mayer-Steinacker R, Riester A, Prokein A, Erhardt E, Kunecki J, Eisenschink AM, Rawer R, Dohner H, Kirchner E, Schlenk RF
grid.410712.1Department of Internal Medicine III, University Hospital Ulm, Albert Einstein Allee 23, 89081 Ulm, Germany.


BACKGROUND: Chemotherapy-induced polyneuropathy (CIPN) is a common toxicity after chemotherapy, immunomodulatory drugs or proteasome inhibitors, which is difficult to treat and may also have impact on quality of life. The objective of the study was to evaluate whole-body vibration (WBV) on the background of an integrated program (IP) including massage, passive mobilization and physical exercises on CIPN.

PATIENTS AND METHODS: In an exploratory phase-2 study patients with CIPN (NCI CTC grade 2/3) were randomized for WBV plus IP (experimental) to IP alone (standard). 15 training sessions within 15 weeks were intended. As primary endpoint we used chair-rising test (CRT) to assess physical fitness and coordination. In addition, locomotor and neurological tests and self-assessment tools were performed.

RESULTS: A total 131 patients with CIPN were randomized (standard, n = 65; experimental, n = 66). The median age was 60 (range 24-71) years; 44 patients had haematological neoplasms and 87 solid tumors. At baseline, all patients presented with an abnormal CRT. Fifteen (standard) and 22 (experimental) patients left the program due to progression/relapse or concomitant disease. There was no significant difference in the proportion of patients with normal CRT (<10 s) at follow up between experimental (68%) and standard (56%) (p = 0.20). All patients experienced less symptoms and pain (p < 0.001) and had improved CRT (p < 0.001) over time. WBV was significantly associated with a higher reduction of time needed for CRT (p = 0.02) and significantly improved warm-detection-threshold comparing baseline to follow-up assessment (p = 0.02).

CONCLUSION: Whole-body vibration on the background of an IP may improve physical fitness and coordination in patients suffering from CIPN. Trial registration Retrospectively registered at (ISRCTN 51361937) and (NCT02846844).

Cardiopulmonary response during severe COPD

ERJ Open Res, 2017; 3:00101-2016:

Cardiopulmonary response during whole-body vibration training in patients with severe COPD

Gloeckl R, Richter P, Winterkamp S, et al.
Dept of Respiratory Medicine and Pulmonary Rehabilitation, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany. 2Dept of Prevention, Rehabilitation and Sports Medicine, Klinikum rechts der Isar, Technical University of Munich (TUM), Muni


Background: Several studies in patients with chronic obstructive pulmonary disease (COPD) have shown
that whole-body vibration training (WBVT) has beneficial effects on exercise capacity. However, the acute cardiopulmonary demand during WBVT remains unknown and was therefore investigated in this study.

Method: Ten patients with severe COPD (forced expiratory volume in 1 s: 38}8% predicted) were examined on two consecutive days. On day one, symptom-limited cardiopulmonary exercise testing was performed on a cycle ergometer. The next day, six bouts of repeated squat exercises were performed in random order for one, two or three minutes either with or without WBVT while metabolic demands were simultaneously measured.

Results: Squat exercises with or without WBVT induced comparable ventilatory efficiency (minute ventilation (VE)/carbon dioxide production (VŒCO2): 38.0}4.4 with WBVT versus 37.4}4.1 without, p=0.236). Oxygen uptake after 3 min of squat exercises increased from 339}40 mLEmin.1 to 1060}160 mLEmin.1 with WBVT and 988}124 mL min.1 without WBV (p=0.093). However, there were no significant differences between squat exercises with and without WBVT in oxygen saturation (90}4% versus 90}4%, p=0.068), heart rate (109}13 bpm versus 110}15 bpm, p=0.513) or dyspnoea (Borg scale 5}2 versus 5}2, p=0.279).

Conclusion: Combining squat exercises with WBVT induced a similar cardiopulmonary response in patients with severe COPD compared to squat exercises without WBVT. Bearing in mind the small sample size, WBVT might be a feasible and safe exercise modality even in patients with severe COPD.

Galileo-Training helps MS

J Neurol Sci. 2016 Oct 15;369:96-101. doi: 10.1016/j.jns.2016.08.013. Epub 2016 Aug 5

 Vibration training improves disability status in multiple sclerosis: A pretest-posttest pilot study.

Yang F1, Estrada EF2, Sanchez MC2.

The purpose of this study was to examine the effects of an 8-week vibration training program on changing the disability level in people with multiple sclerosis (MS).

Twenty-five adults with clinically-confirmed MS underwent an 8-week vibration training on a side-alternating vibration platform. The vibration frequency and peak-to-peak displacement were set at 20Hz and 2.6mm, respectively. Prior to and following the training course, the disability status was assessed for all participants characterized by the Patient Determined Disability Steps (PDDS) and MS Functional Composite (MSFC) scores.

The training program significantly improved the PDDS (3.66±1.88 vs. 3.05±1.99, p=0.009) and the MSFC scores (0.00±0.62 vs 0.36±0.68, p<0.0001). All three MSFC components were improved: lower extremity function (9.37±4.92 vs. 8.13±4.08s, p=0.011), upper extremity function (dominant hand: 27.81±5.96 vs. 26.20±5.82s, p=0.053; non-dominant hand: 28.47±7.40 vs. 27.43±8.33s, p=0.059), and cognitive function (30.55±13.54 vs. 36.95±15.07 points, p=0.004).

Our findings suggested that vibration training could be a promising alternative modality to reduce the disability level among people with MS.


Mobility; Multiple Sclerosis Functional Composite; Patient Determined Disability Status; Side-alternating vibration Copyright © 2016 Elsevier B.V. All rights reserved.

PMID: 27653872 DOI: 10.1016/j.jns.2016.08.013


Galileo – Study Shows CP Improvement

A new clinical trial shows that adolescents and young adults with cerebral palsy (CP) enjoy stronger bones and greater mobility after training on a specialized vibration plate.

Researchers at the University of Auckland (New Zealand) and The Children’s Hospital at Westmead (Sydney, Australia) conducted a clinical trial in 40 participants (11.3–20.8 years of age) with mild to moderate CP to study whole-body vibration training (WBVT) effects on muscle function and bone health. Study participants underwent 20-week WBVT on a vibration plate for 9 minutes a day, 4 times a week. Assessment measures included a six-minute walk test, whole-body dual X-ray absorptiometry (DXA), lower leg peripheral quantitative computed tomography (pQCT) scans, and muscle function.
Dr. Silmara Gusso and the WBVT plate (Photo courtesy of the University of Auckland).
The patients stood barefoot on a special vibration plate that produced a see-saw movement, stimulating a movement similar to walking. The results showed that the 20 weeks of WBVT were associated with increased lean mass in the total body, trunk, and lower limbs. Bone mineral content and density also increased in the total body, the lumbar spine, and the lower limbs. Participants also improved the distance walked in the 6-minute walk test by 11 to 35%. The study was published on March 3, 2016, in Scientific Reports.

“We expected them to increase their bone mass and muscle mass, which is what happened. What we didn’t expect was that their day-to-day functioning would also improve,” said lead author Silmara Gusso, PhD. “The feedback from parents and caregivers about the changes they were noticing was especially encouraging: improved mood, greater maneuverability, and fewer falls. In a group with troublesome constipation vibration therapy was also unexpectedly beneficial.”

CP is the most common cause of physical disability in childhood, affecting two of 1,000 children, and usually appears at birth or in early infancy. Children with CP have impaired muscle function, reduced muscle and bone mass, and a higher-than-normal risk of bone fractures. Muscles that normally work in complementary action will simultaneously go into spasm, making movement difficult, and over time the muscles waste. Treatments to relieve the disorders’ effects are limited, and include botox injection, surgery, passive stretching, and injection of bisphosphonates to increase bone density.


Galileo in ICU

J Rehabil Med.
 2016 Mar 1;48(3):316-21. doi: 10.2340/16501977-2052.

Whole-body vibration therapy in intensive care patients: A feasibility and safety study.

Boeselt T1, Nell C, Kehr K, Holland A, Dresel M, Greulich T, Tackenberg B, Kenn K, Boeder J, Klapdor B, Kirschbaum A, Vogelmeier C, Alter P, Koczulla R.



Admission to the intensive care unit is associated with sustained loss of muscle mass, reduced quality of life and increased mortality. Early rehabilitation measures may counteract this process. New approaches to rehabilitation while the patient remains in bed are whole-body vibration alone and whole-body vibration with a dumbbell. The aims of this study are to determine the safety of whole-body vibration for patientsadmitted to the intensive care unit, and to compare the effects of these techniques in intensive care unit patients and healthy subjects.



Twelve intensive care unit patients and 12 healthy subjects using whole-body vibration for the first time were examined while lying in bed. First both groups performed whole body vibration over 3 min. In a second step whole body vibration with dumbbell was performed. In order to determine the safety of the training intensity, heart rate, oxygen saturation and blood pressure were measured. The study was approved by the Marburg ethics committee.


There were minor reversible and transient increases in diastolic blood pressure (p = 0.005) and heart rate (p = 0.001) in the control group with whole-body vibration with a dumbbell. In intensive care patients receiving whole-body vibration alone, there were increases in diastolic blood pressure (p = 0.011) and heart rate (p < 0.001).


This study demonstrates the feasibility of using whole-body vibration and whole-body vibration with a dumbbell for intensive care unit in-bed patients. No clinically significant safety problems were found. Whole-body vibration and whole-body vibration with a dumbbell might therefore be alternative methods for use in early in-bed rehabilitation, not only for hospitalized patients.

PMID: 26805786

Low-Magnitude Vibration Has No Effect

J Bone Miner Res. 2015 Jul;30(7):1319-28. doi: 10.1002/jbmr.2448.

Low-Magnitude Mechanical Stimulation to Improve Bone Density in Persons of Advanced Age: A Randomized, Placebo-Controlled Trial.

Kiel DP, Hannan MT, Barton BA, Bouxsein ML, Sisson E, Lang T, Allaire B, Dewkett D, Carroll D, Magaziner J, Shane E, Leary ET, Zimmerman S, Rubin CT.


Nonpharmacologic approaches to preserve or increase bone mineral density (BMD) include whole-body vibration (WBV), but its efficacy in elderly persons is not clear. Therefore, we conducted the Vibration to Improve Bone in Elderly Subjects (VIBES) trial, a randomized, placebo-controlled trial of 10 minutes of daily WBV (0.3g at 37 Hz) in seniors recruited from 16 independent living communities. The primary outcomes were volumetric BMD of the hip and spine measured by quantitative computed tomography (QCT) and biochemical markers of bone turnover. We randomized 174 men and women (89 active, 85 placebo) with T-scores -1 to -2.5 who were not taking bone active drugs and had no diseases affecting the skeleton (mean age 82 ± 7 years, range 65 to 102). Participants received daily calcium (1000 mg) and vitamin D (800 IU). Study platforms were activated using radio frequency ID cards providing electronic adherence monitoring; placebo platforms resembled the active platforms. In total, 61% of participants in the active arm and 73% in the placebo arm completed 24 months. The primary outcomes, median percent changes (interquartile range [IQR]) in total volumetric femoral trabecular BMD (active group (2.2% [-0.8%, 5.2%]) versus placebo 0.4% [-4.8%, 5.0%]) and in mid-vertebral trabecular BMD of L1 and L2 (active group (5.3% [-6.9%, 13.3%]) versus placebo (2.4% [-4.4%, 11.1%]), did not differ between groups (all p values > 0.1). Changes in biochemical markers of bone turnover (P1NP and sCTX) also were not different between groups (p = 0.19 and p = 0.97, respectively). In conclusion, this placebo-controlled randomized trial of daily WBV in older adults did not demonstrate evidence of significant beneficial effects on volumetric BMD or bone biomarkers; however, the high variability in vBMD changes limited our power to detect small treatment effects. The beneficial effects of WBV observed in previous studies of younger women may not occur to the same extent in elderly individuals.

Muscle Bone Relationship

Galileo® Training – the Muscle-Bone Relation 

During our lifetime bone adapts to the daily maximum forces, which act upon it. These maximum forces cause small, elastic deformations of the bone (typically about 0.1% to 0.2% of its length). If these deformations exceed a certain threshold, it stimulates bone growth, but if this deformation is below a second (lower) threshold, the bone is resorbed. Examples of this effect are the bone loss in astronauts during long-term space flights and in old people when they adopt a sedentary lifestyle. Both will suffer from a function-related bone loss, which can be easily confused with a pathological osteoporosis. Selective Galileo Training can compensate for the functional bone loss.

Resulting maximum forces during everyday movements

Somewhat surprisingly, the maximum forces acting on bones are not created directly by external influences, but by the muscles themselves.

This becomes clear when one takes the typical leverage ratios in the body into account. A good example is the ankle. A healthy person hopping on one leg (like when using a skipping rope) generates a force, which is roughly equivalent to 3.5 times the body weight.  Mainly the calf muscle, obviously, generates this force.

If we consider that the ratio between the distance from the forefoot to the ankle and the distance from the ankle to the Achilles tendon that is attached to the calf muscle, is approximately 3:1, the calf muscles must generate a force that corresponds to 10.5 times body weight in order to produce a force of 3.5 times the body weight at the forefoot (ground reaction force). Since the calf muscle requires an abutment, this force must therefore also act on the bone. So during everyday movements a force of 14 times body weight or more can act easily on the lower leg bones. For a person with a body mass of 80 kg this would correspond to over one ton, i.e., the weight of a small car.


For comparison: Hitting the ground with straight leg, a force equal to typically 2 or 3 times body weight is generated. In this case, however, there is no leverage, so that the same force acts on the bone. This simple example shows that, normally, the contribution of muscle forces on bone is significantly larger than external forces.

The peak forces described above in a healthy fit subject result in a deformation of bone between 1000 µStrain and 2000 µStrain. In a tibia length (shin-bone length) of about 40 cm this corresponds to a deformation between 0.4 mm and 0.8 mm. This shows the magnitude of the impact of everyday movements in bone strength.

This fact makes it clear that appropriate daily exercise is needed to avoid bone resorption. Targeted Galileo Training can help prevent this bone loss.


Galileo improves strength and balance in Diplegic cerebral palsy

Effect of whole-body vibration on muscle strength and balance in diplegic cerebral palsy: a randomized controlled trial.
Am J Phys Med Rehabil. 2014 Feb;93(2):114-21
El-Shamy SM


The purpose of this study was to investigate the effects of whole-body vibration training on muscle strength and balance in children with diplegic cerebral palsy.

Fifteen children were assigned to the experimental group, which received whole-body vibration training (9 mins per day, 5 days per week). Another 15 were assigned to the control group, which participated in a traditional physical therapy exercise program for 3 successive months. Baseline and posttreatment assessments were performed using the Biodex isokinetic dynamometer to evaluate the knee extensors peak torque at 60 degrees per second and 90 degrees per second and using the Biodex balance system to evaluate stability index.

The children in the experimental group showed a significant improvement when compared with those in the control group (P < 0.001). The peak torque at 60 degrees per second and 90 degrees per second after treatment was 28.8 ± 0.45 and 47.5 ± 0.7 N · m and 30.9 ± 0.68 and 54.2 ± 1.7 N · m for the control and the experimental group, respectively. The overall stability index after treatment was 2.75 and 2.2 for the control group and the experimental group, respectively.

Whole-body vibration training may be a useful tool for improving muscle strength and balance in children with diplegic cerebral palsy.


PMID: 24434887 [PubMed – indexed for MEDLINE]

Postural Control in Parkinsons

Res Sports Med. 2005 Jul-Sep;13(3):243-56.

Effects of random whole-body vibration on postural control in Parkinson’s disease.

Turbanski S, Haas CT, Schmidtbleicher D, Friedrich A, Duisberg P.


Institute of Sport Sciences, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.


We investigated spontaneous effects of random whole-body vibration (rWBV) on postural control in Parkinsonian subjects. Effects were examined in biomechanical tests from a total of 52 patients divided equally into one experimental and one control group. Postural control was tested pre- and post-treatment in two standardized conditions (narrow standing and tandem standing).

The intervention was based on rWBV (ŷ: 3 mm, f: 6 Hz/sec) consisting of 5 series lasting 60 seconds each.

The main findings from this study were that:

  1. rWBV can improve postural stability in Parkinson’s disease (PD) spontaneously
  2. these effects depend on the test condition.
  3. Based on the results of this study, rWBV can be regarded as an additional device in physical therapy in PD.

PMID: 16392539

28-Hz Vibration on Arm

Med Sci Sports Exerc. 2009 Mar;41(3):645-53. doi: 10.1249/MSS.0b013e31818a8a69.

The effects of a 28-Hz vibration on arm muscle activity during isometric exercise.

Mischi M, Cardinale M.


Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands.



The aim of this study was to evaluate activation and coactivation of biceps and triceps muscles during isometric exercise performed with and without superimposing a vibration stimulation.


Twelve healthy volunteers (age = 22.7 +/- 2.6 yr) participated in this study. The subjects performed five trials of isometric elbow flexion and five trials of elbow extension with increasing levels of force in two conditions: vibration (V) and normal loading (C). V stimulation was characterized by a frequency of 28 Hz. Surface EMG activity of biceps and triceps muscles was simultaneously measured by bipolar surface electromyography and assessed by the estimation of the root mean square (RMS) of the electrical recordings over a fixed 5-s interval. Frequency analysis was adopted to estimate the RMS related to muscle activation and to exclude the harmonics generated by movement artifacts due to V.


The analysis of the recordings revealed a significant EMG RMS increase when V was applied. On average, the EMG RMS of biceps and triceps during elbow flexion was, respectively, 26.1% (P < 0.05) and 18.2% (P = 0.15) higher than C. During elbow extension, the EMG RMS of biceps and triceps was 77.2% and 45.2% (P < 0.05) higher than C, respectively. The coactivation was assessed as the ratio between the activation of antagonist and agonist muscles during arm flexion and extension tasks. The results revealed an increase of coactivation during V exercise, especially for lighter loads.


This study shows that V exercise at 28 Hz produces an increase of the activation and the coactivation of biceps and triceps. This exercise modality seems therefore suitable for various applications.

PMID: 19204585

Vibration Effects Shoulder Motion

Int J Sports Med. 2009 Dec;30(12):868-71. doi: 10.1055/s-0029-1238288.

Handheld vibration effects shoulder motion.

Tripp BL, Eberman LE, Dwelly PM.


University of Florida, Applied Physiology & Kinesiology, Gainesville, USA.


We explored effects of handheld vibration on glenohumeral motion in competitive overhead-throwing athletes. We used a randomized, blinded pre-test post-test cross-over design. Each arm of each subject experienced 2 conditions (1-control, 1-experimental), each with pre-test and post-test measures; the order of which was randomized. Participants included Division-I baseball and softball players (n=35: age=20+/-2 yr, height=178+/-9 cm, mass=84+/-12 kg, years of sport participation=13+/-4 yrs). During the experimental condition, participants held a vibrating (2.2 mm, 15 Hz, 20 s), 2.55 kg (5.62 lbs) Mini-VibraFlex dumbbell in neutral glenohumeral rotation. During the control condition, participants held the still dumbbell (0 mm, 0 Hz, 20 s). Participants rested one min after each trial (3). We used a digital protractor to assess range of motion bilaterally, employing a standard technique for measuring maximal internal (IR) and external rotation (ER). Repeated-measures analyses of variance indicated that range of dominant IR increased 6.8% ( P=0.001, ES=0.16) after handheld vibration. Handheld vibration did not affect range of dominant ER ( P>0.05, 1-beta=0.20), non-dominant IR ( P>0.05, 1-beta=0.41), or non-dominant ER ( P>0.05, 1-beta=0.05).

Short bouts of handheld vibration increased dominant IR in collegiate baseball and softball athletes.These results suggest that handheld vibration may help maintain glenohumeral IR that is vital to the healthy and competitive throwing shoulder.

PMID: 19885779

Vibration Effects Mechanical Power & EMG

Eur J Appl Physiol Occup Physiol. 1999 Mar;79(4):306-11.

Influence of vibration on mechanical power and electromyogram activity in human arm flexor muscles.

Bosco C, Cardinale M, Tsarpela O.


University of Rome-Tor Vergata, Fondazione Don Gnocchi, Italy.


The aim of this study was to evaluate the influence of vibration on the mechanical properties of arm flexors. A group of 12 international level boxers, all members of the Italian national team, voluntarily participated in the experiment: all were engaged in regular boxing training. At the beginning of the study they were tested whilst performing forearm flexion with an extra load equal to 5% of the subjects’ body mass. Following this. one arm was given the experimental treatment (E; mechanical vibration) and the other was the control (no treatment). The E treatment consisted of five repetitions lasting 1-min each of mechanical vibration applied during arm flexion in isometric conditions with 1 min rest between them. Further tests were performed 5 min immediately after the treatment on both limbs. The results showed statistically significant enhancement of the average power in the arm treated with vibrations. The root mean square electromyogram (EMGrms) had not changed following the treatment but, when divided by mechanical power, (P) as an index of neural efficiency, it showed statistically significant increases. It was concluded that mechanical vibrations enhanced muscle P and decreased the related EMG/P relationship in elite athletes. Moreover, the analysis of EMGrms recorded before the treatment and during the treatment itself showed an enormous increase in neural activity during vibration up to more than twice the baseline values.

This would indicate that this type of treatment is able to stimulate the neuromuscular system more than other treatments used to improve neuromuscular properties.

PMID: 10090628

Vibration + Isometric Contractions

J Strength Cond Res. 2004 Nov;18(4):777-81.

Effect of vibration during fatiguing resistance exercise on subsequent muscle activity during maximal voluntary isometric contractions.

McBride JM, Porcari JP, Scheunke MD.


Musculoskeletal Research Center, Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA.


This investigation was designed to determine if vibration during fatiguing resistance exercise would alter associated patterns of muscle activity. A cross-over design was employed with 8 subjects completing a resistance exercise bout once with a vibrating dumbbell (V) (44 Hz, 3 mm displacement) and once without vibration (NV). For both exercise bouts, 10 sets were performed with a load that induced concentric muscle failure during the 10th repetition. The appropriate load for each set was determined during a pretest. Each testing session was separated by 1 week. Electromyography (EMG) was obtained from the biceps brachii muscle at 12 different time points during a maximum voluntary contraction (MVC) at a 170 degrees elbow angle after each set of the dumbbell exercise. The time points were as follows: pre (5 minutes before the resistance exercise bout), T1-T10 (immediately following each set of resistance exercise), and post (15 minutes after the resistance exercise bout). EMG was analyzed for median power frequency (MPF) and maximum (mEMG). NV resulted in a significant decrease in MPF at T1-T4 (p < or 0.05) and a significant increase in mEMG at T2 during the MVC. V had an overall trend of lower mEMG in comparison to NV. The mEMG and MPF values associated with NV were similar to previously reported investigations. The lower mEMG values and the higher MPF of V in comparison to NV are undocumented.

The EMG patterns observed with vibration may indicate a more efficient and effective recruitment of high threshold motor units during fatiguing contractions. This may indicate the usage of vibration with resistance exercise as an effective tool for strength training athletes.