This was this month’s Journal Club article at the hospital.
What they did: Applied 3 different whole body vibration (WBV) protocols while performing static standing exercises (1. exercises with no WBV, 2. low intensity WBV + exercises, 3. high intensity WBV + exercises) on patients who had a chronic stroke (> 6 months post event) and hemiparesis. While doing the exercises, they had the patient’s biceps femoris and tibilais anterior hooked up to surface EMG, to monitor how the muscles’ activation changed between protocols and exercises.
What they were looking at (aka hypotheses): 1. higher intensity WBV = higher levels of EMG muscle activation, 2. different exercises would activate different muscles at different levels, 3. vibration would effect the involved and non-involved leg muscle activity the same, 4. vibration would effect the muscles the same regardless of muscle spasticity or motor impairment.
What they found: They proved ALL their hypotheses as true!
What I found interesting in this article were the exercises they chose. All the exercises were standing exercises that were held statically in the middle of the move for 10 seconds. I NEVER do any exercises like that with my patients. I tried some out (on even surface) with one of my higher level patients and they were tough on her! If nothing else, I may try out more of those static exercises as a progression from regular ol’ standing therex. I was also really excited about this paragraph, which I will bring along as a direct quote, because it is just that awesome:
“The effects of WBV on muscle activation may not be entirely restricted to the peripheral mechanisms (eg, reﬂex activation of muscles)36,37 but also may involve corticospinal and intracortical processes.38,39 Using transcranial magnetic stimulation, Mileva et al39 showed that, in a sample of healthy men, the application of WBV (30 Hz, 1.5 mm) during static squat exercises increased the motor-evoked potential of the TA muscle, indicating an increase in excitability of the corticospinal pathway. There was also evidence of a WBV-induced alteration of the intracortical processes (increased short-interval intracortical inhibition and decreased facilitation).39”
Meaning that the peripheral stimulation provided by the WBV also seems to show promise in central neuroplasticity! No, really, I am jumping up and down excited about that!
I wish we had WBV in my clinic. This isn’t the first good thing I’ve heard of it. Do you use WBV in your practice? Tell us about it!