On Tuesday I took Ryan to Children’s Hospital in Washington, D.C. for a “bone clinic” to measure his skeletal health. The results were not as I had hoped, which was to gain bone strength. Everything I do with him still isn’t enough. He continues to slowly lose bone density. The good news is that his therapies (i.e., RT-300 FES Cycle, ActivCycle, HBOT, Range-of-motion, etc.) seemingly greatly reduced the rate of deterioration.

Still, without more intervention and left untreated it will only be a matter of years until he’s like a brittle old man. I refuse to allow this to happen! It’s means more work for me and only adds to all he already does, but that’s not what this is all about. 

Initially, we will probably use drug therapy to begin restoring bone density. This is a good start, but I don’t want it to be the ongoing therapy. My intent is to make that a short-term solution of just a few months; although it could be used long-term if needed. I’m aiming higher. In fact, it is my goal to restore his bone health completely. To do this, I need to find a way to emulate “normal” conditions that keep his skeleton strong. Normal? Well, like putting small bursts of jarring weight through his body. Think of it as what we do when we simply tap our foot or use a pencil to write.

My launching point was something the doctor said, almost in passing, as a potential practical remedy. Why was it an afterthought to her? Because, like every other therapy I already told you about in the opening paragraph, it is in clinical trial, she said. I could only think to myself that Ryan’s entire recovery is exactly the same — a clinical trial — and we (Team Diviney) brought him further than anyone would have ever imagined because we are pioneers. We, my friends, are the clinical trial!

So, what is it this time?

It’s vibration therapy.

Now, if you’re like me, the first thing you think of is one of those machines with a leather belt-strap attached to a motor. You know the one I’m talking about. The contraption that was passed-off a weight loss machine back in the 1950’s. Then I thought about the latest craze sweeping the fitness centers where there is usually a vibrating platform off in some corner of the gym. Yes, these have proven beneficial, but are too intense for Ryan. I tell you, if it wouldn’t have been said by a doctor I probably would have laughed and never thought about it again.

I made a mental note of it and went on my way, none the wiser.

After I returned home I started to research it. Always a cynic, I went into it convinced these miracle machines the doctor spoke of were the latest fitness gimmicks.  Surely, not suitable for an incapacitated person. Expecting the worst, I began my search at the most reputable source that came to mind, The American Council on Exercise.

Imagine my surprise when this always non-committal agency says it’s still too early to give a formal conclusion, but there’s a growing body of evidence that this therapy is legitimate. It read like they came just short of endorsing it. Yes, they are apparently convinced it improves bone density in certain populations, but there isn’t enough data to say all the other benefits it has.  Benefits that can help Ryan in important ways. Even at the hormonal level, which could help beat urinary tract infections.

Further into today’s post I share my research with you. Remember, I started out knowing absolutely nothing! Still, I want to share this for several reasons, but mostly because I want you to see is that I do my homework before doing what I’m about to do. That is, again, asking for your help to raise funds (as a targeted fundraiser) to purchase the machine. I’ll set up this campaign early next week and again humbly beg you to charge forward, at full-tilt, with me in to unchartered territory. My plan is to pay for this immediately, pending approval from Ryan’s Special Needs Trust Fund, then using you generous donations to replenish the fund.

Like every time before, I’m offering nothing more than my instincts that this is what needs to happen for Ryan’s well being. I promise that I’ll represent you well, through effective use of this equipment, for my son’s sake.

Geesh, who am I kidding anyhow? I just sound silly… as though I have something to valuable offer to you.

I’m sorry.

MY RESEARCH

Disclaimer: This research, which is given below as a summary of my total effort, is for my own purpose and should not be used by others. It is performed for a specific person (Ryan) with specific needs. I make no claims nor endorsements. This should never be considered medical, therapeutic, fitness, or any other type of advice. As with everything I write, it is my opinion and personal conclusions based upon information that I believe as true.

 

The History of Vibrational Therapy

In modern times, Whole Body Vibrational (WBV) Therapy is founded in Rhythmic Neuromuscular Stimulation (RNS) dating back to the 1960s. Professor W. Biermann, of the former East Germany, proported ‘cyclical vibrations’ capable of quickly improving the condition of joints. At the same time, although independently, Russian doctor Nazarov was experimenting with athletes.

For those who want to be technical, there is solid evidence that vibration therapy was used as treatment dating back to the ancient Greeks. The next documented use was by Dr. John Kellogg. This is who you might be thinking… the founder of the cereal enterprise. He was big into nutrition and fitness and even delved into water (hydro) and light (photo) therapies.

As the theories of WBV developed, Russian ballet dancers that tweaked their muscle discovered that vibration reduced healing time. They also discovered their strength and height of their leaps increased with just a mere 25% of time achieved through traditional training. Since then many athletes, like the Denver Bronco football team, discovered the benefits of WBV (also called “acceleration training”).

It was further pioneered by the Russian space program in rehabilitating cosmonauts who lost bone density and muscle strength in the zero-gravity of space. The therapy was later refined by NASA, as well as the European Space Agency, as they looked more closely at the optimum duration and intensity of the therapy. WBV has since become popular among doctors, chiropractors, and therapists for its wide health benefits. They learned that with WBV, a person can exercise almost all of the body’s muscle tissue all at once and growing research shows that WBV can increase balance, mobility, bone density, range-of-motion, and strength.

 

How Does It Work?

This is a bit technical, but for those who are curious it is an amazing process. WBV creates mechanical oscillations that engage muscle spindle fibers. From here, the brain sends a reflexive signal down the spinal cord that causes the muscles to fire. As the WBV machine vibrates muscle fibers, information is whisked back through the spinal cord where two things happen: a signal is sent along the sensory nerves to the many regions of the brain , including the somatosensory system (the system that processes touch) and the signal synapses within spinal cord neurons and a signal is carried along the motor nerves back to the muscle, resulting in contraction.

Studies show that the best results occur when WBV is used for less than fifteen minutes because, beyond this, there is a refractory period in which muscle contraction is not beneficial enough. Many feel short bursts, of about one minute at a time, is best when there is an equal one minute rest. In effect, a treatment would be 10 repetitions of one minute on, one minute off.

With WBV a great level of muscle contraction is achieved without weights that could stress ligaments and joints. So, vibration is effective for a wide variety of people, from the elderly to those with spine or extremity injuries that prevent them from holdings weights.

Whole body vibration machines users can sit or stand while receiving vibrations. The vibration, at a precise frequency and amplitude, is believed to engage muscle fibers which, in turn, stimulates bone growth. This is supported by recent studies in the United Kingdom and Belgium. 

Recovery from a broken bone or help in building strength to offset the advancement of osteoporosis is further aided by using WBV. The therapy is completely customizable to the user’s limitations, meaning that even a fragile person can benefit. Incremental frequency changes allow for progressive training. This is important so that an person can gradually build bone, muscle, and joint stability safely.

A person with diminished bone density, even full-blown osteoporosis, can do WBV by simply standing on the platform. The foot platform pivots on a fulcrum, causing weight shifts in every direction. The platform also sends upward vibrations through the body and stimulates almost every muscle fiber. Absent of any other involvement, the therapy still offers a complete workout. Remarkable! Of course, for those who are able they can incorporate other exercises while standing on the platform.

The Physics

Scientifically, the more accurate term for WBV is Acceleration Training, because it applies Newton’s second law of motion, which you might actually remember from high school physics:

F = M x A; where the force (F) on an object is a function of its mass (M) and its acceleration (A).

As it relates to physical therapy, you can think of force as the quantity of work performed. In order to benefit from therapy, a person must increase the forces on the body by increasing at least one of the two variables, mass or acceleration. Let me try to explain this a little better. Weight lifting increases mass, whereas vibration therapy increases acceleration. The vibrations are very quick and tiny movements. The changes of directions in the vibrating platform produce strong accelerating and decelerating forces, usually between 25 to 60 times per second (a.k.a. Hertz, or Hz). The body provides the mass and the vibration is the acceleration.

Got it? Yeah, I took me a while to understand it too.

By increasing one, or both, of these variables, you increase the amount of force on your body, which is what puts the “work” into your workout. A high quality Acceleration Training machine can generate forces from two to six Gs (gravity) depending on the frequency and amplitude settings used. So, even at the lowest setting, you are almost doubling your body weight in terms of applied forces.

When you stand on the vibrating platform, each muscle in your body reacts in a continuous flow of micro adjustments, contracting reflexively. This is important in Ryan’s case that it is reflexive, since voluntary movement is difficult. The up-and-down movement improves muscle tone. The left-to-right, and front-to-back movements improves balance and coordination. The net result is a dramatic improvement in strength and power, flexibility, balance, tone and leanness.

Consider this: If you apply 30 Hertz (30 cycles per second) for 30 seconds, simple multiplication equates to the triggering/stimulating of the neuromuscular system a total of 900 times in just half a minute. No wonder the results are so impressive!

 

 

Bone Mass Density

When using a vibration, the vibrational frequency is transferred throughout the muscular and skeletal systems. Given that the frequency is within the proper range (more on that later), the vibration is substantial enough to increase bone mass density. To be clear, this doesn’t make it a sure-fire cure for osteoporosis, but density is improved. In an “Osteoporosis International” study from April 2010, patients on bed rest or immobile, whole body vibration contributes to bone formation and minimizes bone loss. The study specifically measured and accessed bone mineral density in male patients restricted to bed for eight weeks. It determined that those men receiving consistent WBV had less bone leg loss than those who did not receive vibration therapy.

The machine’s gravitational force (a..k.a., G-Force), is greater than 1G — which is the pull of the earth’s gravity that we feel when walking — and achieves more in less time. This makes this kind therapy ideal for osteoporosis as well as those who want to avert it. WBV puts three-dimensional force on the bone (up-and-down, side-to-side, and front-and-back), resulting in increase in blood flow and osteoblasts (these are the cells responsible for bone formation located in the bone marrow).

Wolff’s law is a theory developed by the German anatomist and surgeon Julius Wolff (1836–1902) in the 19th century that states that bone in a healthy person or animal will adapt to the loads under which it is placed.

Utilizing Wolff’s Law, as muscles contract, the bone is stressed (the same as lifting weights) producing an increase in both muscular strength and plyometric strengths. Nerves, just as muscles, can atrophy (i.e., waste away) without adequate input.  The muscle contractions caused by WBV also help strengthen spinal cord neuropathways sent to the brain.

 

Strength

A 2003 study published in the British Journal of Sports Medicine, Whole Body Vibration Exercise: Are Vibrations Good For You?,”  found that this therapy can achieve strength gains similar to resistance training. An additional study at Catholic University researched the outcomes of WBV on muscle strength in men over sixty years, finding it to be as efficient as weight training. In this test, a group regularly stood on a vibration plate over a year, while another group lifted weights. A third group, the control group, did nothing over the course of the year. Both the WBV and weight training groups saw a significant increase in strength, while the control group showed none.

 

Balance

Although probably not an apparent benefit to Ryan, WBV also benefits here too. Purely from my gut instinct, I see this as a way to independently engage the hemispheres of the brain. I base this on a study from the International Journal of Sports Medicine,” where WBV was determined as effective with a younger audience of professional female dancers. The month-and-a-half study, conducted at the University of Wolverhampton, used WBV on dancers with functional ankle instability that caused difficulty in intricate movements. These dancers experienced marked gains in balance and movement.

 

Muscle Mass

The Catholic University studies that I mentioned earlier also looked at sarcopenia (the muscles loss related to age-related that can lead to diabetes, osteoporosis, and functional disability). The results were significant, concluding that vibration therapy has the potential to reverse or prevent age-related skeletal muscle loss. The ease of performing WBV therapy — study participants in this case simply stood on the machine — led researchers to recommend ongoing research.

Fortunately, vibration therapy has been extensively studied for dangerous effects at specific amplitudes and frequencies. What it suggests is low amplitude, low frequency mechanical stimulation is both safe and effective in exercising musculoskeletal structures. Specifically, the effects of WBV have been studied with specially-designed vibrating plates that create sinusoidal vibrations. These vibration plates, that oscillate, are currently on the market!

WBV therapy beefs up muscles by draining them of harmful toxins. The machine’s repeating motion acts as an isometric stimulator. This effectively expels muscle tissue toxins. You see, this is why those using this therapy are advised to drink plenty of water before and after sessions.

There’s a basic principle at work here, bone strength depends (and is relational) upon muscle strength. WBV machines touch every body muscle throughout the entire workout. 

 

Improved Mobility

Again, there is no immediate benefit to Ryan here, but I like that this therapy doesn’t cause marked fatigue. When used for elderly and institutionalized patients it does improve mobility. While resistance training also improves mobility, it can cause fatigue in performing the amount of exercise required to see benefits. With this population many are not even able to perform weight training. Immobile or limited mobility patients who used the vibration machine demonstrated significant improvements in mobility compared to those who performed isometric exercise only.

 

Improved Hormone Levels

For Ryan, this is a big deal. Hormone levels should be strived for by healthy living, first-and-foremost, and I do this with him already. Still, WBV can take testosterone and growth hormone to another level. This is immediately beneficial to Ryan since he is on testosterone replacement. It does this while also decreasing cortisol, which is a completely different from conventional training methods. Bosco, et al. proved that after 10 repetitions of WBV there is a tremendous effect on the hormonal system, by:

• 460% increase in Growth hormone,
• 7% increase in testosterone
• 27% decrease in cortisol

A similar study states WBV stimulates Growth Hormone secretion; thus reduces circulating cortisol and plasma glucose.

Overall, WBV is not stressful on the neuroendocrine system. Again, this is the opposite of most conventional training. Notably, a famous study done in 1995 by Frank Perna and Sharon McDowell states that cortisol levels spike 20 hours after conventional training. This stress can negatively affect the body’s recovery process. On the other hand, WBV Training decreases cortisol levels in the body during and after training.

 

Contraindications

Contraindications are reasons why this therapy could not be used or might be risky. It’s not to say that the therapy cannot be used even with risk, but people with conditions defined here must take extra consideration beforehand. However, despite the numerous benefits, WBV is not for everyone. The most common red flags are:

1. Recent prosthetics or any surgical hardware such as pins, coils, plates or pacemakers.
2.  Epilepsy
3.  Otosclerosis (an abnormal growth of bone in the middle ear). WBV can cause dizziness and vertigo.
4. Spondylosis, spondylolisthesis or recent, unhealed fractures
5. Chronic fatigue syndrome
6. Detached retina
7. Plaques or clots – thrombosis
8. Pregnancy or the use of IUDs
9. Cardiovascular disorders

 

Buyer Beware: Not All WBV Equipment are Created Equally

There are a vast amount of WBV machines currently on the market. Sadly, there are many that are cheaply constructed or imitations. Some can even have faulty construction that are downright dangerous! Knowing the market is key since even with the legitimate machines, not all machines will provide identical benefits or optimal therapy for certain conditions. In a nutshell, different types of machines vibrate differently. What I’m speaking about is the machine’s frequency and amplitude, as I explained earlier.

In my opinion, here’s what is fundamental when deciding upon WBV equipment:

• Solid Steel/Carbon Construction. Plastic platforms can, and do, break.
• Optional Settings/Automatic Programs. As Ryan makes gains I want the leeway to challenge him more.
• Adequate Weight Limit. If must handle Ryan’s weight (and perhaps the additional weight of the standing frame or wheelchair).
• Manufacturer/Seller. Like all fitness-related equipment, the company and their reputation must be spotless.
• How Loud Is It? Many machines are excessively noisy and can contribute to psychological stress.
• Warranty and Customer Service.  Hey, these things break and require constant maintenance.

One thing’s for sure, I’ll take my time and check the fine print when shopping for WBV equipment. A reliable, well-constructed platform will be a truly great therapy that will benefit Ryan for many years to come. I’ll test the machine myself to see how it feels when using it and afterwards. If it doesn’t feel good, I’ll take that as a red flag that the machine’s vibrations are not in tune with the body’s natural frequencies.

When evaluating machines, there are three basic types of movement they produce:

• Side-to-side (x axis)
• Front-to-back (y axis)
• Up-and-down (z axis)

No matter anything else, a machine must at least produce the up-and-down motion. This can be accomplished in three different forms and is considered a requirement of any quality platform:

1. Oscillating or Triangular. Actually, these are two distinct types, but they essentially produce the same effect. Think of this motion as the “see-saw effect” where the platform alternates; one side goes up, while the other goes down. 
2. Linear/Vertical. This moves the entire platform up-and-down at once, like a piston.
3. Sonic. This transmits sound waves up through the body and the platform is actually stationary. These can be either oscillating or linear.

Again, certain machines are more beneficial than others, in general. For example, it is well documented that linear types, although helpful, are not as effective as the other types. For Ryan, it would most benefit him to use a platform that achieves both improved bone density and positive effects on the lymphatic system.  The best type for this is sonic, as it is for almost every major concern. So, by now you probably guessed it. These sonic styles are also the most expensive. That’s not to say that the others might not be equally suited for concerns not listed in the table below. They just don’t work the best for Ryan.

[via http://www.wbvreviewed.com]

In particular, some foreign-made machines are particularly poor;  faulty electronics, buttons, cheap bearing,s and shoddy welds. I’ll pay attention to the frame support posts, the unit’s stability, the size of the platform, and the strength of the motor (weak motors have insufficient power to support the vibration capacity). Finally, some WBV machines produce a side-to-side type motion (“wobble board”) that should be avoided.

CONCLUSIONS

The current evidence indicates that WBV therapy is an effective therapy intervention in musculoskeletal structures. It would also appear that vibration might be an effective countermeasure to microgravity and muscular atrophy. However, for the sake of safe and effective progressions, it is important that I follow future studies to understand the neurophysiological effects of muscle/bone activation. Not only the optimal frequency and amplitude must be identified (specific to Ryan), but also the level of muscle activation that would more benefit him. Considering the current WBV research and technology, it is possible to conclude that the therapy seems safe for Ryan and the sonic delivery is most beneficial.  The initial appraoch is for him to stand and/or sit on vibrating plates for a relatively short time (less than ten minute for three to five times per week) with knees slightly flexed (to limit vibrations to the head). Occupational medicine research shows that prolonged exposure (i.e., greater than fifteen minutes per session) to WBV can have major negative effects and proper care must be taken to guarantee safety. 

 

Selected Sources and Research:

• The feasibility of Whole Body Vibration in institutionalized elderly persons and its influence on muscle performance, balance and mobility: a randomized controlled trial” I. Bautmans, E Van Hees, J.C. Lemper, T. Mets, BMC Geriatrics 2005 Vo 22 pp5-17.
• The Influence of whole body vibration on jumping performance” Bosco et al; Biol Sport 1998 Vol 15 pp 157-64.
• Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents.” O. Bruyere, M.A.Wuidart, E. Di Palma, M. Gourlay, O. Ethgen, F. Richy, J.Y.Reginster. Arch. Phys.Med. Rehabil 2005 Vol Feb 86(2) pp 303-7.
• Strength increase after whole-body vibration compared with resistance training.” 2003 Vol Jun 35(6) pp1033-1041.
• Effect of whole-body vibration exercise on lumbar bone mineral density, bone turnover, and chronic back pain in post-menopausal osteoporotic women treated with alendronate” Vol Apr 17(2) pp 157-63 chronic back pain).
• Whole-body vibration exercise leads to alterations in muscle blood volume.” Clinical Physiology 2001 Vol May 21(3) pp 377-382.
• Vibratory stimulation for the alleviation of chronic pain” T.C. Lundeberg; Acta Physiol Scand Supple 1983 Vol 523 pp1-51.
• Effects of 24 weeks of whole body vibration training on body composition and muscle strength in untrained females.” Int J Sports Med 2004 Vol Jan 25(1) pp1-5.
• Balance training and exercise in geriatric patients.” J Musculoskeletal Neuronal Interact 2000 Vol Sep 1(1) pp 61-5.
• Will whole-body vibration training help increase the range of motion of the hamstrings?” R. Van den Tillaar;J Strength Cond Res 2006 Feb: 20(1): pp 192-6.
• Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study.” Verschueren SM.; Jbone Miner. Res. 2004 Vol Mar 19(3) pp 352-9.