Mechanical vibration

Related Terms

Biomechanical muscle stimulation, BMS, energy medicine, massage therapy, mechanical vibration, myotatic stretch reflex, occupational therapy, physical therapy, Power Plate?, vibration, vibration healing, vibration medicine, vibration therapy, WBV, whole body vibration.

Background

Vibration healing (also called vibration therapy) is the use of mechanical vibration to prevent, treat, and promote recovery from a variety of physical ailments, including pain, sports injuries, and bone density loss.
Vibration therapy involves the application of vibration to part or all of the body. This vibration is delivered through a variety of massage tools and/or specialized equipment found in clinical and health club environments, as well as sometimes available for home use.
Ancient Greeks promoted vibration therapy to heal the local stagnation of blood (bruising) and increase joint mobility (arthritis). Practitioners created vibration by placing a long piece of wood, which an assistant held, over the affected area. The practitioner would then use the patient's body as a stabilizer and saw the wood; vibrations of this motion would be transferred to the affected area. In 16th Century Japan, a popular book advocated the use of percussion and vibration massage to improve rheumatic complaints and encourage the healing of broken bones. Over 40 years ago, the Russian space program noticed that astronauts returning from space experienced bone fractures and bone mass loss much earlier than their earth-bound counterparts. The Russians used whole-body vibration devices to help build up the bone mass of astronauts. NASA (the National Aeronautics and Space Administration) has used vibration therapy to prevent the loss of bone mass in astronauts, particularly females, who are more prone to osteoporosis.
Vibration therapy was analyzed by 19th Century neurologist Jean-Martin Charcot. Charcot created a vibration chair after observing Parkinson's patients and the beneficial effects they endured after a train or carriage ride. Later a colleague of Charcot's, Gilles de la Tourette, created a vibrating helmet, thinking that the brain would react to the vibrations.
Advocates have promoted vibration therapy to treat a variety of other conditions, such as multiple sclerosis, phantom limb syndrome, cerebral palsy, arthritis, tinnitus, ulcers, and fibromyalgia. They also claim that this modality reduces cellulite, regulates reproductive function, boosts the lymphatic system, improves wound healing, and increases glucose and body metabolism.
Multiple clinical trials have investigated the validity of this therapy for pain, sports injuries, and bone density loss; however, high-quality human clinical trials are necessary before any firm recommendation can be made.

Theory / Evidence

General: The mechanism of action behind vibration therapy is unclear; however, several theories have been put forth. In the treatment of bone density, advocates claim that mechanical vibration applies significant but safe stress on the patient's bones. The stress created by the vibration sends an unknown chemical signal to the bones. This signal may cause bones to increase their internal mass. Similarly, advocates claim that vibration therapy induces a tiny stretch in the muscles of the area where it is applied. Because of a principle known as the myotatic stretch reflex, the muscles respond to this tiny stretch by contracting. The continuous stretch and contraction of a muscle may help build muscle mass. The strengthening of muscles prevents injuries from occurring and promotes the restoration of muscle mass after an injury. Lastly, mechanical vibration offers a constant stimulus that may override, and thus block, the pain signal being sent to the nervous system.
Vibration therapy is the topic of significantly more investigation in clinical trials than most other integrative modalities. The most researched uses of vibration medicine are for alleviation of pain and increasing bone density, and as an adjunct therapy for sports-related injuries.
Repeated clinical trials have not shown if vibration therapy is actually beneficial to patients. It is unknown if the unproven benefits of vibration medicine are due to the placebo effect.
The Centers for Disease Control and Prevention (CDC) partially sponsored the First American Conference on Human Vibration in June of 2006. Position statements from major medical organizations on the use of vibration medicine are lacking. The U.S. Food and Drug Administration (FDA) has not approved whole-body vibration machines for medical purposes. Also, there are no standards to regulate the manufacture of these machines.
Children: The complete biological effect on children of whole-body vibration (WBV) therapy is not known. After receiving standing WBV therapy, it was observed that children transmitted vibration differently in the ankle and hip at higher intensities (33Hz) when compared to adults. Also, transmission of the vibration was not different in children in other areas, including the head.
Children with cerebral palsy receiving WBV therapy in addition to physiotherapy were found to have a faster average walking speed measured by the 10-minute walk test.
Constipation: Two weeks (six 15-minute sessions) of low-intensity WBV therapy in patients with chronic functional constipation reduced the severity of symptoms.
Incontinence: WBV therapy was shown to be effective in decreasing urine loss and increasing voided amounts in patients after radical removal of the prostate gland and removal of all or part of the urinary bladder. The authors of the trial proposed that additional studies to be conducted combining WBV, pelvic floor education, and electrostimulation and biofeedback.
Multiple sclerosis: It has been reported in clinical trials that exercise may help patients with multiple sclerosis. Evidence of additional benefits from WBV in this patient population is lacking.
Muscle soreness and injury: Localized vibration therapy in adults with ankle or hamstring injuries was found to have beneficial effects, such as increasing flexibility and decreasing perceived stiffness. The long-term effect of localized vibration therapy in injury recovery is unclear.
Vibration therapy on upper and lower legs in downhill male runners was found to decrease delayed-onset muscle soreness. Also, WBV therapy was found to have beneficial effects in leg and knee muscle strength. Additional effects were lacking in the upper extremities in female student-athletes compared to resistance training.
Osteoporosis: WBV therapy has been proposed as another option for individuals with osteoporosis, to be used in conjunction with the recommended clinical guidelines, including diet changes, bone medications, and weight-bearing exercise, in preventing bone fractures.
According to multiple clinical trials, evidence of increased bone density for individuals receiving WBV therapy was lacking. One clinical trial in older females with osteoporosis showed increased femoral neck and lumbar bone density after receiving WBV therapy.
Pain: Clinical trials have suggested that low-intensity whole-body vibration therapy may be a suitable option for reducing pain in patients with chronic low back pain.
HIV patients with distal symmetrical polyneuropathy (DSPN) oftentimes do not respond to medications in alleviating the pain associated with DSPN. According to a study, vibration therapy may not reduce pain in patients with DSPN foot pain.
Research also suggests that vibration therapy may not have better results than usual postoperative care for treating pain in females.
WBV therapy in fibromyalgia patients was found to improve balance and prevented the loss of health-related quality of life.
Sinusitis: Vibration therapy was found to be a potential drug-free treatment option for individuals with sinusitis.
Stroke: Research suggests that WBV therapy used in stroke patients may be no more effective than exercises alone.
Patients with right hemisphere stroke received localized vibration therapy in the neck muscle and found improvements in spatial neglect (awareness of objects or persons in the opposite side of stroke impact).
Ulcers: Localized vibration therapy was found to have beneficial effects in healing pressure and venous ulcers.

Author information

This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography

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Technique

Practitioners vary the rate and intensity of the vibration applied to the patient in order to tailor the curative effects of therapy to the diagnosis. Practitioners also vary the pressure of the device upon the affected area for the same reason. Patients are advised to relax and not hold their breath during the application of vibration. Vibration therapy should not be painful.
Localized vibration therapy: In a clinic, the patient lies on a massage table with the affected area of the body face up. The therapist applies the vibration using a plug in massager or specialized piece of equipment. Visits may last from 20 minutes to an hour. The duration of treatment in patients with an injury lasts until recovery. For patients seeking the therapy as a preventive measure, sessions may be ongoing. Some individuals choose to administer vibration therapy to an area of complaint without the consultation of a doctor or physical therapist. There is no protocol for such application, and the duration and type of therapy vary. Another name for localized vibration therapy is biomechanical muscle stimulation (BMS).
Whole-body vibration (WBV): This form of therapy is applied for more systemic complaints. The patient stands on a machine or sits in a chair that vibrates at varying intensities. According to secondary sources, when standing on the machine, the patient is either stationary or performing rigorous movements. Many physical therapists for professional athletes use vibration therapy to decrease the recovery time after an injury. One example of a product in this category is called the Power Plate?.
Clinical trials have noted effects such as a decrease in cellulite, muscle strengthening and toning, increased bone mass, improved blood circulation, improved balance, and decreased reaction of hormones correlated with stress following whole-body vibration therapy. However, a consensus has not been reached on the effects of whole-body vibration in providing the purported benefits using all available machines.
Massage therapists, occupational therapists, physical therapists, and other body workers integrate vibration therapy into their practices. There is no licensure program for vibration therapy, and U.S. states do not regulate the use of this modality. Some manufacturers of vibration therapy products offer training seminars.