Ann Rehabil Med.  2018 Dec;42(6):804-813. 10.5535/arm.2018.42.6.804.

Effect of Whole Body Horizontal Vibration Exercise in Chronic Low Back Pain Patients: Vertical Versus Horizontal Vibration Exercise

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Dongguk University College of Medicine, Goyang, Korea. bskwon@dumc.or.kr

Abstract


OBJECTIVE
To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE).
METHODS
Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment).
RESULTS
According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p < 0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group.
CONCLUSION
HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

Keyword

Vibration; Low back pain; Visual analog scale; Muscle strength; Balance

MeSH Terms

Humans
Hypertrophy
Low Back Pain*
Muscle Strength
Paraspinal Muscles
Ultrasonography
Vibration*
Visual Analog Scale

Figure

  • Fig. 1. A participant stands on the vibrating platform of horizontal whole-body vibration (EXXTREAM 1000) with flexions of both knees.

  • Fig. 2. Comparison between horizontal vibration exercise (HVE) and vertical vibration exercise (VVE) groups. (A) Visual analog scale, (B) Oswestry disability index, (C) lumbar flexor peak torque, (D) lumbar flexor average power, (E) lumbar extensor peak torque, (F) lumbar extensor average power, (G) transverse abdominis, (H) multifidus, (I) anteroposterior index, and (J) medio-lateral index. All variables except for muscle thickness were significantly changed according to time in each group; however, no variables with significant time-group interactions between the groups existed. All results were obtained using repeated-measures of ANOVA. Ho, horizontal vibration group; Ve, vertical vibration group; t0, assessment at baseline; t1, assessment at 6 weeks; t2, assessment at 12 weeks; t3, assessment performed after 4 weeks from the end of intervention. *p<0.05, a significant difference according to time in each group (solid line, difference in horizontal vibration exercise group; dotted line, difference in vertical vibration exercise group.


Reference

1. Krismer M, van Tulder M; Low Back Pain Group of the Bone and Joint Health Strategies for Europe Project. Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). Best Pract Res Clin Rheumatol. 2007; 21:77–91.
2. Trapp W, Weinberger M, Erk S, Fuchs B, Mueller M, Gallhofer B, et al. A brief intervention utilising visual feedback reduces pain and enhances tactile acuity in CLBP patients. J Back Musculoskelet Rehabil. 2015; 28:651–60.
Article
3. Bagheri R, Takamjani IE, Dadgoo M, Sarrafzadeh J, Ahmadi A, Pourahmadi MR, et al. A protocol for clinical trial study of the effect of core stabilization exercises on spine kinematics during gait with and without load in patients with non-specific chronic low back pain. Chiropr Man Therap. 2017; 25:31.
Article
4. Graves JE, Pollock ML, Foster D, Leggett SH, Carpenter DM, Vuoso R, et al. Effect of training frequency and specificity on isometric lumbar extension strength. Spine (Phila Pa 1976). 1990; 15:504–9.
Article
5. Gill KP, Callaghan MJ. The measurement of lumbar proprioception in individuals with and without low back pain. Spine (Phila Pa 1976). 1998; 23:371–7.
Article
6. Iverson BD, Gossman MR, Shaddeau SA, Turner ME Jr. Balance performance, force production, and activity levels in noninstitutionalized men 60 to 90 years of age. Phys Ther. 1990; 70:348–55.
Article
7. Wang XQ, Pi YL, Chen PJ, Chen BL, Liang LC, Li X, et al. Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial. Trials. 2014; 15:104.
Article
8. Chen H, Ma J, Lu B, Ma XL. The effect of whole-body vibration training on lean mass: a PRISMA-compliant meta-analysis. Medicine (Baltimore). 2017; 96:e8390.
9. Park SY, Son WM, Kwon OS. Effects of whole body vibration training on body composition, skeletal muscle strength, and cardiovascular health. J Exerc Rehabil. 2015; 11:289–95.
Article
10. Bagheri J, van den Berg-Emons RJ, Pel JJ, Horemans HL, Stam HJ. Acute effects of whole-body vibration on jump force and jump rate of force development: a comparative study of different devices. J Strength Cond Res. 2012; 26:691–6.
Article
11. del Pozo-Cruz B, Hernandez Mocholi MA, Adsuar JC, Parraca JA, Muro I, Gusi N. Effects of whole body vibration therapy on main outcome measures for chronic non-specific low back pain: a single-blind randomized controlled trial. J Rehabil Med. 2011; 43:689–94.
Article
12. Rittweger J, Just K, Kautzsch K, Reeg P, Felsenberg D. Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: a randomized controlled trial. Spine (Phila Pa 1976). 2002; 27:1829–34.
13. Sitja Rabert M, Rigau Comas D, Fort Vanmeerhaeghe A, Santoyo Medina C, Roque i Figuls M, Romero-Rodriguez D, et al. Whole-body vibration training for patients with neurodegenerative disease. Cochrane Database Syst Rev. 2012; (2):CD009097.
Article
14. Kaeding TS, Karch A, Schwarz R, Flor T, Wittke TC, Kuck M, et al. Whole-body vibration training as a workplace-based sports activity for employees with chronic low-back pain. Scand J Med Sci Sports. 2017; 27:2027–39.
Article
15. Gillan SN, Sutherland S, Cormack TG. Vitreous hemorrhage after whole-body vibration training. Retin Cases Brief Rep. 2011; 5:130–1.
Article
16. Vela JI, Andreu D, Diaz-Cascajosa J, Buil JA. Intraocular lens dislocation after whole-body vibration. J Cataract Refract Surg. 2010; 36:1790–1.
Article
17. Kiiski J, Heinonen A, Jarvinen TL, Kannus P, Sievanen H. Transmission of vertical whole body vibration to the human body. J Bone Miner Res. 2008; 23:1318–25.
Article
18. Lee G. Does whole-body vibration training in the horizontal direction have effects on motor function and balance of chronic stroke survivors? A preliminary study. J Phys Ther Sci. 2015; 27:1133–6.
Article
19. Shim C, Lee Y, Lee D, Jeong B, Kim J, Choi Y, et al. Effect of whole body vibration exercise in the horizontal direction on balance and fear of falling in elderly people: a pilot study. J Phys Ther Sci. 2014; 26:1083–6.
20. Jung IG, Yu IY, Kim SY, Lee DK, Oh JS. Reliability of ankle dorsiflexion passive range of motion measurements obtained using a hand-held goniometer and Biodex dynamometer in stroke patients. J Phys Ther Sci. 2015; 27:1899–901.
Article
21. Sweeney N, O’Sullivan C, Kelly G. Multifidus muscle size and percentage thickness changes among patients with unilateral chronic low back pain (CLBP) and healthy controls in prone and standing. Man Ther. 2014; 19:433–9.
Article
22. Nuzzo JL, Haun DW, Mayer JM. Ultrasound measurements of lumbar multifidus and abdominal muscle size in firefighters. J Back Musculoskelet Rehabil. 2014; 27:427–33.
Article
23. Sohn MK, Lee SS, Song HT. Effects of acute low back pain on postural control. Ann Rehabil Med. 2013; 37:17–25.
Article
24. Glave AP, Didier JJ, Weatherwax J, Browning SJ, Fiaud V. Testing postural stability: are the star excursion balance test and Biodex Balance System limits of stability tests consistent? Gait Posture. 2016; 43:225–7.
Article
25. Kakigi R, Shibasaki H. Mechanisms of pain relief by vibration and movement. J Neurol Neurosurg Psychiatry. 1992; 55:282–6.
Article
26. Shilpapriya M, Jayanthi M, Reddy VN, Sakthivel R, Selvaraju G, Vijayakumar P. Effectiveness of new vibration delivery system on pain associated with injection of local anesthesia in children. J Indian Soc Pedod Prev Dent. 2015; 33:173–6.
Article
27. Torvinen S, Kannus P, Sievanen H, Jarvinen TA, Pasanen M, Kontulainen S, et al. Effect of four-month vertical whole body vibration on performance and balance. Med Sci Sports Exerc. 2002; 34:1523–8.
Article
28. Perchthaler D, Grau S, Hein T. Evaluation of a six-week whole-body vibration intervention on neuromuscular performance in older adults. J Strength Cond Res. 2015; 29:86–95.
Article
29. Baard ML, Pietersen J, van Rensburg SJ. Interventions for chronic low back pain: whole body vibration and spinal stabilisation. S Afr J Sports Med. 2011; 23:35–9.
Article
30. Torabi M, Okhovatian F, Naimi SS, Baghban AA, Vafaee R. The effect of core stability training with and without whole body vibration in chronic low back pain patients. J Paramed Sci. 2013; 4:17–25.
31. Hagbarth KE, Hongell A, Wallin BG. The effect of gamma fibre block on afferent muscle nerve activity during voluntary contractions. Acta Physiol Scand. 1970; 79:27. A-28A.
32. Yang J, Seo D. The effects of whole body vibration on static balance, spinal curvature, pain, and disability of patients with low back pain. J Phys Ther Sci. 2015; 27:805–8.
Article
33. Tsaklis PV, Grooten WJ, Franzen E. Effects of weightshift training on balance control and weight distribution in chronic stroke: a pilot study. Top Stroke Rehabil. 2012; 19:23–31.
Article
34. Knuttgen HG. Strength training and aerobic exercise: comparison and contrast. J Strength Cond Res. 2007; 21:973–8.
Article
35. Kurz I, Gimmon Y, Shapiro A, Debi R, Snir Y, Melzer I. Unexpected perturbations training improves balance control and voluntary stepping times in older adults: a double blind randomized control trial. BMC Geriatr. 2016; 16:58.
Article
36. Haas CT, Turbanski S, Kessler K, Schmidtbleicher D. The effects of random whole-body-vibration on motor symptoms in Parkinson’s disease. NeuroRehabilitation. 2006; 21:29–36.
Article
37. Nelson AJ, Staines WR, McIlroy WE. Tactile stimulus predictability modulates activity in a tactile-motor cortical network. Exp Brain Res. 2004; 154:22–32.
Article
Full Text Links
  • ARM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr