SHAKING YOUR FASCIA!
WHOLE BODY VIBRATION FOR SUCCESSFULLY ADDRESSING CHRONIC PAIN AND CHRONIC ILLNESS
As you might imagine, WBV is much different today. A quick peek on Amazon shows that Whole Body Vibration machines range in price from $13,500 to just over 100 bucks, with everything in between (interestingly enough, their highest-rated machine --- almost 2,000 reviews at an average of 4.5 stars --- was an economical 240 bucks, with free shipping). The question now becomes, why would you want one in the first place (or after you've read this post, why wouldn't you want one)?
To answer these questions effectively, we first need to understand just a little bit about how WBV works and it's neurobiological effects. Let's start with proprioception. My most popular post ever (48,000 Facebook likes and counting) pertains to fascia's role in proprioception (HERE). In part II (RESTORING INJURED FASCIA'S PROPRIOCEPTIVE ABILITIES), I discuss ways that people can help both CHRONIC PAIN and CHRONIC ILLNESS (including, as you will soon see, AUTOIMMUNE DISEASES) by increasing joint and soft tissue proprioception. Study after study after study shows that WBV stimulates proprioception.
Just remember that no tissue has more proprioceptive power than FASCIA (not surprising considering it is the most abundant connective tissue in your body), which is the reason that some of the smartest physicians and researchers in the world are suggesting that it provides the basis for understanding all pain and disease (HERE)! In fact, one of the methods I discuss with patients for increasing proprioception and kinesthesia is Whole Body Vibration (I use it in my clinic with certain protocols, including SPINAL DECOMPRESSION THERAPY). Understanding proprioception is important, but let's dig a bit deeper and look at a few of the practical outcomes of increasing or stimulating proprioception in your joints and connective tissues.
The August issue of the European Journal of Applied Physiology (Acute and Chronic Neuromuscular Adaptations to Local Vibration Training) concluded that, "Vibratory stimuli are thought to have the potential to promote neural and/or muscular (re)conditioning. This has been well described for whole-body vibration, which is commonly used as a training method to improve strength and/or functional abilities. The functional improvements are principally triggered by adaptations within the central nervous system." Intriguing already. And speaking of the Central Nervous System...
A study from last December's issue of the Journal of Musculoskeletal and Neuronal Interactions published a study called Acute Corticospinal and Spinal Modulation After Whole Body Vibration, that actually proves that WBV brings about its various effects not just via cord-based reflexes, but via activation of various brain pathways. What sort of changes do these five authors from Germany's Freiburg University mention? (This is cherry-picked due to time and space constraints as are most quotes I use)
"The impact of acute exposure to WBV on neuronal control of the skeleton muscle is extensively discussed in literature. Various scientific reports state that WBV can immediately have beneficial effects on strength and power, motor coordination and postural control among athletes, sedentary populations or patients in rehabilitation. Based on the evidence of neural modulation following WBV, the application in subjects suffering from disorders of movement control, such as in neurological diseases affecting the CNS, has increasingly been focused on. Investigations clearly point towards neuronal modulation regarding spasticity in patients with spinal cord injuries or cerebral palsy. By improving neuromuscular activation, e.g. through muscle strength, positive effects with regard to gait pattern and gross motor functioning were achieved in several populations with neurological disorders. WBV can be associated with the activation of more than one muscle group, and it involves sensory as well as motor nerve pathways with a contribution of spinal stretch reflex responses. Despite the difference between both vibration methods regarding sensory integration, they apparently result in similar effects, such as up to a 50% reduction in spinal excitability following vibration. An intact interaction between supraspinal and spinal modulation is indispensable for any kind of movement, such as during locomotion or postural control in everyday life. Vibration is the only treatment so far that is reported to persistently reduce spinal excitability."
A study from the July issue of the Journal of Aging and Physical Activity (Whole-Body Vibration Training Improves Heart Rate Variability and Body Fat Percentage in Obese Hispanic Postmenopausal Women) took this issue even farther, showing that not only does WBV help restore underlying metabolic function in obese individuals, it actually helps increase something called Heart Rate Variability or HRV. Why is this a big deal? Because I've previously shown you that when function of the vagus nerve improves, HRV is improved (HRV is the physiologic basis for biofeedback), and virtually every function in your body tends to improve when it increases (HERE). This study showed that "there was a significant group by time interaction for heart rate, sympathovagal balance, and body fat percentage (BF%) such that all significantly decreased; and R-R intervals significantly increased following WBV compared to no changes after control".
From these three studies alone, it's becoming clear that if you are struggling with any chronic health issues, or whether as an athlete or housewife you simply want to improve your health, you really need to take a look at the previous link (when I published it last month, I said it was the most important thing I had written out of the 1,500 posts on my site) as it provides at least a significant part of the reason that WBV is so beneficial to so many aspects of your metabolic and structural health. Allow me to show you a few areas where WBV shines.
WHOLE BODY VIBRATION AND BONE HEALTH
For instance, just two short months ago the Journal of Back and Musculoskeletal Rehabilitation published a rather cool study (Whole Body Vibration Versus Magnetic Therapy on Bone Mineral Density in Elderly Osteoporotic Individuals) showing that both magnetic therapy and WBV "increased BMD (bone mineral density) in elderly....osteoporotic patients. No significant difference in effectiveness was detected between these two alternative therapy modalities." Earlier this summer, the June issue of Medical and Biological Engineering and Computing published as study that dealt with one of the ways that this occurs --- increased bone vascularization (blood supply), concluding that "Low Intensity Whole Body Vibration-promoted bone repair is associated with the modulation of vascularization."
Another study, this one from September's issue of European Cells and Materials (The Effect of Whole Body Vibration on Fracture Healing) looked at 19 studies on the subject and concluded that "Most of the studies show positive effects on fracture healing... In three studies, vibration results in positive effects on angiogenesis [increased blood supply] at the fracture site and surrounding muscles during fracture healing. No serious complications or side effects of vibration are found in these studies." How big a deal is this considering that fracture incidence is literally exploding in the United States (HERE)? Once you realize that MOST CALCIUM SUPPLEMENTS are worthless and that BISPHOSPHONATE DRUGS (the drugs given to osteoporotic women to "increase" bone density) actually lead to more fractures, you'll start to get a greater appreciation for this aspect of WBV therapy.
Not only did I find several studies showing positive effects of WBV in treating OSTEOARTHRITIS (Degenerative Arthritis), but there were two large meta-analysis of using WBV to treat osteoporosis published a year ago in September, one in the Malaysian Journal of Medical Sciences and the other in the Journal of Musculoskeletal and Neuronal Interactions. After looking at over 50 studies on the subject, they respectively concluded that, "In conclusion, our group found no strong evidence to contradict the finding that the WBV machine is a good alternative or good additive for the prevention and management of osteoporosis in postmenopausal women." And "WBVE are a relevant non-pharmacological option, as one of the modalities of exercises recommended for the management of postmenopausal osteoporosis."
I even found a cool study concerning bone regeneration in diabetics. Although this study pertained to Type I Diabetics (Autoimmune Diabetes), best guess is that the majority of the findings from this month's issue of Bone (Low-Level Mechanical Vibration Improves Bone Microstructure....) could be extrapolated for Type II Diabetics --- a big deal when you consider that over half the American adult population has diabetes or pre-diabetes (HERE), with few going about solving it the right way (HERE). Oh; and if you notice, in the third line below, these authors mention our culture's AUTOIMMUNITY EXPLOSION.
Type 1 diabetes mellitus (T1DM) is associated with reduced bone mass, increased fracture risk, and impaired bone defect regeneration potential. These skeletal complications are becoming important clinical challenges due to the rapidly increasing T1DM population, which necessitates developing effective treatment for T1DM-associated osteopenia/osteoporosis and bone trauma. T1DM-induced reduction of bone formation was inhibited by WBV... WBV also stimulated more adequate ingrowths of mineralized bone tissue into pore spaces, and improved peri-implant bone mechanical properties and MAR in T1DM bone defects. Our findings demonstrated that WBV improved bone architecture, mechanical properties, and osseointegration by promoting canonical Wnt signaling-mediated skeletal anabolic response. This study not only advances our understanding of T1DM skeletal sensitivity in response to external mechanical cues but also offers new treatment alternatives for T1DM-associated osteopenia/osteoporosis and osseous defects in an economic and highly efficient manner.
Speaking of diabetes and the problems associated with........
DIABETES & OBESITY
"The International Diabetes Federation estimates that there will be approximately 642 million diabetics by 2040. Whole-body vibration (WBV) has been used in patients with neurological or musculoskeletal disorders as a new and effective intervention method to improve physical function. When a diabetic patient is trained, the body decomposes glucose to supply energy, which causes blood glucose to drop. In addition, as blood circulation in the body increases, the amount of glucose and insulin delivered to the muscles increases, resulting in increased glucose levels in the peripheral tissues. As a result, insulin sensitivity is increased, and microcirculation, perfusion rate, and peripheral sensory function are improved. This physiological mechanism seems to be effective in improving peripheral sensory function of WBV of this study. This study confirmed the improvement in VPT (vibration perception threshold) by applying WBV to elderly patients with diabetic neuropathy, and it is thought to be a cornerstone for patients with sensory impairment."
Earlier this summer, just after OUR BIG FLOOD, the May issue of Oxford Academic's Endocrinology published a study on WBV as related to the hormone leptin --- a hormone made by fat cells that tells your body its full (the heavier a person gets, the more likely they become leptin-resistant, losing their sensitivity to the hormone, and thus never feeling full). The authors compared groups of mice that used WBV for 12 weeks to groups that did nothing, to groups that exercised in a traditional manner (treadmill). What they found was that WBV increased leptin sensitivity, decreased body fat, and increased lean muscle mass. And that's just for starters. Although you'll find some doctor-speak, the paragraph below is nothing short of astounding if you are wanting to lose body fat and / or gain lean body mass (is there anyone in America who wouldn't?).
Obesity is accompanied by lipid deposition in multiple tissues, including the skeleton, where infiltration of adipocytes into the bone marrow niche may negatively impact bone formation. Bone marrow stem cells express receptors for multiple adipokines, including the adipose-derived hormone leptin. Data from leptin-deficient rodent models have revealed regionally specific effects on the skeleton, with reports of cortical bone atrophy in weight-bearing long bones like the femur and tibia. Leptin-deficient mice also exhibit lower femoral cortical bone mineral density and strength compared with wild-type littermates. Bone loss in models of leptin or leptin receptor deficiency has been linked with lower osteoblast activity [osteoblasts are cells that build bones] suggesting that cellular leptin resistance in obesity might reduce bone formation. Participation in regular physical activity protects against bone loss, and increasing evidence suggests that whole-body vibration (WBV) elicits similar effects in certain patient populations. Exercise and WBV reduced adipocyte hypertrophy in visceral fat, attenuated hepatic steatosis, and enhanced glycemic control in leptin receptor–deficient mice......
Back in May, there was a cool study on WBV's effects on HIGH BLOOD PRESSURE in the journal Hypertension Research. The authors concluded that, "WBV could reduce not only aortic stiffness but also muscular artery stiffness, which was associated with an increase in leg muscle strength. This means that isometric exercise is not mandatory with WBV to reduce arterial stiffness... Thus, dynamic WBV is a safe and effective modality for the improvement of arterial function in young overweight / obese women." This increase in vascularity and circulation reached all the way to the feet --- a huge deal for Type II diabetics who tend to have foot problems --- as shown by a study published in the January issue of Medicina Clinica Barcelona (Effect of Mechanical Vibration on Transcutaneous Oxygen Levels in the Feet of Type 2 Diabetes) when the authors concluded that "Foot conditions in patients with diabetes mellitus (DM) are major causes of morbidity and disability. Whole body vibration may increase transcutaneous oxygen levels levels with useful implications for the prevention or management of complications associated with restricted blood perfusion in the diabetic foot syndrome."
And think about this for a moment. The number of people who have had vascular accidents (strokes) is literally exploding in this country. As long as a person has some help (someone to make sure they don't fall over); if as we've seen for both osteoporosis and diabetes, WBV helps increase blood supply by creating new blood vessels, what could possibly be easier for stroke rehab than some form or another of WBV? Speaking of strokes and other neurological conditions......
BALANCE, STROKE REHAB, AND OTHER NEUROLOGICAL HEALTH ISSUES
"Current methods to improve the balance and gait capability of stroke patients include muscle strengthening exercises, task oriented training, and auditory and visual feedback exercises using unstable surfaces, whole body vibration exercise, and weight movement training). Recently, visual control whole body vibration exercise has been used as a new form of vestibular sensory stimulation). Visual control whole body vibration exercise causes changes in the cerebral hemispheres through stimulating afferent fibers). While receiving the vibration stimulus, muscles experience small changes in length). Vibration also excites the spinal reflex through enhancing connections between short spindle-motor neurons and motor nerves). Activation of muscle spindle receptors by vibration impacts muscles directly receiving the vibration stimulus and adjacent muscles). Whole body vibration exercise has been reported to improve the balance and gait of the elderly, stroke patients, and patients with Parkinson’s disease)."
Suffice it to say, in this study WBV proved very helpful for a wide variety of neurological conditions, including stroke rehab. If you or a loved one have had a stroke, I would strongly suggest you read the "discussion" part of this paper (it is free online) to see what kind of variations help make the WBV even more effective (blindfolded, using visual or auditory cues --- touching numbers or colors on the wall to the beat of music, etc, etc.). Another study, this one in the September issue of Top Stroke Rehabilitation (The Effect of Whole-Body Vibration Therapy on the Sitting Balance of Subacute Stroke Patients) not surprisingly showed that "WBV therapy led to improvement of the recovery in balance recovery for subacute stroke patients. Because the WBV therapy was as effective as conventional physical therapy, we can consider a WBV therapy as a clinical method to improve the sitting balance of subacute stoke patients." Another study from September, this one from Metabolic Brain Disease (The Macroscopic and Microscopic Effect of Low-Frequency Whole-Body Vibration after Cerebral Ischemia), showed that "Low-frequency WBV showed the potential in improving coordination and muscle strength and promoted neurogenesis after long-term exposure." But you don't need to have had a stroke to have balance issues.
Within the past several months there have been studies showing benefits for improving balance and preventing falls in women (PLoS One), middle-aged and older adults (the European Review of Aging and Physical Activity), and athletes with chronic ankle instability (the International Journal of Sports Medicine). There was even a study from the May issue of the Journal of Biomechanics that showed (as the title would suggest) the Effects of Vibration Training in Reducing Risk of Slip-Related Falls Among Young Adults with Obesity. In this study, groups were trained with WBV and without, and then exposed to a purposeful jarring on a treadmill, meant to cause one to lose one's balance. "The results indicated that vibration training significantly increased the muscle strength and improved dynamic stability control at recovery touchdown after the slip occurrence. The decline of the fall rates from the pre-training slip to the post-training one was greater among the vibration group than the placebo group (45% vs. 25%)." How about loss of balance caused by MULTIPLE SCLEROSIS?
A study from last December's issue of Disability Rehabilitation (Effects of Controlled Whole-Body Vibration Training in Improving Fall Risk Factors Among Individuals with Multiple Sclerosis). "Compared with pre-test, almost all fall risk factors and the bone density measurement were significantly improved at post-test, with moderate to large effect sizes varying between 0.571 and 1.007. The important findings of this study were that vibration training may increase the range of motion of ankle joints on the sagittal plane, lower the fear of falling, and improve bone density." WBV seems to help other neurological issues as well. It was interesting to see just how many studies there are showing WBV to be beneficial for for people (especially children) with Cerebral Palsy --- a group of disorders with a common denominator of muscle weakness / loss of muscle tone, loss of coordination, and problems with balance (I also found a bunch of studies on PARKINSON'S and WBV).
There was even a study from April of this year (Feasibility and Safety of Whole-Body Vibration Therapy in Intensive Care Patients) published in Critical Care that looked at studies conducted on unconscious or sedated patients in Intensive Care, concluding that testing for further benefit would be relatively simple. "A short-term response could be detected by electromyography. Longer-term effects involve muscular hypertrophy, which can be assessed by sonography-based morphometry. In summary, WBV, if applicable in conjunction with a vibrating dumbbell, appears safe and feasible in early rehabilitation." A common denominator with most patients in the ICU is an inability to breathe well. Could WBV possibly health respiration?
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
One year ago next month, the journal Respiratory Care published a meta-analysis of four studies of 185 subjects called Does Whole-Body Vibration Improve the Functional Exercise Capacity of Subjects With COPD?. In it the authors concluded that, "All subjects in the groups undergoing WBV showed improvement in distance walked in the 6-min walk test compared with the control group. Regarding the secondary end points, just one article reported improved quality of life and activities of daily living. The quality of evidence for functional exercise capacity outcome was considered moderate. WBV seems to benefit subjects with COPD by improving their functional exercise capacity, without producing adverse effects.... the degree of recommendation is strong." Did you catch that? All 185 subjects improved their score on their ability to walk six minutes --- simply by training with Whole Body Vibration.
Last March the same journal published another study (Low-Volume Whole-Body Vibration Training Improves Exercise Capacity in Subjects With Mild to Severe COPD) that came to essentially the same conclusions. Check this out. "A low-volume WBVT program resulted in significantly and clinically relevant larger improvements in exercise capacity compared with calisthenics exercises in subjects with mild to severe COPD." In other words, a doable amount of WBV (3 months with 2 sessions of 30 min/week) was better than physical exercise as recorded by numerous parameters (6-min walk test, 5-repetition sit-to-stand test, leg press peak force, Berg balance scale, St George Respiratory Questionnaire, and COPD assessment test). I don't care who you are, if you are dealing with COPD, this is super exciting information!
In May of this year, a group of researchers and medical doctors from universities in Austria and Germany, as well a Stanford University, published a study in Respiratory Medicine called What's the Secret Behind the Benefits of Whole-Body Vibration Training in Patients with COPD? After looking at a wide variety of parameters for 74 COPD patients, these authors concluded that, "Patients in the WBV group significantly improved postural balance in several domains compared to the control-group (tandem stance and one-leg stance). Six-minute walk distance and muscle power were also significantly improved compared to control group. Implementation of WBV training improves postural balance performance and muscle power output. The neuromuscular adaptation related to improved balance performance may be an important mechanism of the improvement in exercise capacity after WBVT especially in COPD patients with impaired balance performance and low exercise capacity." Let's be honest; how many COPD sufferers do you know that have a high exercise capacity?
FIBROMYALGIA, THE ELDERLY, BURN VICTIMS, ETC...
Although there are things worse than severe burns, the list is rather short. I've had the opportunity to treat several individuals with Freddy Kruger-like burns, and unfortunately have never seen one improve (I no longer do Tissue Remodeling on burn victims). I've been a long time fan of LLLT for these people, but evidence is mounting that WBV may be a viable option as well. Two months ago, the Journal of Burn Care and Research (A Randomized Pilot Study of the Effect of Whole Body Vibration on Pain in Healing Burn Wounds) published a study done by a dozen researchers at University of Miami's medical school which concluded, "Whole body vibration (WBV) has been shown to improve strength in extremities with healed burn wounds. We hypothesize that WBV reduces pain during rehabilitation compared to standard therapy alone. Exposure to WBV decreased pain during and after physical therapy. This modality may be applicable to a variety of soft tissue injuries and warrants additional investigation." There are so many other health issues that have been shown to respond favorably to WBV, but unfortunately we are just about out of time.
WHAT KIND OF VIBRATION PROTOCOL SHOULD YOU BE SHAKING TO
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For instance, there is a piece of exercise equipment that's been around forever called the Bodyblade. It looks kind of like an unstrung bow, and oscillates in whatever direction you work it --- side to side or up and down. Very cool gizmo that I have played around with previously, but am going to try again in tandem with the WBV (there are actually studies on this creature --- HERE). Another similar device is the Shake Weight Dumbbell, which is a dumbbell with springs that you make oscillate by rapidly pumping it up and down (just go to YouTube and look at it). There are probably numerous others ( hula hoops and especially TRAMPOLINES might even fall into this category).
Not only has the price point come down on all of these items, I'm not convinced that you need to spend a huge amount of time doing these things if you are the average Joe (or Jolene) who is trying to incorporate some sort of vibratory or oscillation training into your normal routine. In fact, while many studies I looked at touted half hour sessions, numerous studies were using sessions as short as ten minutes, and in some cases five. Bottom line, it would not be tough to incorporate WBV or similar into whatever you are currently doing.
And for those of you who want to see what WBV looks like in relationship to the bigger picture, simply take a look at THIS PROTOCOL I created for chronically sick people. While I would never suggest it were a "cure all," the thing that makes it effective for so many people is the fact that most diseases are slightly different manifestations of the same underlying pathophysiological aberrations and metabolic abnormalities (HERE). Sure you might need to see a specialist in FUNCTIONAL MEDICINE. This protocol, however, is meant to save many (arguably most) of you the time and expense.