Power plate/vibrogym/vibration training!

[physiobob]

Hi Guys,
What do you think of vibration training and its application as an adjunct to physiotherapy treatment? I've looked at the research papers, tried the machine and it seems promising!

I feel from a clinical stand point that it has limited uses. I agree with the concept that using vibration does cause confusion on receptors that would inhibit some muscle movement and therefore you could try to strengthen more through range with such a device. However this is mainly of use in the hamstring region and unfortunately you cannot stand in an erect posture on a vibration plate (or else you head feels that it is going to explode!). This would cause one to exercise in a kyphotic/stooped posture or in relative lumbar and thoracic flexion at best when working in a semi-standing position. This can't be ideal.

That said I know they do work in numerous positions e.g. pressups on the vibration plate etc. This might give a useful workout? Perhaps it recruits more fibres when the vibration is on? I'd love to know if they can show that in the research, say when compared to a standard pressup.

Overall it seems a bit like a toy to get people to exercise, which after all is a good thing. Maybe it recruits more fibres (not seen any hard core evidence at this time) and if it does then this could be interesting in maintaining optimal available function in neurological disease. However is it any better than time spent say on stability work with a gym ball that can be done at home on independently in the gym at a fraction of the cost.

Please do post any useful reference or research that truly shows the benefits of this as an adjunct to therapy. I'd love to read it an comment.

[Physiofit]

Hi there,

In term of discomfort when standing on vibration plate, i agree with you. However in term of clinical use it has limited use i do disagree with you!
I Have looked at a various research papers related to vibration training and the benefits are great and helps with the following conditions, here some of them:
- MS
- Fibromyalgia
- OA pain relief
- Osteoporosis
- Activate Blood circulation, and therefore helps with acceleration of healing
process to tendons and muscles
- Power Plate Stimulates Recovery After ACL Rupture

links to some of the research papers:
Application of vibration training in physiotherapy: http://www.powerplateusa.com/researc...rapy%20(7).pdf
Osteoporosis: http://www.bettervibrations.com/medical/hipDensity.pdf
Improving walk and mobility with elderly population: http://www.bettervibrations.com/medical/ortho08.pdf
physiological effects: http://www.bettervibrations.com/medical/acute.pdf
ACL repair: http://www.powerplate.com/research/docs/ACL%20(1).pdf


We physios use ultrasound, TENS, cold/heat therapy and other modalities. I see vibration training as another modality that can offer real physiological changes and aids treatments. I do think we physios should do some research on this machine to find out more about it!

Regards,

Physiofit

[physiobob]

Application of vibration training in physiotherapy: http://www.powerplateusa.com/researc...rapy%20(7).pdf
Osteoporosis: http://www.bettervibrations.com/medical/hipDensity.pdf
Improving walk and mobility with elderly population: http://www.bettervibrations.com/medical/ortho08.pdf
physiological effects: http://www.bettervibrations.com/medical/acute.pdf
ACL repair: http://www.powerplate.com/research/docs/ACL%20(1).pdf

Do any of these compare performing the same exercises on the vibration plate with it turned off? Only such a study would convince me that the vibration plate itself if actually causing the change, rather than the exercise alone. In several of the studies the exercise given to the powerplate group and the control group are in fact different. The conclusions also do not match the data in relation to controls. It does however show it is an effective tool that one can use, but no where does it show that it is better than the same exercises without the plate.

That said i think this is a great tool for training downhill skiers to improve their squat endurance.

[KarenLowenstein]

Hi. I have a power-plate and have found that it helps for pain relief in knee and ankle injuries and use it for strengthening in patients such as wheel-chair bound patients. It has been a great 'tool' in my practice. There are some patients that are not good candidates for e.g.hip and knee replacements, children under the age of 12, cancer patients, fractures, patients with pacemakers, unstable diabetes and very high blood pressure. Physiotherapists are fortunate that they have a variety of 'tools' that they can use for each patient. I think the more we learn about various modalities the more effective we become in our work. There are a lot of other disciplines that have taken various physiotherapy equipment and exercise techniques and made it into a trend for example the pezzi ball/gym ball/physio ball and even exercises such as pilates=core strength exercises.
Please get more acquainted with this machine and other modalities that are considered different as knowledge does help you when a patient asks your opinion. Acupuncture was always the local Chinese doctor's domain and now physiotherapists are finding that it works very well as well as aromatherapy oils etc. Enjoy the journey of knowledge.

[alophysio]

Hi Karen,

Thanks for the post.

I was wondering what your specific responses to physiobob's concerns were - it would be interesting to hear your point of view considering you have one of these machines.

Is his point valid that you have to adjust your standing posture to accomodate the vibration?

Does the exercises with vibration make any difference compared to the exercise without the vibration?

Maybe a small study would be useful - you could just tell the patients that the vibration is so small that they can't feel it to have the placebo group do their exercises!

Maybe a study is asking too much! But what about the other questions???

Thankin you in advance! Consider it learning more about the machine so i know more about it when patients ask me about it!

[KarenLowenstein]

Hi.
There is a study done by Janneke Kelderman on this website :
http://www.pmlfilestore.com/vibratra...ower-Plate.pdf

The other site to look at is also: www.powerplateusa.com

Studies have been done and are in the process of being carried out. This is still new technology. The power-plate was introduced in the Netherlands in 1999.

[alophysio]

Thanks for the reply.

Just quickly, do you have to change the way you stand when it is vibrating?

[KarenLowenstein]

Yes. The feeling of vibration going through the body can be changed just by tilting the body forwards or sideways etc. and even by flexing the neck the feeling of the vibration in the head changes when standing on the power-plate. Biokinetists are using this machine and also Sureslim salons.

[alophysio]

thanks for that.

From what you say, it would seem that the posture changes to "feel" the vibration in the target areas - would this be right? In this way you can try to stimulate the muscles in that area?

When do you decide to progress the patient into non-vibration functional exercises to integrate what they have developed on the machine?

Thanks

[Laura01]

I was just about to post the same question!
I have been working with the Galileo vibration training and I think It is an excellent modality. As far as I'm aware this method does not just apply a vertical force but has lateral movement as well (which some of the trainers don't). With this machine you can alter the amplitude of the vibration by altering the distance between your feet on the plate.

when standing on this machine muscle recruitment has been shown to be between 95-97% for a 10 minute session when compared with standard exercise which was between 40-60%. I will find the reference for this.

Since vertical vibrations transmit force straight up and through the head, this system using lateral vibrations allows the energy to be transmitted to the core, strengthening here as well as the lower limbs.
The use of different positions does allow you to focus on particular areas. The therapist needs to observe the patients posture very carefully since the treatment time is so short, and advise any adaptations.

So far I have seen the machine used for general fitness, propriceptively and used in a patients with primary progressive MS and a parkinsons. Also
for patients with pelvic floor weaknesss. Further i would like to see it included in falls prevention where it has already been sucessful.
I would love to do a study and am docummenting case studies.
I will get the references from work for this machine.

[alophysio]

The real question is...does the TrAb really act as a torque generator???

In other words, does it need strengthening? At 3% MVC, is it really enough to generate the force closure it needs to secure the SIJ and tension the TLF?

What if we think of it as a proprioceptive device? Then the vibration training might actually serve to increase information input to the brain because more things are being stimulated therefore requiring more activation to try sort out all the movements and stabilise them...

Whaddya think?

[physiobob]

The real question is...does the TrAb really act as a torque generator???

In other words, does it need strengthening? At 3% MVC, is it really enough to generate the force closure it needs to secure the SIJ and tension the TLF?

What if we think of it as a proprioceptive device? Then the vibration training might actually serve to increase information input to the brain because more things are being stimulated therefore requiring more activation to try sort out all the movements and stabilise them...

Whaddya think?

I do agree that this is a useful tool for proprioceptive retraining for some of the population. Again though I must ask for some evidence for difference in individuals doing the same exercise on the vibration plate 1. With it turned on and 2. With it turned off. Only then might I consider its use worthwhile. And perhaps 3. Compared to someone standing on an airex mat with the machine turned off to simulate some proprioceptive retaining without the actual vibration.

[physiobob]

Thanks for the reply.

Just quickly, do you have to change the way you stand when it is vibrating?

Just to be clear, You cannot stand in an erect position on a vibration plate!