Vibrations produced in oscillating/vibratory platform generate whole body vibration (WBV) exercises, which are important in sports, as well as in treating diseases, promoting rehabilitation, and improving the quality of life. WBV exercises relevantly increase the muscle strength, muscle power, and the bone mineral density, as well as improving the postural control, the balance, and the gait. An important number of publications are found in the PubMed database with the keyword “flexibility” and eight of the analyzed papers involving WBV and flexibility reached a level of evidence II. The biggest distance between the third finger of the hand to the floor (DBTFF) of a patient with metabolic syndrome (MS) was found before the first session and was considered to be 100%. The percentages to the other measurements in the different sessions were determined to be related to the 100%. It is possible to see an immediate improvement after each session with a decrease of the %DBTFF. As the presence of MS is associated with poorer physical performance, a simple and safe protocol using WBV exercises promoted an improvement of the flexibility in a patient with MS.
Physical inactivity is a strong health problem, mainly in developed countries with undesirable consequences to the society due to several facilities. On the other hand, physical activity has important consequences to the health [
Considering the patients with osteoporosis, exercise is associated with a decreased risk of hip fractures [
Physical fitness components related to health, such as muscle strength and mass, play a significant role in carrying out motor tasks, reducing the risk of falls, and having repercussions in health, longevity, and quality of life of elderly people [
It is important to consider the investigation reported by Beavers et al. [
Although a wide range of physical activities is available to patients with diseases and the exercises, only a limited number of scientific information had shown the superiority of a kind of activity that would lead to relevant health benefits [
The exercises in the whole body due to the exposition to energy as vibrations (whole body vibrations exercise—WBV) generated in oscillating/vibratory platform that is transferred to a subject that is in direct contact with the platform seem to bring various benefits [
There are various devices of platforms that can be used to transfer energy when the individual, in general, is with the feet on the teeterboard of the platform. However, two of them are widely used, as (i) the teeterboard of the platform goes up and down synchronously and (ii) the right side of the teeterboard goes up when the left side goes down in a side-alternating way (and vice versa) [
Vibrations, defined as an oscillatory motion, can be generated in oscillating platforms and transmitted, in general, by the feet to whole body of a person [
Authors have demonstrated that WBV exercises might improve muscle strength [
In addition, Gómez-Cabello et al. [
Flexibility is related to the ability to move joints through their full range of motion (ROM), from a flexed to an extended position and this physical characteristic is highly desired and relevant to a subject to do their daily activities. The flexibility of a joint depends on conditions related to the muscles, ligaments, bones, and cartilage which form the joint. Although the flexibility of a joint can be genetic, it can also be improved by stretching and appropriated exercises [
Cardinale and Bosco [
Putting together all the information about the potential effects of the WBV and the limitations of the patient with syndrome metabolic, it is important to consider studies involving this kind of exercise and syndrome metabolic patient. The aim of this investigation is to present a short review, using information of the PubMed database, about the findings related to the flexibility in subjects that have performed WBV exercises, and to present a case report of a patient with metabolic syndrome that has improved her trunk flexibility due to a protocol of WBV exercises using lower frequencies.
PubMed database was searched on August 7, 2014. PubMed comprises more than 24 million citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites (
Papers were included for analysis if they described a study using whole body vibration generated by an oscillating or vibratory platform in the flexibility of subjects, independently on the clinical conditions. Moreover, the papers must be available in English and reviews were excluded. Articles published before the year 2000 were excluded. Studies involving occupational findings were not also considered. Investigations using medications and whole body vibration were deleted. The publication in which the flexibility was used as a modality of exercise was also deleted. These searches were supplemented with material identified in the references and in the authors’ personal files. Data were independently abstracted by four of the authors and disagreements were resolved by consensus.
The determination of the level of evidence of the selected papers has followed the publication of the “NHMRC additional levels of evidence and grades for recommendations for developers of guidelines” [
A 50-year-old patient Caucasian female is an outpatient of the
This investigation was approved by Ethic Committed under the reference CEP/HUPE 2874/2011, CAAE 0025.0.228.000-11, and the authors have followed the concepts of the Declaration of Helsinki and this research has protected the life, health, privacy, and dignity of the human. All the patients, as well as this patient of this work, read and signed a written informed consent.
The oscillating platform (Novaplate fitness evolution, DAF
Sessions of the whole body vibration protocol: in the first session, to aid in the proprioception, the subject was sat in a chair [
In the second session, the subject was stood up with both feet under the platform in the amplitude of 2.07 mm of the teeterboard and the frequency used was 5 Hz during 1 min. In this step the man was instructed to be in a comfortable squat position for 1 min of rest. It was repeated once again with a rest of 1 min. Then, the patient still stood up and changing her feet to the amplitude of 4.04 mm sustained the squat comfortable position for 1 min rest. The procedure was repeated once again at the same frequency and amplitude with 1 min of rest. Finally, the patient stood up and changing her feet to the amplitude of 7.07 sustained the squat comfortable position with 1 min of rest. The procedure was repeated once again at the same frequency and amplitude with 1 min of rest.
In the next sessions, the procedures of the second session were repeated in the same conditions in the next sessions; however, in each session, the frequency used was increased in one Hz up to 14 Hz.
In the several steps of the protocol, a physiotherapist was close to the subject.
Anterior trunk flexion [
The biggest DBTFF was found just before the first session and was considered 100%. The percentages to the other measurements in the different session were determined related to the 100% of the first session.
An automated device (OMRON, model HEM-7113, China) was used to verify the systolic blood pressure (SBP) and diastolic blood pressure (DBP) (mmHg) and the heart rate (HR) (beats per min-bpm), which were measured on the right arm of seated subjects after a 10-minute rest. These determinations were done just before the first session and just after the last session. Means of three readings of SBP, DBP, and HR were used in the analyses.
Statistical analysis was performed to compare the change in anterior trunk flexibility, SBP and DBP and HR before the first and after the last session of WBV exercise. The level of significance was set at
The findings of this investigation, using information of the PubMed database, reveal that there is interest in evaluating the effect of WBV exercises in the flexibility of subjects. Moreover, a case report of a patient with metabolic syndrome is presented which has significantly (
Table
Number of publications studying the use of whole body vibrations in the flexibility of subjects.
Keywords | Number of publications |
---|---|
Flexibility | 46,489 |
“Whole body vibration” | 1,158 |
Flexibility and “whole body vibration” | 32 |
“Whole body vibration” and diabetes | 11 |
“Whole body vibration” and hypertension | 3 |
“Whole body vibration” and heart | 60 |
“Whole body vibration” and “metabolic syndrome" | No items found |
Flexibility and “whole body vibration exercises” | Quoted phrase not found |
Flexibility and “oscillating platform” | No items found |
Flexibility and “vibratory platform” | No items found |
In this study the publications searched with the keywords flexibility and “whole body vibration” that has rendered thirty-two publications were considered. Considering the exclusion criteria, (a) one of these papers was in Russian, (b) three publications before the year 2000, (c) two studies involving occupational findings, (d) four publications involving revisions, (e) one investigation evaluating the effect of medication (alendronate) and whole body vibration [
Fifteen publications that reached the inclusion criteria were analyzed considering the effect of the WBV on the flexibility. The frequency and amplitudes used and the mean age and sex of the subjects in the studies and the findings are shown in Table
Findings about the effect of the WBV in the flexibility, the frequency used, and the mean age and sex of the subjects in the selected studies.
Publication | Effect in the flexibility/level of evidence (LE) | Age (years) | Sex | Frequency and amplitude |
---|---|---|---|---|
Despina et al., |
Superiority of WBV training, especially in the post 15 measurement, in all flexibility and strength measures, as well as in a number of balance tests in comparison to exercise program performed without vibration. |
17.54 ± 0.52 | 11 women | 30 Hz/2 mm |
|
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Horstmann et al., |
WBV training may be an alternative or a complementary treatment in patients who do not respond well to eccentric training with improvements in symptoms and pain, structural changes, and muscle flexibility an,d strength of the triceps surae muscle-tendon unit |
46.0 ± 6.9 | 13 men |
13 to 18 Hz/0.4 to 0.6 mm |
|
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Lee and Chow |
Improvement in lumbopelvic coordination and flexibility after WBV |
23.2 ± 1.2 | 10 men | 18 Hz/6 mm |
|
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Tsuji et al., 2014 [ |
Effect on flexibility was similar with and without vibration stimulus |
69.1 ± 2.5 | Nine men and |
40 Hz/2–4 mm |
|
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Gómez-Cabelloet al., 2013 [ |
WBV group showed better ( |
75.0 ± 4.7 | 20 men and |
40 Hz/2 mm |
|
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Karatrantou |
Short-term side-to-side WBV training program improved flexibility ( |
20.40 ± 0.27 | 26 women | 25 Hz/6 mm |
|
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Wheeler and Jacobson 2013 [ |
No differences ( |
20.85 ± 1.81 | 10 men and |
1 min—20 Hz, |
|
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Bunker et al., |
An increase in the flexibility and power output of individual golfers occurs when a WBV warmup bout is performed |
45 ± 15 | 10 men | 50 Hz/2 mm |
|
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Di Giminiani et al., 2010 [ |
Individualized WBV without superimposing other exercises is an effective method of acutely increasing lower back and hamstring flexibility |
18.37 up to |
15 men and |
20–55 Hz/1 mm |
|
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Feland et al., |
Stretching with vibration on a WBV platform appears to be a good adjunct to static stretching with the potential to enhance retention of flexibility gains |
23.4 ± 1.7 | 22 men, |
26 Hz/4 mm |
|
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Gerodimos et al., |
Single WBV bout may increase flexibility which persists for at least 15 min and the effects were observed irrespective of frequency and amplitude |
20.5 ± 1.7 | 25 women | 15–30 Hz/4–8 mm |
|
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Jacobs |
Short-term WBV standing elicits acute enhancements of lower-extremity muscular torque and flexibility |
28.6 ± 9.73 | 10 men and |
Up to 26 Hz |
|
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Fagnani et al., |
WBV is a suitable training method to improve knee extension maximal strength, countermovement jump, and flexibility ( |
21 up to 27 | 26 women | 35 Hz/4 mm |
|
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van den Tillaar, |
A significant increase in hamstring flexibility was found |
21.5 ± 2.0 | 12 women and 7 men | 28 Hz/10 mm |
|
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Cochrane and Stannard, 2005 |
Acute WBV causes improvement ( |
21.8 ± 5.9 | 18 women | 26 Hz/6 mm |
WBV: whole body vibration.
LE: level of evidence.
The level of evidence of the selected papers is also shown in the Table
Sixteen papers involving the flexibility and whole body vibration were analyzed and eight of them were with level of evidence II.
The findings concerning to the systolic blood pressure (SBP) and diastolic blood pressure (DBP) indicated that before the first session, SBP and DBP were
Figure
% of the distance between the third finger of the hand of the patient and the floor (DBTFF) in sessions in various days.
WBV generated a type of exercise in an oscillating platform that, in appropriated conditions, is safe [
Flexibility is regarded as a major component of physical ability and good physical health, particularly the anterior flexibility of the truck [
Beavers et al. [
Although the mechanisms of this effect related to the flexibility are not fully known, previous studies suggest that the improvement in flexibility by WBV is associated with several mechanisms, such as suppression of the central nervous system owing to a decrease in motor neuron pool excitability increasing the blood flow [
An important number of publications (more than forty-six thousand) were found in the database PubMed with the keyword “flexibility.” Eight of the selected papers involving the flexibility and whole body vibration had level of evidence II. This fact could be due to the flexibility be a major component of physical ability and good physical health. WBV is a modality of exercise in an oscillating platform that, in appropriated conditions, is safe and has been proposed as clinical intervention in the treatment of several disorders as well as to improve the performance of subjects, as the improvement of the flexibility. A poor physical performance is observed in the patient with metabolic syndrome and with a simple and safe protocol using WBV exercises, an improvement of the flexibility in a patient with this syndrome was obtained. It is concluded that the WBV exercises could be useful to aid the patient with metabolic syndrome.
The authors declare that there is no conflict of interests regarding the publication of this paper.
The authors thank the support of the Fundação Carlos Chagas Filho de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).