Whole-Body Vibration Training
Effects on Balance, Lower Body Strength, Balance Confidence and
Health-related Quality of Lifein Older Adults
Lyndsay Foisey Western University, Ontario Canada
Introduction Methods Statistical Analysis Results Conclusion Limitations Recommendations for Future Trials
Overview
30% older adults 65 years + fall at least once per year ◦ Leading cause of disability, injury, death
Major cause of functional decline and increased dependency health care system usage
Poor muscle strength, poor balance, fear of falling common age-related factors associated with fall risk
Introduction
Balance and strength training programs decrease fear of falling, improve balance, strength
However, older adults may be unwilling/unable to exercise ◦ >50% not meeting current PA standards
New exercise method gaining popularity is whole-body vibration (WBV) training◦ Less time/effort than traditional exercise
Introduction (cont.)
What is Whole-Body Vibration (WBV) Training?
Typically consists of standing or exercising on vibrating platform for single or multiple sessions
Vibrations transmitted through lower body from the point of contact (i.e. the feet)
Vibration creates reflex muscle contraction which is theorized to be reason for strength improvements
Increased muscle activity compared to no vibration
Introduction (cont.)
Whole-Body Vibration training and Aging Research
Safe method of exercise for older adults Study durations of 6 weeks to 18 months Significant improvements in strength, balance Increased compliance to WBV program than Ex
program
No study on fear of falling and WBV Need for research on effective and efficient program Questions about tolerance of program; not many
studies in North America
Introduction (cont.)
Research Question
What are the effects of an 8-week whole-body vibration training
program on the balance, lower body strength, balance confidence and
quality of life in older adults?
N = 23 (12 WBV; 11 control), randomized Aged 62 – 92 years old WBV protocol
◦ 3 sessions per week (8 weeks)◦ 60 seconds on platform, rest, repeat; total time 6 to 11
minutes Measures conducted before and after 8 weeks:
1. Body Sway2. Lower Body Strength3. Functional Balance4. Balance Confidence5. Quality of Life
Methods
1. Body Sway (Balance)
◦ Specific balance measure that records spontaneous sway while standing on force platform (technical device to measure balance)
◦ Stood as still as possible, arms relaxed by side◦ Significant results reported in previous WBV
studies
Methods (cont.)
2. Sit-to-Stand Test (Lower Body Strength)
◦ From seated position with feet on floor, participant stood and returned to seated position 5 times as quick as possible. Time to complete 5 sit-to-stands recorded.
◦ Indirect measure of knee extension strength/power
◦ Fast, low cost equipment (chair, time watch)◦ Implemented in previous WBV study
Methods (cont.)
3. Activities-specific Balance Confidence scale (Balance Confidence)
◦ Fear of falling measure for community-dwelling older adults
◦ Completed a one-page survey◦ Participant rated their perceived balance
confidence from 0-100% on tasks such as stepping on escalator, standing on a chair
◦ Improved in previous physical activity studies
Methods (cont.)
4. Berg Balance Scale (Functional Balance)
◦ Participant asked to perform 14 balance tasks such as seat transfer, one-leg stance, pick up object from floor
◦ Rated from 0-4, to maximum of 56 points 0-20 total points indicates severe fall risk 21-40 Medium fall risk 41-56 Low fall risk
Methods (cont.)
5. Medical Outcome Survey Short-form 36 (Health-related Quality of Life)
◦ Participants completed survey of 36 questions◦ Evaluates levels from 0 to 100 for 4 phys health, 4
mental health areas◦ Improved in previous WBV study with long-term
care residents
Methods (cont.)
Two-way Analysis of Variance (ANOVA); Group and Time for Body Sway parameters
Wilcoxon Signed-Rank for within-subject analysis for Berg Balance Scale, Sit-to-Stand, Balance Confidence, Quality of Life
Mann Whitney for between-group analysis Berg Balance Scale, Sit-to-Stand, Balance Confidence, Quality of Life
Statistical Analysis
After 8 weeks:Results
Measure WBV Control
Body Sway No Change No Change
Lower Body Strength Significant Improvement
(p = 0.04)
No Change
Functional Balance Significant Improvement
(p = 0.04)
No Change
Balance Confidence No Change No Change
Quality of Life No Change No Change
Body Sway◦ No change after 8 weeks◦ No difference in body sway detected between
WBV group or control group
Results (cont.)
WBV group Control Group
Resultant Sway
Pre-test 8 weeks Pre-test 8 weeks
Medial-lateral sway range (mm)
33.85±10.19 31.89 ±7.78 35.90 ±9.27 43.37±19.06
Anterior-posterior sway range (mm)
22.31±23.85 14.94±6.17 22.64±18.17 18.80±5.98
Sit-to-Stand scores (Lower Body Strength)
Results (cont.)
Pre-test 8 weeks10
10.5
11
11.5
12
12.5
WBV
Control
Time
Tim
e in
Secon
ds
*
Berg Balance Scale scores (Functional Balance)
Results (cont.)
Pre-test 8 weeks3940414243444546474849
WBV
Control
Time
Score
/5
6
*
Activities-specific Balance Confidence Scale (Balance Confidence)
No change for either WBV or control after 8 week trial; however WBV slightly improved compared to control (ns)
Results (cont.)
Pre-test Week 880
81
82
83
84
85
86
87
WBVControl
Time
AB
C S
core
(/1
00
)
MOS Short-Form 36 (Health-related quality of life measure)
◦ No statistically significant difference for either group after 8 week trial
◦ Noteworthy: Physical Function for WBV (p = .059)
Results (cont.)
Take Home Message Functional balance and lower body strength
measures significantly improvement in the WBV group after 8 weeks
Balance confidence and quality of life ceiling effect?
All study participants found WBV program very tolerable
More research needed for optimal training prescription to improve balance, balance confidence
Conclusion
Small sample size◦ Results in low statistical power
Study duration ◦ To improve body sway, may need 1)to be longer
than 8 weeks, 2) to implement more difficult balance protocol during WBV training
Participants and researcher not blinded◦ Could create bias in test responses
Limitations
Implement balance protocol during WBV intervention
Larger sample size Participants with lower balance confidence
Recommendations for Future Trials
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