Introduction

General Introduction

It is world wide accepted that exercise is beneficial for improvement of patient’s health. In various cases, such as a patient recovering from injuries or surgical intervention, exercise is recommended to improve patient’s health, condition and well being.

It has been clinically proven that exercise has a positive influence on muscle strength, blood flow and stabilization and coordination. Obviously there are a large number of exercise modalities for the physician to treat his/her patient. Home exercise or sports are the easiest accessible and easiest to perform for the patients and therefore they are frequently recommended. However, the medical control is low. In some cases it is required that the exercise is done in a more controlled manner. One can easily imagine that a patient who recently suffered from a heart attack may need to improve his/her general health status in a more controlled medical setting.

For these patients exercise must be performed in a clinical environment, e.g. within the hospital. In order to make the exercise more controlled, devices such as treadmills, powered bicycles and Whole Body Vibration (WBV) can be used. The various powered exercise devices supply exercise in different ways. Depending on the preference of the patient, but more importantly depending on the clinical capabilities of the patient, an appropriate exercise and device must be selected. E.g. patients incapacitated regarding running or even walking with a treadmill exercise device may benefit more from a powered bicycle or vibrating plate. The same may hold true e.g. for patients with vertebral disorders.

It should also be considered that a significant amount of patients who are advised to exercise at home or sports environment are likely to discontinue the exercise task, because of their unfamiliarity with exercise and/or sports. For this group of patients an exercise that is restricted in time and supervised in a clinical setting is more likely to be adhered to over time.

Training and exercise helps improving the rehabilitation of patients and affects secondary events of these diseases or injuries positively. For instance, patient recovering from injury, surgery or disease, requiring bed rest for a period of time, suffer from muscle atrophy as a secondary event. In order to improve their rehabilitation after an immobile period, training is essential to improve their muscle strength, blood flow, and coordination. The diseases immobilizing subjects are numerous but examples are broken/splinted limbs, brain injury (stroke), myocardial infarction, coma, etc.
In the medical world, the biomechanical aspects of vibration training and therapy are broadly applied for the treatment, control and prevention of different disease patterns and injuries. Vibration training is successfully used for the treatment of e.g. osteoporosis, arthrosis, multiple sclerosis, rheumatism and varicose veins. Vibration training is also applied to revalidation after accidents or serious injuries. Although there are other methods of training such as running, cycling etc is it preferably for these populations to offer exercise in a more controlled setting and by a safer method and therefore the WBV is used for medical purposes.

Vibration exercise

Vibration is a mechanical stimulus characterized by an oscillatory motion. The variables that determine its intensity are the frequency and amplitude. The effects of whole body vibrations (WBV) have been studied on vibrating plates producing sinusoidal vibrations by two different systems:

  • Reciprocating vertical displacements on the left and right side of a fulcrum
  • The whole plate oscillating uniformly up and down

The body relies on a range of structures and mechanisms to regulate the transmission of impact shocks and vibrations through the body including: bone, cartilage, synovial fluids, soft tissues, joint kinematics and muscular activity. WBV exercise devices deliver vibrations across a range of frequencies (15-60 Hz) and displacements from

Vibration training

Vibration is defined by three characteristics: direction, frequency and amplitude. The combination of these three characteristics determines the speed and the acceleration of the motion. Within a vibration, the speed of the mass is zero at the peak of the motion, meaning that the speed of the vibrations with regard to time is variable and so is the acceleration. This results in a function of the speed and acceleration, which is called a sinusoidal curve.
Three principles of vibration are described:-

  • Rotating vibration The platform makes rotating movements in the horizontal plane.
  • Vertical vibration The platform moves constantly and exclusively up and down.
  • Tilting vibration The platform ‘rocks’ around an axis.

The direction created by the VibroGym Medical is vertical, where the platform moves exactly vertically; straight up and straight down.

Muscle

Muscle is contractile tissue of the body and is derived from the mesodermal layer of embryonic germ cells. The function of the muscle is to produce force and cause motion, either locomotion or movement within internal organs.

There are three types of muscles:-

  • Skeletal muscle: Skeletal muscles are anchored by tendons to bones and are used to affect skeletal movement (such as locomotion) and in maintaining posture (Figure 1)
  • Smooth muscle: These are found within the walls of organs.
  • Cardiac muscle: A special type of muscle tissue only found within the heart.

anatomy of knee

Anatomy of the skeletal muscle

Vibration training is not only based on an increase of the acceleration, but also on a reflex of the muscles (myotatic reflex).

Motion of the body is enabled by skeletal muscles. Skeletal muscles are attached to skeletal structures. For cardiac and smooth muscle this is not the case. Muscles, in general, use the movement of actin against myosin to create contraction. In skeletal muscle, contraction is stimulated by electrical impulses transmitted by the nerves, the motor nerves and motor neurons in particular. All skeletal muscles are facilitated by the neurotransmitter acetylcholine.

In general, a muscle is always connected to at least two bones by way of sinews (= tendon: a cord or band of inelastic tissue connecting a muscle with its bony attachment) and affects the t-motion (a natural event that involves a change in the position or location of something) of the skeletal structures in relation to each other. In order words skeletal muscles move our body structures: arms, legs, etc. One muscle moves at least one joint but it can move more than one joint as well (Figure 1).

This means that by applying exercise, muscles are being trained, and by that bone structure, blood flow, lungs and all other organs supporting these activities, directly or indirectly receiving training and exercise as well.