Abstract
BackgroundDynapenia (age-associated loss of muscle strength not caused by neurologic or muscular diseases) and functional limitations (e.g. climbing stairs, chair rising) are important problems in elderly persons. Whole body vibration, used as an adjunct to classical resistance training or even as a stand-alone alternative, might help to reduce these problems. Its value might be highest in elderly persons with very low function, where whole body vibration can be used as a skilling up training until more conventional exercise types are possible. This systematic review and meta-analysis summarized the current evidence for whole-body vibration interventions on isometric maximum voluntary contraction, dynamic strength, power, rate of force development and functional strength in elderly categorised in different subgroups based on function levels.MethodsAn extensive literature search was carried out in February 2014 and repeated in February 2015 at PubMed, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database and CINAHL electronic databases. The International Clinical Trials Registry Platform from the World Health Organization was also searched. Randomized controlled trials measuring isometric maximum voluntary contraction, dynamic strength, power, rate of force development and functional strength in studies using WBV intervention in 65 years or older elderly individuals were included. The methodological quality of included studies was assessed using the Cochrane Collaboration’s tool for assessing Risk of Bias. Studies were classified based on the level of physical capacitiy of the participants as “Go-Go”, “Slow-Go” or “No-Go”. Data were pooled using a random effects model.ResultsThirty-eigth articles of moderate methodological quality were included. The vibration modes for sinusoidal vertical whole-body vibration was between 25 and 40 Hz, the amplitude varied from 2 to 4 mm. Sinusoidal side-alternating -whole-body vibration revealed frequencies from 2.5 to 35 Hz with amplitudes ranging from 0.05 to 12 mm. Stochastic resonance whole-body vibration used frequencies between 3 and 6 Hz. Effect sizes in Go-Go were moderate after vertical sinusoidal Whole-body vibration compared to non-training control groups for isometric maximum voluntary contraction with effect size 0.48 (95 % CI 0.33 to 0.63) and for Dynamic Strength with effect size 0.47 (95 % CI 0.06 to 0.88). Side-alternating sinusoidal whole body vibration showed moderate effect sizes with 0.69 (95 % CI 0.32 to 1.06) for isometric maximum voluntary contraction, 0.50 (95 % CI 0.07 to 0.92) for power, 0.40 (95 % CI 0.16 to 0.64) for Rate of Force Development and 0.42 (95 % CI 0.13 to 0.71) for Functional Strength compared to non-exercise control. The analysis for Slow-Go showed for stochastic resonance whole-body vibration and Functional Strength an effect size of 0.97 (95 % CI −0.07 to 2.00) compared to non-exercise control in one study. No-Go showed for stochastic resonance whole-body vibration a moderate effect size with 0.50 (95 % CI −0.32 to 1.33) for Functional Strength compared to non-exercise control.ConclusionsWhole-body vibration shows beneficial effects, mainly in the No-Go group elderly compared to non-training control and conventional strength training groups. The results suggest that WBV can be used as a skilling-up exercise in participants not able to perform standard exercises. Further studies with the various types of WBV in various sub-populations of elderly persons are needed to determine the most effective vibration modes.Trial registrationRegistration number: CRD42013006489.Electronic supplementary materialThe online version of this article (doi:10.1186/s11556-015-0158-3) contains supplementary material, which is available to authorized users.
Highlights
Dynapenia and functional limitations are important problems in elderly persons
Effect sizes in independent person (Go-Go) were moderate after vertical sinusoidal Whole-body vibration compared to non-training control groups for isometric maximum voluntary contraction with effect size 0.48 and for Dynamic Strength with effect size 0.47
Side-alternating sinusoidal whole body vibration showed moderate effect sizes with 0.69 for isometric maximum voluntary contraction, 0.50 for power, 0.40 for Rate of Force Development and 0.42 for Functional Strength compared to non-exercise control
Summary
Dynapenia (age-associated loss of muscle strength not caused by neurologic or muscular diseases) and functional limitations (e.g. climbing stairs, chair rising) are important problems in elderly persons. The term dynapenia, coined by Manini and Clark [3,4,5], best describes the condition of decreased muscle strength and power instead of the term sarcopenia. The latter only refers to an age-related loss in skeletal muscle mass. Muscle weakness is related to falls, lower walking speed, functional limitation, a decrease in mobility, and disability [6,7,8] In this context, the elderly are viewed as a group of people in need [9]. A classification of elderly based on physical abilities; e.g. physical and mental functions is more appropriate
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