Following completion of this chapter, the student will be able to:
Understand the influence of vibration therapy on various tissues and systems.
Understand potential clinical applications of vibration therapy.
Identify different forms of vibration therapy.
Identify the influence of vibration characteristics on the efficacy of application.
Vibration therapy has received increasing attention as a potential rehabilitation modality. While long-term exposure to vibration can have negative health-related consequences such as neuropathy,1,2 benefits for somatosensory function, muscle function, bone and cartilage health, and self-report patient outcomes have been reported. This chapter provides an overview of the potential applications for rehabilitation and recommendations for clinical use.
Vibration is generally applied to the target tissue either directly with local vibration (Figure 17–1) or indirectly using whole body vibration (Figure 17–2). Local vibration is provided by a small device that is either hand-held by the clinician or secured to the patient, and provides a vibratory stimulus via a small oscillator. Whole body vibration is delivered via a stationary platform that cyclically accelerates the body upward. Vibration provided by these devices is most commonly delivered to patients for periods of time ranging 30–60 seconds over a frequency range of 10–100 Hz and with a magnitude of 0.1–10 g and amplitude of 2–9 mm, and these characteristics appear to influence the efficacy of vibration on the target tissues.
Whole body vibration device.
Several musculoskeletal pathologies (e.g., anterior cruciate ligament injury, osteoarthritis, functional ankle instability) and neuromuscular disorders (e.g., Parkinson’s disease, stroke, cerebral palsy, and multiple sclerosis) incur somatosensory dysfunction that manifests as impaired proprioception, kinesthesia, postural control, and reflexive neuromuscular control. These sensory functions result from a combination of inputs from multiple receptors (e.g., cutaneous, tenomuscular, articular, bone), many of which are stimulated by vibration (Figure 17–3).3–6 As such, incorporating vibration into rehabilitation may be beneficial for improving somatosensory function including proprioception, kinesthesia, balance, and reflexive neuromuscular control.
Vibration can stimulate multiple types of sensory receptors that collectively send information to the central nervous system where it is integrated to improve somatosensory function drive motor commands.
Effects of Vibration on Proprioception and Kinesthesia
Proprioception refers to the ability to detect the relative orientations of body segments, and is typically evaluated by measuring joint position sense (JPS; i.e., the ability to passively or actively replicate a given joint position). Kinesthesia refers to the sensation of joint motion, and is typically evaluated by measuring the threshold to detection of passive motion (TDPM, i.e., the minimum magnitude of joint motion ...