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      Efficacy of whole body vibration therapy on pain and functional ability in people with non-specific low back pain: a systematic review

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          Abstract

          Background

          Whole body vibration (WBV) is currently increasing in popularity as a treatment modality for musculoskeletal disorders and improving health-related quality of life. Recent research has shown that WBV can reduce low back pain and improve the functional abilities for patients, however, optimal frequency and duration of vibration for therapeutic use is unclear. This review was conducted to summarize and determine the efficacy of whole body vibration therapy on individuals with non-specific low back pain (NLBP) and evaluated methodological quality of the included studies.

          Methods

          Online literature searches through the Web of Science, PubMed, Cochrane Library databases, PEDro, Ovid, EBSCO (Medline) and Scopus were conducted up to December 2019. Randomized controlled trials investigating the effect of WBV on pain intensity and/or functional ability in individuals with non-specific low back pain (NLBP) were included. Details of the sample characteristics, treatment of the comparison group, WBV parameters and outcome measures were recorded, and methodological quality appraised using the PEDro scale.

          Results

          7 published RCTs (418 patients) were included in the systematic review. Due to heterogeneity in vibration parameters and prescriptions, and small number of studies, no meta-analysis was performed. Four out of the six included studies using pain as an outcome measure showed that WBV had a beneficial effect on pain compared with the control group, whereas only two trials were considered to be of high methodological quality. Among the six studies which measured functional ability, three studies with good quality reported significant between-group differences in favor of WBV.

          Conclusions

          There is limited evidence suggests that WBV is beneficial for NLBP when compared with other forms of interventions (stability training, classic physiotherapy, routine daily activity). Due to the small sample sizes and statistical heterogeneity, we still cannot draw conclusions that WBV is an effective intervention. Further high-quality studies are needed before clinical recommendations can be provided to support its use in a general population with NLBP and to explore the optimal treatment protocol.

          Trial registration

          PROSPERO registration number: CRD42017074775.

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          Most cited references30

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          The measurement of lumbar proprioception in individuals with and without low back pain.

          A clinical trial comparing a back pain group with a pain-free group. To investigate whether proprioceptive deficits existed in a group of individuals reporting low back pain. Little work has so far been conducted on the measurement of proprioception in the spine. Those studies that have been carried out, however, have failed to identify proprioceptive deficits in individuals with back pain. Previous work on peripheral joints has revealed that proprioception is affected with muscular or joint injury or degeneration. Forty individuals took part in the study, 20 with back pain and 20 with no pain. Participants were required to reproduce a predetermined target position, in standing and four-point kneeling, 10 times in 30 seconds. A computer screen was used to provide visual feedback on position. A mean deviation from the target position was obtained for each individual. A measurement of left elbow position sense was conducted in five individuals from each group to establish differences in short-term motor memory between the groups. There were no differences between the subject groups in terms of short-term motor memory (P > 0.05). A two-way analysis of variance between subject groups and position to identify differences in accuracy (deviation from the target) found that there were differences between subject groups in either position (P 0.05). Differences in proprioception do exist between individuals with back pain and those free from back pain. Further research needs to be undertaken on proprioceptive exercise programs and their effect on back pain.
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            Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise.

            The effects of hard squatting exercise with (VbX+) and without (VbX-) vibration on neuromuscular function were tested in 19 healthy young volunteers. Before and after the exercise, three different tests were performed: maximum serial jumping for 30 s, electromyography during isometric knee extension at 70% of the maximum voluntary torque, and the quantitative analysis of the patellar tendon reflex. Between VbX+ and VbX- values, there was no difference found under baseline conditions. Time to exhaustion was significantly shorter in VbX+ than in VbX- (349 +/- 338 s versus 515 +/- 338 s), but blood lactate (5.49 +/- 2.73 mmol l-1 versus 5.00 +/- 2.26 mmol l-1) and subjectively perceived exertion (rate of perceived exertion values 18.1 +/- 1.2 versus 18.6 +/- 1.6) at the termination of exercise indicate comparable levels of fatigue. After the exercise, comparable effects were observed on jump height, ground contact time, and isometric torque. The vastus lateralis mean frequency during isometric torque, however, was higher after VbX+ than after VbX-. Likewise, the tendon reflex amplitude was significantly greater after VbX+ than after VbX- (4.34 +/- 3.63 Nm versus 1.68 +/- 1.32 Nm). It is followed that in exercise unto comparable degrees of exhaustion and muscular fatigue, superimposed 26 Hz vibration appears to elicit an alteration in neuromuscular recruitment patterns, which apparently enhance neuromuscular excitability. Possibly, this effect may be exploited for the design of future training regimes.
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              Effects of whole body vibration therapy on main outcome measures for chronic non-specific low back pain: a single-blind randomized controlled trial.

              The aim of this study was to determine whether a 12-week course of low-frequency vibrating board therapy is a feasible therapy for non-specific chronic low back pain, and whether it improves the main outcome measures. Randomized controlled trial. A total of 50 patients with non-specific low back pain were included. They were randomly assigned to either a vibrating plate via reciprocation therapy group (n = 25) or a control group (n = 25). The 12-week vibration therapy programme consisted of a total of 24 training sessions (2 times/week, with 1 day of rest between sessions). Assessments of the main outcome measures for non-specific low back pain were performed at baseline and at 12 weeks. In the vibration therapy group there was a statistically significant improvement, of 20.37% (p = 0.031) in the Postural Stability Index (anterior-posterior); 25.15% (p = 0.013) in the Oswestry Index; 9.31% in the Roland Morris Index (p = 0.001); 8.57% (p = 0.042) in EuroQol 5D-3L; 20.29% (p = 0.002) in the Sens test; 24.13% (p = 0.006) in visual analogue scale back; and 16.58% (p = 0.008) in the Progressive Isoinertial Lifting Evaluation test. A 12-week course of low-frequency vibrating board therapy is feasible and may represent a novel physical therapy for patients with non-specific low back pain.
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                Author and article information

                Contributors
                wangweim@mail2.sysu.edu.cn
                wangshut@link.cuhk.edu.hk
                linwj35@mail.sysu.edu.cn
                sophielixian@163.com
                lla@nfa.dk
                wangyul@mail.sysu.edu.cn
                Journal
                BMC Complement Med Ther
                BMC Complement Med Ther
                BMC Complementary Medicine and Therapies
                BioMed Central (London )
                2662-7671
                27 May 2020
                27 May 2020
                2020
                : 20
                : 158
                Affiliations
                [1 ]GRID grid.488525.6, Department of Rehabilitation Medicine, , The Sixth Affiliated Hospital, Sun Yat-sen University, ; Guangzhou, China
                [2 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Faculty of Medicine, , The Chinese University of Hong Kong, ; Hong Kong, SAR China
                [3 ]GRID grid.418079.3, ISNI 0000 0000 9531 3915, National Research Centre for the Working Environment, ; Copenhagen, Denmark
                Author information
                http://orcid.org/0000-0002-2079-3568
                Article
                2948
                10.1186/s12906-020-02948-x
                7251707
                32460819
                bb73a266-c5c1-4697-9ce1-ca14bb21b051
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 13 March 2019
                : 12 May 2020
                Funding
                Funded by: National Natural Science Foundation of China (CN)
                Award ID: 81472155
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                low back pain,vibration,physical therapy modalities
                low back pain, vibration, physical therapy modalities

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