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Vibration Therapy

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 Vibration Abstracts News Update  What is Multiple Sclerosis? Quick Reference Guide
There is ongoing interest in the Australian MS Social Media about vibration therapy. Originating from the aerospace industry to combat muscle degeneration arising from 'weightless' environments vibration therapy is now increasingly used by fitness and rehabilitation practitioners in a variety of settings. Watch a ''must view" video on this topic.
Shortly stated, the physiological basis behind the therapy is simple: vibration platforms vibrate up and down over a distance of a few millimeters, up to 50 times per second, thereby naturally stimulating the stretch reflex to, in turn, create an involuntary muscle contraction. Originally commercialised for use in a sport and fitness environment it is gaining recognition as a rehabilitation aid for people with a range of disabilities. The vibration 'energy' is transferred from the platform via a range techniques. The most common of these is by standing or lying on the platform, via arm straps (upper body work) or combinations thereof. Within one minute, a patient can undergo up to 3,000 muscle contractions. This involuntary stretch reflex leads to the many benefits that vibration exercise therapy can provide.
Disabilities Vibration exercise therapy is well suited as an effective exercise solution for those having difficulty engaging in a conventional exercise program due to physical limitations. Research has shown similar strength gains from 20 minutes of vibration exercise as compared to an hour of conventional exercise. Moreover, many people with disabilities are simply not able to effectively engage in 'conventional' exercise.
Strength and flexibility training can initially be done in static, pain free range of motions. Patient populations reported to have benefited from this include those with multiple sclerosis, fibro myalgia, spinal cord injury, osteoporosis, and Parkinson’s Disease, to name a few - visit the Canadian Chiropractor for more background information.
While many people with MS are not able to effectively engage in ‘conventional' exercise it is reported that appropriately supervised vibration therapy can be a great help. Examples include maintaining/restoring muscle integrity, recovering from exacerbations, wheelchair applicability and general well being.  This document brings together some examples, including research references, whereby people with MS identify benefits from this innovative and adaptable technology.
In July 2009 Rachael Mason, from the Institute of Food, Nutrition and Human Health at Massey University, New Zealand, provided a presentation to the Australasian Rehabilitation Conference in relation to a study at Massey that addressed the issue of diminished neural input to facilitate muscle contraction
Vibration  Therapy In discussing the study Rachael said, “We wanted to apply vibration therapy to a group who could benefit the most, People with MS, because they can't use their muscles in a fully co-ordinated way, often don't get any physical activity. Some of the health problems they end up with are, in fact, related to the fact they are not exercising so there is real potential for these people.” Rachael conducted the study as her Masters of Science Exercise Physiology project. -

The purpose of this study was firstly to investigate whether 8 weeks of whole body vibration (WBV) training was an acceptable form of exercise for Multiple Sclerosis (MS) patients and secondly what effect may it have on measures of functional capacity. This is believed to be one of the first studies to investigate WBV as an exercise training modality for MS patients. The study was supported through funding from the Palmerston North Medical Research Foundation.


  The study supervisor Dr Steve Stannard said ''the trial was devised to see whether side-to-side alternating vibration therapy was able to assist MS sufferers, who often became unable to move their muscles normally due to damage caused in the central nervous system''. Dr Stannard went on to say that ''the vibration stimulus is thought to cause a reflex contraction of muscle so in MS patients this might be therapeutic - it's a way of side-stepping the brain and making the muscles contract'

Fifteen MS participants volunteered for WBV training three times a week on a commercialised Galileo Sport™ vibration machine with an oscillating platform.  Training consisted of two four week blocks based on an increasing stimulus training programme (overload principle).  The first fours weeks involving five sets of 1-min WBV with 1-min rest in between with increasing vibration frequency (15-25Hz, 2.6mm-4.1mm amplitude); the second four weeks training increased to eight sets of 1-min WBV (15-20Hz, 6.1mm amplitude).  Functional performance measures (Timed up and Go, Standing Balance, Functional Reach and Timed walk) and quality of life questionnaire (SF-36) were conducted prior to training, at 4 weeks, 8 weeks and 2 weeks (10wk) following the completion of the training.

Study Results and Conclusions: The 10m walk test showed significant improvements at the 2m, 8m and 10m measure between pre vs. 8wk (P<0.05) and pre vs.10wk (P<0.05).  Timed up and Go demonstrated a significant time effect (P<0.05).  Standing balance showed significant improvements at pre and 4 week (p<0.05) and pre and 10 week (p<0.05). This is one of the first studies to investigate WBV as an exercise training modality for MS patients.  It was shown that not only is WBV training safe, well tolerated by MS patients but it also improved standing balance and walking speed in MS patients.   Read more about this study.
  While some earlier research on this topic at the Department of Physical Medicine and Rehabilitation, Medical University of Vienna, Austria was published in 2005 the Massey study appears to be more comprehensive in its scope and the ways it sets out to translate the outcomes into 'real word' environments - click here to read the Austrian study and some related references.  
Dr Lucas Dreyer says the study involving whole body vibration was a success and the therapy will be added to the programmes of clients with a more advanced form of the disease.
The Massey School of Sport and Exercise Science in conjunction with the Multiple Sclerosis Society's Central District Office provides an ongoing exercise Clinic for pwMS. Each program accommodates 20 people.  This is a practicum course that sees third-year sport and exercise science students become personal trainers, guiding clients through a workout each week. Dr Dreyer said the clinic gives those involved the chance to get a tailored workout they couldn’t get anywhere else. The student works with the client on cardio fitness, with weights and at balance training, and it seems to be getting results. The clinic builds on the outcomes of the project carried out by Rachael Mason.

  The main focus of the programme is to improve cardiovascular fitness, as that deteriorates quite dramatically once walking ability is affected by the disease. Vibration training is used to help give those clients adequate leg strength motor ability to do other forms of exercise.  
Some participants start with the vibration training - once their strength and fitness have improved to a level that they can tolerate in combination with other exercises. Dr Dreyer says the program gives students sound practical experience. “They have to come up with the exercise programme themselves and tailor it to the client’s needs, and then train them one-on-one,” he says. “It’s good preparation for the workforce” 
It is hoped the clinic will run every year in conjunction with the Multiple Sclerosis Society’s Central Districts office. Field officer Philippa Russell says the clinics are proving a huge success. “The feedback is all positive both in terms of the physical side of things, and with the camaraderie they foster. I really hope this partnership continues. - Read comments by clinic participants.
Commitment Incorporating a meaningful exercise regime in one's lifestyle is a long term commitment for pwMS. Professional guidance in formulating and revising plans appropriate to individual needs is important. Programs that include options to participate in group activity (involving other pwMS) are an important aspect of the NZ experience. The involvement of the MS Society as a partner in the process helps to engender 'unity of purpose'.  Institutional assistance strengthens professional cultures relating to the importance of exercise for pwMS and may also address some cost issues.
Performance standards (based upon reasonable expectations) need to be both quantitative and qualitative - the importance of enhancing quality of life perceptions was recognised in the NZ trial. Incorporating an element of 'try before you buy' helps to minimise possible apprehension by potential participants - it also helps to create awareness - the NZ vibration trial ran over an 8 week period followed by an ongoing exercise program that also incorporated vibration therapy. Private sector participation helps to establish broader based long term service delivery. Vibration therapy can, as a starting point, play an important role in strengthening and maintaining muscles at a risk of atrophying through lack of regular and relevant use. You have to feel it to believe it.
As best understood, neither study examined ways in which vibration benefits could best be translated to people with MS in wheelchairs and who may not be able to stand on vibration platforms. There also did not appear to be any significant attention placed upon ways in which the vibration process can be used to enhance upper body strength for those in wheelchairs. Both of these aspects were subsequently addressed (2009 to 2012), to good effect, by members of the Northern Rivers (Australia) MS Support Group, in association with two regional gyms who incorporated vibration therapy into their programs.
Wheelchairs Some interesting experimentation and innovation took place in transferring vibration energy to people in appropriately supported wheelchairs. Common practices included placing the feet on the vibration platform and applying downward  knee pressure and the use of straps to transfer vibrations via the arms.
Also highly effective was for wheelchairs to be 'backed' against the vibration platform and pressure applied to the knees - forcing the chair wheels against the platform (solid tyres only and not electric wheelchairs or scooters) -.this allows the vibrations to travel via the tyres of the wheelchair through all parts of the body in direct contact with the chair, i.e the lower back and upper leg area. Gripping the rubber tyres while this is happening provides a great hand and arm workout. In addition to stimulating blood flow and muscle tone this is reported by many to be a great body massage. Good back support and seating is essential for both comfort and the maintenance of vibration integrity. The specialist vibrogym trainers included Kate Hewitt from Alstonville and Carl Fail since relocated to Melbourne (Caulfield South)

All wheelchair work should be on a 'one to one' basis with an experienced vibration practitioner who can tailor your program to your circumstances. For those considering the use of this therapy it is recommended that you share this document with your practitioner. If in doubt consider asking your GP to provide a referral to a physiotherapist/exercise physiologist for the purpose of developing programs specific to your needs.
More broadly, it would be great if Australia could emulate the NZ model whereby MS Australia partnered with educational institutions and service providers to provide access to exercise environments for pwMS that incorporate vibration therapy. It is understood that until quite recently it was available through the South Australian MS Society. Please let us know If are aware of other practitioners or organisations whose first hand experience in this aspect of MS might similarly assist others.
In March 2015 Australian researchers reported on a "revolutionary new exercise system to help people with multiple sclerosis (MS) build muscle mass and improve their physical health". This involves a specially adapted bicycle which uses electronic stimulation to involuntarily activate the leg muscles to drive the pedals, similar to methods used for spinal cord injuries. Lead researcher Dr Che Fornusek said 'results from early trials had been positive for those who still have sensation in their legs. Their leg muscles grew and the participants reported better blood flow, better skin and their legs felt better", Larger muscle mass in itself is important because it has an effect on the central metabolism -  a decent muscle mass can give protection from metabolic diseases like diabetes. Through a continuation of the study, it is hoped to determine whether increased activity might even slow the MS disease process.
The foregoing examples highlight the importance of maintaining a healthy vascular system whereby blood flows properly throughout the body - a situation that can be progressively and significantly diminished in many people with multiple sclerosis. The examples identify two (of several) differing forms of "external" approaches to enhancing muscle integrity by stimulating blood flow. The duration and extent of the benefits described likely depends upon the nature of these irregularities (as related to blood flow) and possible associated  neurodegeneration. In all probability enduring relief may also depend upon addressing these underlying issues - the most common of which is Chronic Cerebro Spinal Vascular Insufficiency (CCSVI)
Plasticity In the frontiers of Brian Science there are a growing number of reports about how neural pathways can be side-stepped by alternate stimuli with the aim of improving functionality. Many of these reports also observe a capability of the brain (termed brain plasticity), over time, to develop new pathways that recognise this improved functionality.  The publication The Brain that Changes Itself - Norman Doidge MD provides details of many case histories.
The book is about the discovery that the human brain can change itself, as told through the stories of the scientists, doctors, and patients who have together brought about the transformations documented in the book.  This overview of the relevance of vibration based of exercise for PwMs would be lacking if readers were not also encouraged to learn more about developments in this field of research.




  Facts Sheet RM1248MS

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