Effects of whole-body vibration on postural control in elderly: a systematic review and meta-analysis

Slavko Rogan, Roger Hilfiker, Kaspar Herren, Lorenz Radlinger, Eling D de Bruin, Slavko Rogan, Roger Hilfiker, Kaspar Herren, Lorenz Radlinger, Eling D de Bruin

Abstract

Background: This systematic review was performed to summarize the current evidence for whole body vibration (WBV) interventions on postural control in elderly.

Methods: English and German language papers in Medline, PEDro, Cinahl and the Cochrane databases were searched. Two reviewers extracted data on patients' characteristics, type of WBV intervention and outcomes. Two independent reviewers rated the methodological quality of these studies. Data were pooled using random-effects meta-analysis.

Results: Fifteen papers reporting quantitative data were included. Results from 15 papers could be pooled for a meta-analysis. The studies involved 933 participants. In 7 studies the authors investigated the effects of vibration plates generating vertical sinusoidal vibrations (VS-WBV) and 7 papers described the use of side-alternating sinusoidal vibrations (SS-WBV). One study investigated both VS-WBV and SS-WBV.Weak to moderate evidence of an overall effect as a result of VS-WBV and SS-WBV was observed for (a) static balance for post-intervention values with a standardized mean difference (SMD) -0.06, 95% CI -0.31 to 0.18 and for change values SMD -0.26, 95% CI -1.09 to 0.57, and (b) dynamic balance for post-intervention-values SMD -0.34, 95% CI -0.60 to -0.08. For functional balance (c) an overall outcome for post-intervention values with SMD of 0.34, 95% CI -0.19 to 0.87 was found.

Conclusions: The 15 studies reviewed were of moderate methodological quality. In summary, SS-WBV seems to have a beneficial effect on dynamic balance in elderly individuals. However, the current results should be interpreted with caution because of the observed heterogeneity of training parameters and statistical methods. Future studies are warranted to evaluate the effects of WBV on postural control in an elderly population.

Figures

Figure 1
Figure 1
Results of the systematic review. Studies' flow chart for the review and meta-analysis.
Figure 2
Figure 2
Forest plot of 8 trials comparing the effects of any type of vibration and control interventions on static balance. The analyses were separated for trials reporting post-values (i.e. mean and SD from follow-up) and for trials that reported change values (i.e. mean and SD from the changes from baseline to follow-up). Random effects model with predictive interval. The predictive interval indicates the range within which we expect the effects of 95% of future studies. Values on x-axis denote SMDs.
Figure 3
Figure 3
Forest plot of 8 trials (9 comparisons) stratified for the vibration type (vertical and side alternating). Outcomes were tests for static balance. The analyses were separated for trials reporting post-values (i.e. mean and SD from follow-up) and for trials that reported change values (i.e. mean and SD from the changes from baseline to follow-up). Random effects model with predictive interval. The predictive interval indicates the range within which we expect the effects of 95% of future studies. Values on x-axis denote SMDs.
Figure 4
Figure 4
Forest plot of 9 trials comparing the effects of any type of vibration and control interventions on dynamic balance. The analyses were separated for trials reporting post-values (i.e. mean and SD from follow-up) and for trials that reported change values (i.e. mean and SD from the changes from baseline to follow-up). Random effects model with predictive interval. The predictive interval indicates the range within which we expect the effects of 95% of future studies. Values on x-axis denote SMDs.
Figure 5
Figure 5
Forest plot of 7 trials comparing the effects of any type of vibration and control interventions on the Timed Up and Go Test. Random effects model with predictive interval. The predictive interval indicates the range within which we expect the effects of 95% of future studies. Values on x-axis denote WMD (weighted mean difference).
Figure 6
Figure 6
Forest plot of 6 trials comparing overall effects of WBV-plus-exercise versus isolated WBV. The analysis reports post intervention values. Values on x-axis denote SMDs.
Figure 7
Figure 7
Funnel plot of included WBV trials. A funnel plot with all points evenly distributed on both sides of the solid vertical line indicates no publication bias.

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