Power development has become a primary focus of athletic performance enhancement training. The ability to generate high force in the shortest time possible, also referred to as the rate of force development, is a quality possessed and optimized by elite athletes. Therefore, much research has been conducted in an attempt to discover methods for maximizing the effectiveness of training time and energy. Resistance training and plyometric exercise represent the conventional approach to increasing power. Research has shown these methods to result in improvements in power (26). As new methods or devices become available to assist in the development of physiologic potential and are promoted to enhance power output and development, it is important that research and research syntheses be conducted to examine the effectiveness of the device and the accuracy of the claims made by their manufacturers and proponents.
One of these advancing technologies is the use of vibration platforms during training. Vibration training or whole-body vibration (WBV) constitutes a mechanical stimulus that enters the human body by way of the hands when griping a vibration dumbbell or pulley system, by way of the feet when standing on vibration platform, or applied directly to the muscle belly or the tendon of muscle by a vibration unit. There are basically 2 vibration platforms, in which either the platform vibrates in a predominantly vertical direction or the platform vibrates about a horizontal axis such that, the father from the axis of rotation, the larger the amplitude vibration (1). There are a few theories on how vibration stimuli can have an effect on the neuromuscular system (9,46), such as a stimulation of Ia-afferents by way of spindles, resulting in homonymous α-motor neurons or perturbation of the gravitational field during the time course of intervention (9). A relevant question arises as to the strength of the scientific evidence for vibration training. Several narrative reviews were completed and examined the results of a small number of studies and reported contradictory conclusions: Cardinale and Bosco (8) in 6 articles concluded there was good potential to enhance the neuromuscular performance. Two years later, Luo et al. (28) with 14 studies (8 acute effect, 5 acute residual effect, and only 3 chronic effects) concluded that “Current findings suggest that vibration training may have positive acute and chronic effects on neuromuscular performance and training;” in the same year, Jordan et al. (24) by means of 14 studies (7 acute effects and 7 chronic effects) concluded that “It would appear, based on the limited scientific evidence, that vibration training may serve as a tool to develop explosive ability in athletes” and Cardinale and Wakeling (10) with 23 studies (9 acute effects and 14 chronic effects) concluded that “The current evidence indicates that WBV may be an effective exercise intervention for reducing the results of the aging process in musculoskeletal structures”. In 2007, Rehn et al. (40), in systematic review with 19 studies (14 chronic effects and 5 acute effects), concluded that “There is strong to moderate evidence that long-term WBV exercise can have positive effects on muscular performance among untrained and elderly women. There is no clear evidence for effects on muscular performance after short-term vibration stimuli;” in the same year, Nordlund and Thorstensson (33) by means of 12 studies concluded that there are “No or only minor additional effects of WBV.”
This type of review, which may be perceived as more of an art than science, contains numerous areas in which bias may persuade the results (37). A narrative review is such that the reviewer relies on p values to make conclusions about the body of literature. Unfortunately, the p value can be misleading, especially when studies are performed with small sample sizes, which limit the statistical power and increase the likelihood of the researcher commenting a type II error. A significant p value may also be a misleading type I error if the actual magnitude of the difference between treatments is so small as to be of little consequence (42).
On the other hand, a powerful method of research synthesis is the meta-analysis (42), which has been used widely in many areas of scientific exploration. The meta-analysis is now widely accepted as the gold-standard for literature review and offers many powerful tools for combining research on similar topics. The steps of the meta-analytic review increase the scope, objectivity, and quantification of the overall body of literature on a particular topic. Steps for thoroughly searching the literature, coding of study characteristics, extracting and standardizing data from individual studies, and statistically evaluating treatment effects make the meta-analysis a useful tool when attempting to draw conclusions about the research examining vibration exercise for power improvements. Therefore, the purpose of this meta-analysis was to attempt to gain a clear picture of the magnitude of adaptations in muscular power expected after acute and chronic training, as well as identify specific factors that influence the treatment effects.
Experimental Approach to the Problem
To evaluate the effectiveness of vibration training for increases in power, a meta-analytic review was conducted. Searches were conducted to find studies examining vibration training and power improvements. Relevant studies were combined and analyzed statistically to provide an overview of the body of research on this topic. Conclusions were drawn based on the literature with suggestions for applications and future research presented for strength and conditioning professionals.
Electronic databases (MEDLINE, PubMed, SPORT DISCUS, and Embase) were searched up to February 29, 2008, beginning in 1966, for the word vibration in combination with training, performance, strength, or power. Exclusion of studies with irrelevant content and doublets was carried out in 3 steps. First, the titles of the articles were read. Second, the abstracts were read. Third, the whole articles were read. The reference lists of relevant articles were, in turn, scanned for additional articles with the inclusion criteria. Conference abstracts and proceedings were excluded.
Criteria for study inclusion were that articles must be about vibration training (107 articles satisfied this criteria), the study must use a muscle power assessment (32 articles fulfilled this criterion), the participants must be healthy subjects (31 articles), and the study must include all necessary data to calculate effect sizes (ES) (i.e., mean, SD, and numbers of subjects) (30). A total of 30 studies were included in the analysis of 13 acute effects (5,6,8,11-13,15,17,27,33,38,44,49) and 17 chronic effects (2-4,7,14,18-22,28,36,39,45-47). Many of the initial studies were excluded because they evaluated the effectiveness of vibration exercise for improving muscle strength, balance, bone density, or range of motion assessments and will be synthesized in separate meta-analyses.
Coding of Studies
Each study was read and coded by the primary investigator for the following variables: descriptive information including sex and age, training status of the participants, frequency of training, number of sets performed, volume (seconds of vibration stimuli per session), seconds rest between sets, vibration application, frequency (Hz, average per session), peak to peak amplitude (mmp-p, double the amplitude), protocol exercise (isometric, dynamic, or both), exercise type (squat or squat plus others exercises), parameters change during workout, and acute or chronic effects.
Training status of the participants was divided into athletic, trained, and untrained classifications. Participants must have been weight training for at least 1 year before the study to be considered as trained, and for athlete classification, participants must have been in competitive athletics at the high school, collegiate, professional, or international level.
Coder drift was assessed (35) by randomly selecting 10 studies for recoding. Per case agreement was determined by dividing the variables coded the same by the total number of variables. A mean agreement of .90 was required for acceptance.
Calculation and Analysis of Effect Sizes
Pre/post-ES were calculated with the following formula: [(Posttest mean - pretest mean)/pretest SD] (16). ES were then adjusted for sample size bias (24). This adjustment consists of applying a correction factor to adjust for a positive bias in smaller (n < 20) sample sizes (24). Descriptive statistics were calculated and analysis of variance by groups was used to identify differences between training status, sex, vibration application, acute versus chronic effects, muscle contraction during workout, and age with level of significance set at p < 0.05. All calculations were made with SPSS statistical software package v.16.0 (SPSS, Inc., Chicago, IL, USA). Mean ES for amplitude, frequency, and volume of training were graphed to examine potential dose-response trend lines; however, only vertical vibration, chronic effects offered sufficient data for evaluation. The scale proposed by Rhea (41) was used for interpretation of the overall magnitude of treatment effects.
Overall ESs and moderating variables are presented in Table 1. The descriptive data for vertical and oscillating platforms are shown separately in Table 2. Descriptive data for other vibration devices (punctual, pulley, dumbbell, and bar) are presented in Table 3. The 31 ES for chronic training and 50 ES for acute training were obtained from a total of 30 primary studies.
The mean overall ES for vertical platform used for chronic training was .99(95% confidence interval [CI]: .15, 3.54; n = 15) and used for acute training was −.08 (95% CI: −.53, .37; n = 14). These measures were significantly different (p < 0.01) (Table 1), with significant differences also identified between vertical and oscillating platforms for chronic training (p < 0.05).
An analysis of the differences in muscle power gains achieved in female, male, or combined sex groups was performed to determine sex-biased strength gains. Female groups gained similar muscle power compared with combined groups (male and female) at 1.03 (95% CI: .81, 1.24; n = 7) versus 1.00 (95% CI: .79, 1.21; n = 7), respectively (p > 0.05). Changes in training parameters (frequency or amplitude vibration) during the training program resulted in a larger ES, 1.19 (95% CI: .11, .97, n = 10), when compared with no modifications, .39 (95% CI: −.59, 1.39; n = 5); however, this different was not statistically significant (p > 0.05). The use of dynamic movements plus isometric muscle contractions resulted in a larger mean ES than isometric contraction alone, 1.16 (95% CI: .97, 1.35; n = 9), versus 0.72 (95% CI: 0.47, 0.98; n = 5), respectively; nevertheless, this difference was not statistically significant (p > 0.05) (Table 1).
The mean overall ES for oscillating platforms used for chronic training was .36 (95% CI: .10, .61; n = 16) and for acute training was −.24 (95% CI: −.45, −.03; n = 23). These measures were significantly different (p < 0.01); however, no variables were found to be significant moderators of this effect.
Other Vibration Devices
The mean overall ES for punctual system was a mean of .02 (95% CI: −.06, .15; n = 8). Insufficient ES numbers were available to conduct an evaluation of vibration pulley systems or vibration dumbbell and bar devices (minimum 5 ES).
The results of this meta-analysis have provided valuable information for the proper use of vibration exercise as a means of enhancing neuromuscular power. Although gaps in the literature do exist, as can be seen by the fact that many moderating variables lacked enough data to be completely examined, this analysis offers a more reliable and thorough view of the body of research as compared with narrative reviews. On the basis of the overall analysis, it is apparent that vibration exercise can be effective at eliciting chronic power adaptations.
The first moderator of the treatment effect of vibration on power development is the type of vibration platform used. Differences were noted in both acute and chronic changes in power when vertical vibration platforms are compared with oscillating platforms. Vertical platforms elicit a significantly larger treatment effect for chronic adaptations (ES = .99) as compared with oscillating platforms (ES = .36). This difference between a moderate effect and a small effect is notable and is similar to platform differences noted in a meta-analysis of vibration exercise effects on strength (30).
Chronic improvements in power with vibration exercise, especially when vertical platforms are used, are quite impressive. Traditional methods of power enhancement, including high-velocity resistance training and plyometrics, have demonstrated effectiveness at increasing power (23,31). When compared with the ES scale proposed by Rhea (41) for evaluating the magnitude of strength improvements, the overall chronic vertical vibration treatment effect represents a moderate magnitude (1.52), and ES for subjects under 25 years was 0.43 and over 50 years was 2.24. For comparison, the average treatment effect in meta-analyses of plyometric training (31) found for vertical jump height was 0.44, countermovement jump .88, countermovement jump with the arm swing .74, and drop jump .62; the studies included in this meta-analysis had an intervention duration ranging from 4 to 24 weeks, a total number of training sessions ranging from 12 to 60, and mean age of the subjects ranging from 11 to 29 years.
No positive impact on acute power output was noted for either vertical or oscillating platforms. Both vertical and oscillating platforms demonstrated a slight decrease in acute power output. Insufficient data were available to make a detailed evaluation of moderating variables of this effect, and more research should be performed with an examination of acute power changes. Several factors should be noted and considered for such future research. The range of volumes used for acute power changes was 30 to 600 seconds, with an average of 300 seconds. Greater amounts of data are needed, preferably at the outer limits of this range, for greater understanding. In addition, the time between the vibration application and the test for acute power changes is of utmost importance. The studies included in this meta-analysis used rest periods of 0 to 3,600 seconds post-treatment before testing. This timing could dramatically alter the acute response measured and, once again, additional research throughout those ranges is needed to evaluate the overall influence.
The evaluation of sex as a moderator of the chronic treatment effect (vertical platform only) demonstrated that no significant difference existed between the sexes. Although the average ES for men was visibly lower than women, the variability among men made this difference unreliable. Therefore, it appears that both men and women respond with chronic power adaptations similar to each other.
The data show that age is a moderator of the response to vibration exercise for power. For populations under the age of 25, the ES was .43, and those over the age of 50 (both from vertical platform data) the ES was 2.24. Benefits in power among older populations are of particular importance. Risk of falling among the elderly may relate to a decrease in rate of force development as caused by aging. Their inability to rapidly respond with high amounts of force to correct imbalance, reset their center of gravity, or prevent themselves from stumbling may be positively affected by the inclusion of vibration exercise in an overall training program.
Differences in treatment effects with different prescriptions are apparent and will be discussed in the future; however, alterations in prescription throughout a chronic training program (i.e., periodization and progression of stimulus) is known to be vital to fully achieve the benefits of vibration exercise. Programs that did not alter training variables were found to have a much smaller treatment effect (ES = .39) as compared with periodized programs (ES = 1.28). As has been shown with regard to traditional methods of strength and power development (43), alteration in training prescription must occur to achieve maximum benefits of vibration exercise. The continuous application of an unfamiliar stimulus results in a heightened response to exercise. As the body becomes accustomed to the applied stress, overall adaptations diminish because of the lack of overload. By consistently altering the stimulus, combined with appropriate progression in stress, the physiologic systems are optimally overloaded, and chronic adaptations are greater.
The influence of frequency, amplitude, and volume of vibration stimulus on the resultant power adaptation is noteworthy. Because of the lack of variability and positive effect for acute power enhancement, our focus remains on chronic adaptations among those training with vertical platforms. Figures 1-3 represent the general trend in ES for 3 separate variables. Low frequencies (<35 Hz) showed less effectiveness than mean training frequencies of 35 to 40 Hz, with the effectiveness dropping when the average frequency exceeded 40 Hz, thus demonstrating a dose-response trend. Thus, it appears that mean overall training frequencies of 35 to 40 Hz are most appropriate for vertical platforms.
Amplitudes below 6 mmp-p do not result in large treatment effects as compared with the linear increase in power improvement from 6 to 10 mmp-p. With insufficient data at amplitudes above 10 mm, it is unclear whether 10 mmp-p is the optimal dose, and more research is needed at higher amplitudes to further examine the overall trend. For now, it is apparent that amplitudes from 8 to 10 mmp-p are most effective for long-term power development through vibration exercise. However, one particular fact of importance when considering the reported amplitude of vibration in the published research and among the different platforms available to the public is the fact that body mass is expected to affect the vibration amplitude of vibration. Larger masses are expected to dampen the vibration amplitude generated by the platform, with potentially large variations in vibration between individuals of different body masses. For this reason, amplitude of vibration, unless specifically measured in each subject by the use of accelerometer, carries only theoretical importance with relation to exercise prescription.
Volume of training, as expressed as the total time on the vibration platform per session (s), is also an important factor to be considered when implementing vibration exercise. For power chronic power enhancement, 360 to 720 seconds appears to be the optimal range of volume per workout. The interaction between sets of vibration applications and total volume is a complex relationship, with insufficient data at this point to fully evaluate. It is uncertain as to which variable is the most important, or how best to deal with their interaction. For instance, it is unclear whether shorter sets (i.e., 15-30 s) are most effective or whether 1 10-minute set would achieve the same result. On the basis of the physiologic mechanisms to be presented later, and our knowledge of the neuromuscular expression of power, shorter bouts would appear more appropriate, mimicking highly intense, short-duration resistance/plyometric training, and avoiding the negative influence of fatigue on the neuromuscular system. However, such speculation must be examined in future research and analyses to verify its validity.
Contraindications have been reported for vibration training, including erythema, itching of the legs (45,48), edema (45), and shin pain (as experienced by 1 subject) (19) as well as a case of significant morbidity after 1 session of vibration training in a patient with asymptomatic nephrolithiasis (32); however, little research has been conducted to examine these conditions. Although the current meta-analysis demonstrates that vibration exercise can be an effective tool for increasing chronic power adaptations, we must begin to focus more attention on the physiologic mechanisms underlying the body's response to vibration exercise. These physiologic mechanisms explaining such adaptations are important to our understanding of this form of exercise. Different mechanisms have been suggested in the literature as to how vibration stimuli can have effect on the neuromuscular system (9,46), such as a stimulation of Ia-afferents by way of spindles, resulting in homonymous α-motor neurons or perturbation of the gravitational field during the time course of intervention (9). Although these mechanisms have been suggested, and do appear valid, little basic scientific research has examined vibration exercise effects on the function of different physiologic properties. These mechanisms may help shed light on the benefits of this mode of exercise, guide our progress in seeking the optimal prescription, and enable us to speak more fully to the risks/benefits of this technology.
The applications of vibration exercise, as based on this analysis, cross many populations. Both males and females, of all ages, can enhance power capabilities by participating in vibration training. The expected improvements are similar effects to those in conventional plyometric training. In addition, the vibration exercise requires less technical ability as compared with the performance of correct plyometric workouts and free-weight resistance training, less space as compared with traditional resistance training machines, and less time generally needed to perform workouts on vibration platforms.
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