Whole body vibration for older persons: an open randomized, multicentre, parallel, clinical trial

BMC Geriatrics, Dec 2011

Background Institutionalized older persons have a poor functional capacity. Including physical exercise in their routine activities decreases their frailty and improves their quality of life. Whole-body vibration (WBV) training is a type of exercise that seems beneficial in frail older persons to improve their functional mobility, but the evidence is inconclusive. This trial will compare the results of exercise with WBV and exercise without WBV in improving body balance, muscle performance and fall prevention in institutionalized older persons. Methods/Design An open, multicentre and parallel randomized clinical trial with blinded assessment. 160 nursing home residents aged over 65 years and of both sexes will be identified to participate in the study. Participants will be centrally randomised and allocated to interventions (vibration or exercise group) by telephone. The vibration group will perform static/dynamic exercises (balance and resistance training) on a vibratory platform (Frequency: 30-35 Hz; Amplitude: 2-4 mm) over a six-week training period (3 sessions/week). The exercise group will perform the same exercise protocol but without a vibration stimuli platform. The primary outcome measure is the static/dynamic body balance. Secondary outcomes are muscle strength and, number of new falls. Follow-up measurements will be collected at 6 weeks and at 6 months after randomization. Efficacy will be analysed on an intention-to-treat (ITT) basis and 'per protocol'. The effects of the intervention will be evaluated using the "t" test, Mann-Witney test, or Chi-square test, depending on the type of outcome. The final analysis will be performed 6 weeks and 6 months after randomization. Discussion This study will help to clarify whether WBV training improves body balance, gait mobility and muscle strength in frail older persons living in nursing homes. As far as we know, this will be the first study to evaluate the efficacy of WBV for the prevention of falls. Trial Registration ClinicalTrials.gov: NCT01375790

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Whole body vibration for older persons: an open randomized, multicentre, parallel, clinical trial

Merc Sitj-Rabert 0 M Jos Martnez-Zapata 2 Azahara Fort-Vanmeerhaeghe 1 Ferran Rey-Abella 0 Daniel Romero-Rodrguez 1 Xavier Bonfill 2 3 0 Physiotherapy Research Group (GReFis), Blanquerna School of Health Science (Universitat Ramon Llull) , Barcelona , Spain 1 EUSES Health and Sport Sciences School, Universitat de Girona , Girona , Spain 2 Iberoamerican Cochrane Centre. Institute of Biomedical Research (IIB Sant Pau); Universitat Autonoma de Barcelona; CIBER Epidemiologia y Salud Publica , CIBERESP, Barcelona , Spain 3 Public Health and Clinical Epidemiology Service. Hospital de la Santa Creu i Sant Pau , Barcelona , Spain Background: Institutionalized older persons have a poor functional capacity. Including physical exercise in their routine activities decreases their frailty and improves their quality of life. Whole-body vibration (WBV) training is a type of exercise that seems beneficial in frail older persons to improve their functional mobility, but the evidence is inconclusive. This trial will compare the results of exercise with WBV and exercise without WBV in improving body balance, muscle performance and fall prevention in institutionalized older persons. Methods/Design: An open, multicentre and parallel randomized clinical trial with blinded assessment. 160 nursing home residents aged over 65 years and of both sexes will be identified to participate in the study. Participants will be centrally randomised and allocated to interventions (vibration or exercise group) by telephone. The vibration group will perform static/dynamic exercises (balance and resistance training) on a vibratory platform (Frequency: 30-35 Hz; Amplitude: 2-4 mm) over a six-week training period (3 sessions/week). The exercise group will perform the same exercise protocol but without a vibration stimuli platform. The primary outcome measure is the static/ dynamic body balance. Secondary outcomes are muscle strength and, number of new falls. Follow-up measurements will be collected at 6 weeks and at 6 months after randomization. Efficacy will be analysed on an intention-to-treat (ITT) basis and 'per protocol'. The effects of the intervention will be evaluated using the t test, Mann-Witney test, or Chi-square test, depending on the type of outcome. The final analysis will be performed 6 weeks and 6 months after randomization. Discussion: This study will help to clarify whether WBV training improves body balance, gait mobility and muscle strength in frail older persons living in nursing homes. As far as we know, this will be the first study to evaluate the efficacy of WBV for the prevention of falls. Trial Registration: ClinicalTrials.gov: NCT01375790 - Background Progressive ageing of the population has generated an increase in chronic diseases [1]. The concomitant increases in morbidity create vulnerability and frailty in older persons. Frailty is a common syndrome in older persons [2]. Signs and symptoms of this problem are believed to factors such as fatigue, weight loss, exhaustion, weakness, slow walking speed, decreased balance, low levels of physical activity, slowed motor processing and performance, social withdrawal, cognitive changes, and increased vulnerability to stressors [3-6]. Most falls in older persons are caused by frailty [7,8] and multiple medications [9-11]. Research from the United Kingdom [12], the United States [13] and Australia [14] has shown that falls are a tremendous burden to social and health services. Besides affecting psychological and physical health, fractures from falls often imply hospitalization, thereby increasing morbidity. It has been estimated that total health costs attributable to fallrelated injuries will practically triple in the next 50 years. Strategies to prevent the negative consequences of falls are needed. One such strategy is exercise [15,16]. Institutionalized older people have less capacity to exercise, and greater osteoarticular deterioration and fatigue than non-institutionalized older people [3]. Improving their physical activity could increase their autonomy and help prevent falls [17-23]. Fighting sedentary attitudes and promoting physical exercise are growing challenges for physiotherapists and other health professionals working in nursing homes. Whole body vibration is a type of physical exercise that consists of performing static and dynamic exercises on a platform. These effects of this type of exercise have been studied previously in two studies in nursing home residents [24,25]. The results of these interventions were not conclusive because there are differences in the study protocols and limitations in the study designs. Both studies analysed functional capacity and muscle performance but neither recorded the number of falls. The aim of the present study is to assess the effect of whole-body vibration training on body balance comparing to exercise without vibration in institutionalized older persons. Secondarily, we will evaluate the effects of training on mu (...truncated)


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Mercè Sitjà-Rabert, Mª José Martínez-Zapata, Azahara Fort-Vanmeerhaeghe, Ferran Rey-Abella, Daniel Romero-Rodríguez, Xavier Bonfill. Whole body vibration for older persons: an open randomized, multicentre, parallel, clinical trial, BMC Geriatrics, 2011, pp. 89, 11, DOI: 10.1186/1471-2318-11-89