Whole-Body Vibration
Training and Balance in Recreational Athletes With Chronic Ankle Instability

R, Jiménez-Diaz F, Ramírez C, Esteban P, Abián-Vicén J. J Athl Train. 2018;53(3):000–000. doi: 10.4085/1-62-6050-547-16.
Take-Home Message: Recreational athletes with chronic ankle
instability may benefit from balance training, especially with whole-body
Whole-body vibration is an increasingly
popular technique to challenge and train a patient’s proprioception to improve balance
outcomes, especially in patients with chronic ankle instability (CAI). There is
also limited evidence that whole-body vibration may increase leg muscle mass.
Therefore, the researchers explored the effect of whole-body vibration training
on balance and lean muscle mass among 51 recreational athletes with CAI
compared to balance training without vibration and a control group. Participants in the whole-body vibration group stood on their unstable ankle
limb and performed different balance exercises on a BOSU half-dome ball with
vibrations applied in 3 sets of four 45-second bouts with 45 seconds rest
between. This was repeated 3 times a week for 6 weeks, with exercise
progressions at 3 weeks and increased vibration frequencies every 2 weeks. The
group without vibrations performed the same exercises and exercise progression
with the BOSU ball on the floor, and the control group maintained their current
activity levels. Pre- and post-training balance was assessed with the Star
Excursion Balance Test (SEBT) and Biodex Balance System Test in which
participants were required to balance on an unstable platform with visual
feedback. Body composition was measured using dual-energy x-ray absorptiometry
DEXA). The authors observed
no differences over time between the three groups; however, both balance groups
had hints of improved balance with the SEBT compared with the control group. Only
the whole-body vibration training improved stability on the Biodex Balance
System. However, there were no differences in lean muscle mass for any group.
results from this study highlight that balance training with or without
vibration may improve balance among recreational athletes with CAI.
Furthermore, adding vibration to balance training may lead to unique
improvements in balance outcomes compared to balance alone. It may be
beneficial for future larger studies to verify these results. Vibration
training may especially benefit patients with CAI since balance impairments are
common in this population. It would be interesting to see if adding this
additional layer of difficulty to balance training could help reduce ankle
sprain injury risk in the future. It is important to note that there is no
commonly accepted dosage or method to apply vibrations, which may explain why
some studies have found lean muscle mass adaptations and the current study did
not. It may be important to individualize vibration training based on the
patient’s abilities and on the desired clinical outcomes. In all, clinicians
should use balance training for recreational athletes with CAI to improve
balance. Furthermore, vibration training is an additional challenge that may be
beneficial and is feasible to implement in clinical rehabilitation for patients
with CAI or others with balance deficits.
Questions for Discussion: Have
you implemented vibration training in your rehabilitation setting, and if so
how did you incorporate this training? What other groups do you think would
benefit from this form of training?
by: Alexandra F DeJong
by: Jeffrey Driban