Use of whole body vibration in individuals with chronic stroke: Transmissibility and signal purity

This study examined (1) the influence of whole body vibration (WBV) frequency (20 Hz, 30 Hz, 40 Hz), amplitude (low: 0.8 mm and high: 1.5 mm) and body postures (high-squat, deep-squat, tip-toe standing) on WBV transmissibility and signal purity, and (2) the relationship between stroke motor impairment and WBV transmissibility/signal purity. Thirty-four participants with chronic stroke were tested under 18 different conditions with unique combinations of WBV frequency, amplitude, and body posture. Lower limb motor function and muscle spasticity were assessed using the Fugl-Meyer Assessment and Modified Ashworth Scale respectively. Nine tri-axial accelerometers were used to measure acceleration at the WBV platform, and the head, third lumbar vertebra, and bilateral hips, knees, and ankles. The results indicated that WBV amplitude, frequency, body postures and their interactions significantly influenced the vibration transmissibility and signal purity among people with chronic stroke. In all anatomical landmarks except the ankle, the transmissibility decreased with increased frequency, increased amplitude or increased knee flexion angle. The transmissibility was similar between the paretic and non-paretic side, except at the ankle during tip-toe standing. Less severe lower limb motor impairment was associated with greater transmissibility at the paretic ankle, knee and hip in certain WBV conditions. Leg muscle spasticity was not significantly related to WBV transmissibility. In clinical practice, WBV amplitude, frequency, body postures need to be considered regarding the therapeutic purpose. Good contact between the feet and vibration platform and symmetrical body-weight distribution pattern should be ensured.