Power Plate - How Useful Is Whole Body Vibration Training?

Picture from Power Plate

Recently a patient who is osteopenic came in to our clinic telling me that her trainer/ Pilates instructor got her to do some Power Plate/ vibration training otherwise known as whole body vibration training (WBVT) in the literature to help increase her bone mass or bone mineral density (BMD).

Power Plate machines have been very popular in the USA since the 1990's. I remember being a young physiotherapist at the Singapore Sports Institute (SSI) and having presentations (by the vendors) on how they work at our clinic then. We even had them on loan to us for a while to allow the athletes to try.

How does it work? The theory behind it is that by standing on the vibrating platform, vibrations can be transmitted to the large bones of the body. By "absorbing" these vibrations, the person standing on it gets stimulation in their bones and it helps improve their BMD. This is especially useful for those who cannot (due to osteoporosis) or do not engage in high impact exercises.

Another claimed benefit is that WBVT is very efficient at promoting bone health since the large number of vibrations (> 1,800 per minute) saves you time compared to running or weight training.

WBVT uses high frequency mechanical stimuli generated by a vibrating platform (e.g. Power Plate) transmitting it through the body. There are vertical or side alternating types of vibration. Most common frequencies of the magnitude of vibration are in the 30-50 Hz range.

That's when I decided to see what's been published recently so far on WBVT since the SSI didn't purchase any.

Researchers in South Africa looked at how ten weeks of WBVT affected the bone density of well trained cyclists (Prioreschi et al, 2012). One group did WBVT at 30 Hz for 15 minutes thrice weekly while riding as usual. The other control group continued with their normal training without the WBVT.

In addition, both groups of cyclists were matched by age, body weight and height with other sedentary subjects for further comparison.

All the subjects underwent regional dual X-ray absorptiometry (DEXA) scans to determine bone bass and BMD levels.

As expected, both groups of cyclists had lower pelvic bone mineral density than the sedentary subjects with no other differences observed (showing that cyclists who just cycle) have poorer done density despite having superior aerobic fitness.

After ten weeks of training, the WBVT group showed a significant increase in their hip bone mineral density (1.65% better) while there was no change in the cyclists who didn't do WBVT. By the end of the ten weeks, the control group had significantly lower spine (back) mineral density compared to the start whereas this this loss was not observed in the WBVT group.

However, another study involving swimmers did not show similar results (Gomez-Bruton et al, 2017) Researchers studied the effects of WBVT on a group of adolescent swimmers for six months. They too were split into two groups with one doing 15 minutes of WBVT three times a week. BMD's of all the swimmers were measured before and after six months of training. The results did not show any benefits for the swimmers' BMD.

I have to point out we're comparing adult cyclists and adolescent swimmers, so the results may be conflicting. The groups of cyclists and swimmers tested were also rather small. Other than that, there isn't a lot of other published research on athletes regarding WBVT.

However, there is a comprehensive review published last year summarized the findings from 17 other studies on a range of different populations (Sanudo et al, 2017). The conclusion was the WBVT seems to help children and adolescents with compromised bone mass to increase the BMD. These improvements however, are limited in postmenopausal women while there is no evidence of any benefits in young adults.

So I told my patient that probably a mixture of aerobic exercises and strength training would be more beneficial if she wanted a higher BMD or stronger bones.

Those of you who just swim, bike and do not do weight bearing exercises, do take note that you will probably need to incorporate some form of weight training or high impact/ HIIT activity to your weekly training so that you can keep your bones in good condition.


References

Gomez-Bruton A, Gonzalez-Aguro A et al (2017). Do ^ Months Of Whole-body Vibration Training Improve Lean Muscle Mass And Bone Mass Acquisition Of Adolescent Swimmers? Arch Osteoporos. 12(1): 69. DOI: 10.1007/s11657-017-0362.

Prioreschi A, Oosthuyse T et al (2012). Whole Body Vibration Increases Hip Bone Mineral Density In Road Cyclists.Int J Sp Med. 33(8): 593-599. DOI: 10.1055/s-003201301866.

Sanudo B, de Hoyo M et al (2017). A Systematic Review Of The Exercise Effect On Bone Health: The Importance Of Assessing Mechanical Loading In Perimenopausal And Postmenopausal Women. Menopause. 24(10): 1208-1216. DOI: 10.1097/GME.0000000000000872.

Risk Of Osteoporosis In Male Cyclists

Now that I've gotten your attention, the picture of the CT scan on the left shows a healthy tibia (shin bone) while the one on the right shows one that is osteoporotic.

Now, here's the very surprising news that I read from this article recently. In their study, the researchers found that the group of serious male cyclists had greater rates of osteoporosis when compared to a group of control subjects. That's very surprising as women are more usually prone to having osteoporosis as compared to men.

The very exact reason why cycling is an excellent exercise also has its dramatic drawback because of its low weight bearing nature. Less weight bearing means less loading on your bones and joints (that's why it's good), but it also means that it doesn't stress your bones enough to stimulate it. Our bones need a certain degree of weight bearing stress to stimulate it to regenerate to form new and stronger bone. Hence, some degree of weight-bearing is not only good for the bones but also necessary.

In this study, the serious male cyclists (rides 7-22 hours a week and 9.4 years of racing experience), had lower body fat, more muscle and greater calcium intake compared to an age and weight matched control group. However, they also had 2.5-3 times greater rates of osteoporosis and osteopenia (near-osteoporosis).

So what's a biker gotta do about this, you'll ask? The researchers didn't offer any advice, but it'll be fair for me to suggest that a modest amount of running and/ or strength training in a standing position (hence weight bearing) will probably do the trick. Want something more challenging, try rock climbing.


Reference

Smathers, AM et al (2009). Bone Density Comparisons In Male Competitive Road Cyclists and Untrained Controls. Medicine & Science In Sports & Exercise. Feb; 41(2): 290-296