Whole Body Vibration Methods with Survivors of Polio

This method can help answer key questions in the area of physical rehabilitation, about whole body vibration, and its safety and feasibility as a form of weight bearing exercise for polio survivors. The main advantages of this technique are that it requires little time and it does not seem to worsen typical symptoms of post-polio syndrome, such as increased muscle weakness, pain, or fatigue. Demonstrating the procedure today is Randy Robertson, who is one of our research participants from our study.

For whole body vibration intervention, first have the participant remove their shoes and any lower extremity orthosis. Then, instruct the participant to stand on the whole body vibration platform with their knees slightly bent and their weight as evenly distributed between their two lower extremities as possible, using the bars for light support, as necessary. Make sure to explain that the treatment will require weight bearing through their legs and that they will feel the vibration not only in their feet but throughout the rest of their body.

If the participant is not able to stand at all or to stand long enough, allow the participant to sit in a wheelchair with the seat raised as high as possible or in a plain chair propped up with pillows. Have the participant place their feet on the platform and to place their forearms on their thighs, leaning forward to achieve as much weight bearing through the lower body as possible while keeping the feet on the platform. Polio survivors may find the optimal weight bearing position challenging due to their weakness or contractures, especially when not using their lower limb orthoses.

They may be reluctant to weight shift onto the weaker limb or they may hold onto the handle excessively. Encourage the participants to move into their optimal alignment and use a heel lift or cuff weight under the heel to accommodate leg length discrepancies or plantar flexor contractures, as necessary, to allow weight bearing through as much of the plantar surface of the foot as possible. When the participant is ready, set the vibration frequency to 35 hertz and on this vibration platform to low amplitude to achieve peak-to-peak vertical displacement of 8.82 millimeters, with a result in g-force of 2.76.

And start the whole body vibration with 10, one-minute vibration bouts, with one minute sitting rest periods between the vibrations. After the first session, if the participant is ready, gradually increase the vibrations to 10, two-minute vibration bouts with one minute rests in between vibrations. Continuing to increase the vibration lengths after each session of treatment according to the table, as tolerated by the participant.

Of the 15 survivors who completed this representative study, the pain severity as measured by the brief pain inventory improved significantly after the higher intensity whole body vibration intervention, regardless of treatment order. With the brief pain inventory pain interference trending towards significant improvement. The gait speed also significantly improved after the higher intensity intervention, although only for the group who participated in the higher intervention block first, even though both groups experienced both intensities of vibration in intervention blocks.

Remember to explain the procedures thoroughly and to consider demonstrating how the vibration platform works to reduce participant anxiety. Guard the participants as they step up and down from the platform and during initial vibration bouts. Following this procedure, additional interventions may be conducted over several months to answer questions about whether whole body vibration can impact bone mineral density or other issues that affect polio survivors'health related quality of life.