Vibration and Contraindications: Looking at hip and knee replacements

April 7, 2009 · 1 Comment

We’ve seen vibration exercise go from becoming a sports enhancement tool, to now being an integral part of rehabilitation and exercise for those that have medically associated conditions that prevent them from engaging in regular training. New research is focused heavily in the medical rehabilitation field. However, as more people use it for therapeutic purposes, questions about WHO can actually use it are starting to appear more frequently. This will be one of several articles talking about the contraindications that are listed for vibration exercise and how someone can benefit from this increasingly popular technology.

Originally, hip and knee replacements were listed as contraindications to vibration training. Some gave the time frame of 1 to 2 years post surgery. The reasoning was mostly directed at the consumer or fitness professional that may have the device in their facilities. Therefore, it had to be a no brainer to when a person can actually use vibration exercise. However, since a lot of chiropractors and therapists have started to use vibration in their practices, more and more are having significant results in recovery and function when utilizing vibration at an earlier time of their rehab process. The following are the key points to take away from all this:

Clinical judgment is allowing for more aggressive treatment approaches:

Therapists and doctors have the clinical knowledge in proper rehab protocols to understand how to place a patient on a vibration platform. By providing supervised care, doctors are able to progress a patient in a step wise manner based on patient presentation. If someone has a hip or knee replacement, the type of exercises or approaches to use with vibration exercise will mostly be dictated by what phase of post recovery they are in.

Early use of vibration can have benefits on things other than just strength gains:

Early use of vibration can also provide distal muscular stimulation from the site of injury or surgery, but also provide a valuable tool in increasing circulation. Most patients, after surgery, are sedentary until they can actively engage in exercise. However, this increased circulation can be produced at a much faster pace with vibration exercise. We have patients that, when able to weight bear, can sit on a chair and place their feet on the platform, or we can lie them down and place the calves on the plate. This can produce deep massage and circulatory effects, thereby accelerating the recovery.

vibration positions are modified to allow for earlier use:

Once a patient is weight bearing, the distal stimulation that vibration can offer has several advantages. We all know the positive effects on bone growth when a stress is applied. This is commonly referred to as Wolf’s law. Also, its not uncommon to see some of our patients able to participate in an intense vibration program where they are exercising the rest of the body while providing a slow gradual integration of treatments to the affected surgical hip or knee. This way, the patient is able to stay fit and increase their activity level while they heal.There aren’t too many treatment modalities that can accomplish this so this is a very important advantage of vibration exercise therapy.

Once a patient is weight bearing, low intensities are used, with as little as 15 to 30 seconds of vibration. Since vibration is fast acting, there is less chance of placing too much stress on the joint. Also, patient feedback is important to assess the reaction to vibration training. We’ve seen patients that have started vibration after 8 weeks post surgery and get significant results in function and strength faster than conventional training.

As always, caution is warranted through supervised care:

The issues that always arise is whether vibration is safe. In the proper hands with proper supervision, it is. It’s as same as asking a post surgical patient to begin walking or running on a treadmill, or go to the gym and start doing squats and lunges, when they may not have any training to do so. Any exercise, when done wrong, can be detrimental to the patient population. For this reason, anyone beginning an exercise program with vibration should be supervised until they are comfortable enough to continue on their own.

As we begin to see better results and more studies coming out on the effects of vibration exercise on various medical conditions, we will begin to see the contraindications start to dwindle and most likely see some of them disappear. Until that point, clinical judgment always rules!

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