Whole Body Vibration: for Athletic Performance, Fall Prevention, Bone Loss and Low Back Pain?

Whole-body vibration (WBV) is a relatively new tool used by physical therapists that delivers vibrations across a range of frequencies (15-60 Hz) and displacements (<1-10mm) to stimulate muscles and elicit motor potentials so as to facilitate muscle strength, power, balance and bone remodeling.1-6 Current devices utilize chairs or vertical displacement plates where oscillations are completed from left to right and whole-body vibration plates, which provide uniform oscillations in an up and down manner.1-6

At present, there is limited research on the physiologic mechanisms surrounding the use of WBV; however, some investigators have made the claim that WBV stimulates the neuromuscular system similar to resistance training.7 Others have suggested that WBV may enhance muscle spindle activity8 and corticospinal excitability.9,10 Nevertheless, the optimal frequency and amplitude of WBV remains to be elucidated. However, a frequency and amplitude of 60 Hz and 4 mm, respectively, has been shown to produce the strongest myoelectric activity.11 In general, high-frequency stimulation is thought to be advantageous for bone health,12 while low frequency stimulation may stimulate neural adaptation and strength gains.13


Strength and conditioning training augmented with WBV has been shown to improve athletic performance via increased muscle strength14-20 and flexibility.21 WBV has also been shown to facilitate motor unit recruitment and synchronization of muscles via increased reflex muscle activity, which may ultimately lead to improved training adaptation and faster recovery.22 A recent systematic review of soccer players, divers and MMA fighters concluded that WBV is a safe and useful strategy for improving physical condition.23

Following 10 minutes of WBV, volleyball players experienced increased testosterone and growth hormone levels, decreased cortisol and improved vertical jumping ability.1,2 Likewise, following 6 weeks of WBV on a soft, unstable surface, athletes experienced improved reaction times in lower limb muscles.24,25 In the post-surgical population, WBV may enhance recovery, perhaps even in athletes that have undergone ACL reconstruction, as WBV has been found to increase knee muscle isokinetic strength when combined with a standard rehabilitation program.17


A number of studies have found WBV to be useful in untrained individuals. For example, untrained adult women experienced increased vertical jumping height and improved balance following WBV.4 WBV also led to greater improvements in leg extensor muscle strength and function than resistance exercises in untrained individuals.Furthermore, there is moderate to strong evidence that WBV prevents falls due to improvements in neuromuscular function, particularly in patients that cannot tolerate vigorous exercise.26


According to animal studies, WBV prevents bone loss secondary to disuse, hormonal withdrawal and glucocorticoid exposure.26 Notably, a recent systematic review of 10 studies and 462 postmenopausal women under the age of 65 found that WBV resulted in improved bone mineral density of the femoral neck.27

Following 6-months of whole body vibration, administered three times per week, postmenopausal women demonstrated a statistically significant increase in hip bone mineral density compared to those performing resistance exercises and age-matched controls.28 While WBV with vertical stimulation did not increase lumbar spine bone density better than a wellness control, rotational stimulation resulted in a statistically significant improvement.29 Nevertheless, a 2011 systematic review and meta-analysis of 13 randomized controlled trials totaling 896 subjects concluded that WBV had no effect on bone mineral density in older women.30

Due to the mixed results of WBV trials for bone density, a number of investigators have suggested that WBV may reduce some of risks associated with osteoporosis in other ways.31 For example, although a 2014 trial found no increase in bone density following an 18-month regiment of high-intensity WBV to 710 postmenopausal women, the investigators nevertheless reported significantly less falls and fractures compared to the control group.32 Interestingly, WBV has been shown to significant increases in maximum leg strength in postmenopausal women.6,33,34 Moreover, WBV is associated with improved physical fitness,30,35,36 neuromuscular function,37 mobility and balance in the elderly population.38


A recent systematic review and meta-analysis of 16 controlled trials found that WBV has a positive effect on musculoskeletal pain, with long treatment durations being particularly advantageous.39 However, WBV did not perform significantly better than other conservative treatments.39 Despite the link between occupation vibration and low back pain,40 there is evidence to suggest that WBV may be a useful adjunct treatment for non-specific low back pain,1,41,42  as it has been shown to decrease cortisol levels, improve proprioception, increase strength and decrease pain.1-6,43

Notably, a recent case series of 42 patients with nonspecific low back pain reported significant improvements in lumbar proprioception and decreased low back pain following 12-weeks of WBV exercise.44 Wang et al directly compared WBV with general exercise in an randomized clinical trial of 84 patients with non-specific chronic low back pain.45 After 12 weeks of training, the WBV group experienced lower levels of pain and disability.45 Moreover, the WBV exercise group demonstrated significantly better lumbar joint position sense, quality of life and global perceived effect.45

In a separate randomized controlled trial, patients with non-specific low back pain that received 24 treatments of tilting, low frequency WBV experienced significantly greater improvements in strength, stability, proprioception, function and pain compared to those in the non-treatment control group.43 Notably, WBV with both vertical and horizontal stimulation seems to reduce low back pain and improve core muscle strength.46

Interestingly, a recent systematic review of 16 controlled trials involving 763 patients with chronic conditions, including respiratory, musculoskeletal, neurological, urological, and metabolic diseases even concluded that WBV may improve health-related quality of life.47


WBV appears to be an evidence-based intervention for enhancing athletic performance, fall prevention, reducing non-specific low back pain and disability, and perhaps even improving bone mineral density in postmenopausal women. The specific neurophysiologic effects of WBV are unknown and the most effective amplitudes and frequencies for WBV in various conditions remains to be elucidated.


Mahesh Patel, PT, MPT, Cert. DN
Staff Physical Therapist, Randolph Health Deep River Physical Therapy
Fellow-in-Training, AAMT Fellowship in Orthopaedic Manual Physical Therapy
Asheboro, NC

Ricardo Portillo, PT, DPT, Cert. DN
Clinical Director, Border Therapy Services
Fellow-in-Training, AAMT Fellowship in Orthopaedic Manual Physical Therapy
El Paso, TX

Raymond Butts, PhD, DPT, MSc (NeuroSci), Dip. Osteopractic
Senior Instructor, American Academy of Manipulative Therapy
Louisville, KY

James Dunning, PhD, DPT, MSc (Manip Ther), FAAOMPT, Dip. Osteopractic
Director, AAMT Fellowship in Orthopaedic Manual Physical Therapy
Montgomery, AL


  1. Mannion AF, Muntener M, Taimela S, Dvorak J. Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatology (Oxford). 2001;40(7):772-778.
  2. Bosco C, Colli R, Introini E, et al. Adaptive responses of human skeletal muscle to vibration exposure. Clin Physiol. 1999;19(2):183-187.
  3. Bosco C, Iacovelli M, Tsarpela O, et al. Hormonal responses to whole-body vibration in men. Eur J Appl Physiol. 2000;81(6):449-454.
  4. Torvinen S, Kannu P, Sievanen H, et al. Effect of a vibration exposure on muscular performance and body balance. Randomized cross-over study. Clin Physiol Funct Imaging. 2002;22(2):145-152.
  5. Delecluse C, Roelants M, Verschueren S. Strength increase after whole-body vibration compared with resistance training. Med Sci Sports Exerc. 2003;35(6):1033-1041.
  6. Roelants M, Delecluse C, Verschueren SM. Whole-body-vibration training increases knee-extension strength and speed of movement in older women. J Am Geriatr Soc. 2004;52(6):901-908.
  7. Bagheri J, van den Berg-Emons RJ, Pel JJ, Horemans HL, Stam HJ. Acute effects of whole-body vibration on jump force and jump rate of force development: a comparative study of different devices. J Strength Cond Res. 2012;26(3):691-696.
  8. Rittweger J. Vibration as an exercise modality: how it may work, and what its potential might be. Eur J Appl Physiol. 2010;108(5):877-904.
  9. Krause A, Gollhofer A, Freyler K, Jablonka L, Ritzmann R. Acute corticospinal and spinal modulation after whole body vibration. J Musculoskelet Neuronal Interact. 2016;16(4):327-338.
  10. Pujari AN, Neilson RD, Cardinale M. Effects of different vibration frequencies, amplitudes and contraction levels on lower limb muscles during graded isometric contractions superimposed on whole body vibration stimulation. J Rehabil Assist Technol Eng. 2019;6:2055668319827466.
  11. Krol P, Piecha M, Slomka K, Sobota G, Polak A, Juras G. The effect of whole-body vibration frequency and amplitude on the myoelectric activity of vastus medialis and vastus lateralis. J Sports Sci Med. 2011;10(1):169-174.
  12. Wysocki A, Butler M, Shamliyan T, Kane RL. Whole-body vibration therapy for osteoporosis: state of the science. Ann Intern Med. 2011;155(10):680-686, W206-613.
  13. Carlucci F, Orlando G, Haxhi J, et al. Older Age Is Associated with Lower Optimal Vibration Frequency in Lower-Limb Muscles During Whole-Body Vibration. Am J Phys Med Rehabil. 2015;94(7):522-529.
  14. Delecluse C, Roelants M, Diels R, Koninckx E, Verschueren S. Effects of whole body vibration training on muscle strength and sprint performance in sprint-trained athletes. Int J Sports Med. 2005;26(8):662-668.
  15. Bullock N, Martin DT, Ross A, Rosemond CD, Jordan MJ, Marino FE. Acute effect of whole-body vibration on sprint and jumping performance in elite skeleton athletes. J Strength Cond Res. 2008;22(4):1371-1374.
  16. Cochrane DJ, Stannard SR. Acute whole body vibration training increases vertical jump and flexibility performance in elite female field hockey players. Br J Sports Med. 2005;39(11):860-865.
  17. Costantino C, Bertuletti S, Romiti D. Efficacy of Whole-Body Vibration Board Training on Strength in Athletes After Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Study. Clin J Sport Med. 2018;28(4):339-349.
  18. Fachina R, da Silva A, Falcao W, et al. The influence of whole-body vibration on creatine kinase activity and jumping performance in young basketball players. Res Q Exerc Sport. 2013;84(4):503-511.
  19. Fagnani F, Giombini A, Di Cesare A, Pigozzi F, Di Salvo V. The effects of a whole-body vibration program on muscle performance and flexibility in female athletes. Am J Phys Med Rehabil. 2006;85(12):956-962.
  20. Fort A, Romero D, Bagur C, Guerra M. Effects of whole-body vibration training on explosive strength and postural control in young female athletes. J Strength Cond Res. 2012;26(4):926-936.
  21. Annino G, Iellamo F, Palazzo F, et al. Acute changes in neuromuscular activity in vertical jump and flexibility after exposure to whole body vibration. Medicine (Baltimore). 2017;96(33):e7629.
  22. Kosar AC, Candow DG, Putland JT. Potential beneficial effects of whole-body vibration for muscle recovery after exercise. J Strength Cond Res. 2012;26(10):2907-2911.
  23. Morel DS, Dionello CDF, Moreira-Marconi E, et al. Relevance of Whole Body Vibration Exercise in Sport: A Short Review with Soccer, Diver and Combat Sport. Afr J Tradit Complement Altern Med. 2017;14(4 Suppl):19-27.
  24. Sierra-Guzman R, Jimenez JF, Ramirez C, Esteban P, Abian-Vicen J. Effects of Synchronous Whole Body Vibration Training on a Soft, Unstable Surface in Athletes with Chronic Ankle Instability. Int J Sports Med. 2017;38(6):447-455.
  25. Sierra-Guzman R, Jimenez-Diaz F, Ramirez C, Esteban P, Abian-Vicen J. Whole-Body-Vibration Training and Balance in Recreational Athletes With Chronic Ankle Instability. J Athl Train. 2018;53(4):355-363.
  26. Beck BR. Vibration Therapy to Prevent Bone Loss and Falls: Mechanisms and Efficacy. Curr Osteoporos Rep. 2015;13(6):381-389.
  27. Marin-Cascales E, Alcaraz PE, Ramos-Campo DJ, Martinez-Rodriguez A, Chung LH, Rubio-Arias JA. Whole-body vibration training and bone health in postmenopausal women: A systematic review and meta-analysis. Medicine (Baltimore). 2018;97(34):e11918.
  28. Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S. Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study. J Bone Miner Res. 2004;19(3):352-359.
  29. Zaidell LN, Pollock RD, James DC, et al. Lower Body Acceleration and Muscular Responses to Rotational and Vertical Whole-Body Vibration at Different Frequencies and Amplitudes. Dose Response. 2019;17(1):1559325818819946.
  30. Lau RW, Liao LR, Yu F, Teo T, Chung RC, Pang MY. The effects of whole body vibration therapy on bone mineral density and leg muscle strength in older adults: a systematic review and meta-analysis. Clin Rehabil. 2011;25(11):975-988.
  31. McMillan LB, Zengin A, Ebeling PR, D S. Prescribing Physical Activity for the Prevention and Treatment of Osteoporosis in Older Adults. Healthcare (Basel). 2017 Nov 6;5(4);Nov 6(5(4)).
  32. Leung KS, Li CY, Tse YK, et al. Effects of 18-month low-magnitude high-frequency vibration on fall rate and fracture risks in 710 community elderly—A cluster-randomized controlled trial. Osteoporos Int. 2014;25:1785-1795.
  33. Von Stengel S, Kemmler W, Bebenek M, Engelke K, Kalender WA. Effects of whole-body vibration training on different devices on bone mineral density. Med Sci Sports Exerc. 2011;43(6):1071-1079.
  34. Tapp LR, Signorile JF. Efficacy of WBV as a modality for inducing changes in body composition, aerobic fitness, and muscular strength: a pilot study. Clin Interv Aging. 2014;9:63-72.
  35. Lam FM, Liao LR, Kwok TC, Pang MY. The effect of vertical whole-body vibration on lower limb muscle activation in elderly adults: Influence of vibration frequency, amplitude and exercise. Maturitas. 2016;88:59-64.
  36. Merriman H, Jackson K. The effects of whole-body vibration training in aging adults: a systematic review. Journal of geriatric physical therapy (2001). 2009;32(3):134-145.
  37. Dutra MC, de Oliveira ML, Marin RV, Kleine HC, Silva OL, Lazaretti-Castro M. Whole-body vibration improves neuromuscular parameters and functional capacity in osteopenic postmenopausal women. Menopause.2016;23(8):870-875.
  38. Kawanabe K, Kawashima A, Sashimoto I, Takeda T, Sato Y, Iwamoto J. Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly. Keio J Med. 2007;56(1):28-33.
  39. Dong Y, Wang W, Zheng J, Chen S, Qiao J, Wang X. Whole Body Vibration Exercise for Chronic Musculoskeletal Pain: a Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil. 2019.
  40. Bovenzi M, Schust M, Mauro M. An overview of low back pain and occupational exposures to whole-body vibration and mechanical shocks. Med Lav. 2017;108(6):419-433.
  41. Chou R, Huffman LH, American Pain S, American College of P. Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med. 2007;147(7):492-504.
  42. Mannion AF, Junge A, Taimela S, Muntener M, Lorenzo K, Dvorak J. Active therapy for chronic low back pain: part 3. Factors influencing self-rated disability and its change following therapy. Spine (Phila Pa 1976). 2001;26(8):920-929.
  43. del Pozo-Cruz B, Hernández Mocholí M, Adsuar J, Parraca J, Muro I, Gusi N. Effects of WHole Vibration Therapy on Main Outcome Measures for Chronic Non-specific Low Back Pain: A Single-Blid Randomized Control Trial J Rehabil Med 2011;43:689-694.
  44. Zheng YL, Wang XF, Chen BL, et al. Effect of 12-Week Whole-Body Vibration Exercise on Lumbopelvic Proprioception and Pain Control in Young Adults with Nonspecific Low Back Pain. Med Sci Monit. 2019;25:443-452.
  45. Wang XQ, Pi YL, Chen PJ, et al. Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial. Trials. 2014;15:104.
  46. Kim H, Kwon BS, Park JW, et al. Effect of Whole Body Horizontal Vibration Exercise in Chronic Low Back Pain Patients: Vertical Versus Horizontal Vibration Exercise. Ann Rehabil Med. 2018;42(6):804-813.
  47. Li G, Zhang G, Wang Y, et al. The effect of whole body vibration on health-related quality of life in patients with chronic conditions: a systematic review. Qual Life Res. 2019.