The increased muscle activity during vibration training caused by the TVR, leading to a mechanical overload, may result in improvements in neuromuscular parameters after long-term WBV training. For obtaining increases in strength by WBV, it is evident that the load of a WBV training programme, determined by training volume and training intensity, must be high enough to create an overload on the muscle, resulting in a supercompensation situation, which can end in an increased force-generating capacity. In general, the training load of a WBV programme is low at the beginning but increases gradually according to the ‘overload’ principle [24]. Training volume can be increased by increasing the duration of one vibration session, the number of series per exercise or the number of different exercises. Training intensity can be increased by shortening the rest periods between the exercises, increasing the amplitude and/or frequency of vibration and increasing the load on the muscles (e.g., by changing the execution form from two-legged to one-legged exercises).

Several studies evaluated the effects of long-term WBV training, on muscle strength in the elderly population (Table 10.1). We will go into some of those studies in more detail.

In community-dwelling postmenopausal women (58–74 years), we performed a 6 months WBV training study [24]. Eighty-nine postmenopausal women were randomly assigned to a WBV group (n = 30), a resistance training group (RES, n = 30) or a control group (n = 29). The WBV group and the RES group trained three times a week for 24 weeks. The WBV group performed unloaded static and dynamic knee-extensor exercises on a vibration platform (35–40 Hz, 1.7–2.5 mm, total duration 3–30 min). The RES group performed dynamic leg press and leg extension exercises increasing from low (20 repetitions maximum (RM)) to high (8RM) resistance. The control group did not participate in any training. Isometric and dynamic knee-extensor strength increased significantly in the WBV group by 15.0% and 16.1%, respectively, and in the RES group by 18.4% and 13.9%, respectively, after 24 weeks of training, with the training effects not significantly different between these groups. Countermovement jump height enhanced significantly in the WBV group by 19.4% and in the RES group by 12.9% after 24 weeks of training. Most of the gain in knee-extension strength and speed of movement and in countermovement jump performance had been realised already after 12 weeks of training. The results of WBV were thus comparable with those achieved by conventional resistance training. As can be seen in Table 10.1, several later studies, in different age categories, also found significant increases in isometric knee-extension strength [25–28]. The additional effect of vibration training compared with the same exercises performed without vibration did however not reach significance in the study of von Stengel [28].

Russo et al. [29] found an improved muscle power and velocity of movement in older women after 6 months WBV (10–28 Hz, 3x 1–2 min, 2x/week).

Most studies suggest that especially untrained or older individuals with low fitness levels could benefit from WBV. This assumption is supported by a review article of Rehn et al. [30]. Nine of the 14 analysed WBV studies reported an increase in leg strength or power, whereby eight of these studies included untrained or elderly subjects.

In a meta-analysis of 13 RCTs, it was concluded that whole-body vibration is beneficial for enhancing leg muscle strength among older adults [31]. More specifically they found a significant treatment effect on knee-extension dynamic strength (standardised mean difference = 0.63), leg extension isometric strength (standardised mean difference = 0.57) and functional measures of leg muscle strength such as jumping height (standardised mean difference = 0.51) and performance in sit-to-stand (standardised mean difference = 0.72) among older adults compared with no intervention.

As such, WBV training in older community-dwelling women appears to be a safe, suitable and efficient strength training method with a low starting threshold for those who are not attracted to or not able to perform conventional resistance training. The major part of the subjects who followed a WBV training programme was very enthusiastic and motivated to continue after the end of the study, indicating that WBV has a potential for application in the geriatric and therapeutic sector [24].

Several studies have assessed the effect of WBV on lean body mass (LBM), as measured with DXA, and did not find any effect of WBV training. For example, in our study in 2004 [32], after 6 months of vibration training, increases in maximum strength were reported, but no changes occurred in the total body LBM. In a study of von Stengel [28], increases in LBM were found both for a training group with vibration as a group that performed similar exercises without vibration. However, the effect of resistance training on LBM was not enhanced by the addition of a vibration stimulus.

In contrast, in studies in which local muscle mass was determined with CT scan, increases in muscle mass at the thighs were reported [25, 26], which indicates that the effects of WBV training on muscle mass might be rather site specific. In our 1-year training study, we assessed the effects of WBV training on the muscle mass of the upper leg measured by CT. We compared the results of the WBV group (n = 31, 67.3 ± 6 0.7 years) with those of a fitness (FIT) group (n = 30, 67.4 ± 0.8 years) and a control (CON) group (n = 36, 68.6 ± 0.9 years). Muscle mass increased significantly in the WBV group (3.4%) and in the FIT group (3.8%) with the training effects not significantly different between the groups. No significant changes were found in the CON group (see Fig. 10.3).

Almost no studies assessed the effects of vibration on cardiovascular fitness. In one of our studies [33], 220 community-dwelling adults (mean age 67.1 years) were randomly assigned to a WBV group, fitness group or control group. The WBV group exercised on a vibration platform, and the fitness group performed cardiovascular, resistance, balance and stretching exercises. The control group did not participate in any training. To investigate whether WBV might be a cardiovascular stimulus in that population, we assessed HR during training. Heart rate increased significantly up to 62% of heart rate reserve (HRR) in a traditional vibration session and up to 80% of HRR in a more dynamic training session, in which 15 s of traditional standing exercises on the platform was alternated with 15 s stepping on and off the vibrating platform. After 1 year of training, peak oxygen uptake (VO2peak) and time-to-peak exercise (TPE) as measured during progressive bicycle ergometry increased significantly both in the WBV and fitness groups. Both training groups improved similarly in VO2peak (see Fig. 10.4). The fitness group improved significantly more in TPE than the WBV group.

Rubin showed in animals that exposure to high-frequency (30 Hz) and low-amplitude (0.2 g) vibrations may lead to an improved quality and quantity of the bone [34]. Based on these results, WBV training with its high-frequency (25–60 Hz) and high-amplitude (1–10 mm) stimulation was put forward as a potential tool in the prevention and/or treatment of osteoporosis.

We performed a study of 6 months WBV training (35–40 Hz, 2.02–5.09 g, 3–30 min, 3x/week) in postmenopausal women (age, 58–74 years) that were randomly assigned to a whole-body vibration training group (WBV, n = 25), a resistance training group (RES, n = 22) or a control group (CON, n = 23) [32]. The WBV group and the RES group trained three times weekly for 24 weeks. As mentioned before, the WBV group performed static and dynamic knee-extensor exercises on a vibration platform. The RES group trained knee extensors by dynamic leg press and leg extension exercises, increasing from low (20 RM) to high (8 RM) resistance. The CON group did not participate in any training. We found a net gain of 1.5% in hip bone density (measured on DXA), compared to a control group that did not follow an exercise intervention. No changes in hip BMD were observed in women participating in resistance training or age-matched controls (−0.60% and −0.62%, respectively; not significant). Serum markers of bone turnover did not change in any of the groups.