August 29, 2014

Vibration Therapy: Neuromuscular Re-Education

Vibration Plate TherapyAlthough Neuromuscular Re-Education has no universally accepted definition, it generally refers to a treatment technique or exercise performed by an individual with the purpose of improving, via the nervous system, the level of communication between the body and the brain.

Because of the fact that vibration training and vibration therapy exercises rely on the involuntary stretch reflex, there is a significant amount of communication occurring between the brain and the contracting muscles with each individual exercise.

This serves to “jump start” the muscle through the severely high frequency of muscle contractions thereby enhancing the patient’s ability to efficiently recruit the muscle fibers, coordinate movement being performed by the joint, and muscle tissue, and reduce the typical post-injury mechanical dysfunction in a much more rapid fashion than traditional exercise; exercise that relies on voluntary movement.

This is often best demonstrated by having the patient perform a multi-planar exercise (an exercise that combines movements along several planes of motion. For example, raising a weight from the floor, in front of your left leg, to overhead using the right arm. This movement requires that the weight be raised up (sagittal plane), moved left to right (frontal / coronal plane) and rotated from in front to behind during the motion (transverse plane).

Proprioceptive Training

Also built in to the neuromuscular re-education process of this phase is something referred to as proprioceptive training. Proprioception is defined as the sense of the relative position of neighboring parts of the body. The proprioceptive system provides feedback solely on the status of the body internally. It is the sense that indicates whether the body is moving with required effort, as well as where the various parts of the body are located in relation to each other (thank you Wikipedia!).

In my practice it is joint position that is of primary concern to my patients. Much like in Phase 1 mentioned above, proprioceptive information is sent to the brain by certain receptors in the joints so while performing an exercise on the platform, this positional information “battles” the vibratory information already being overwhelmingly supplied to the brain. With careful consideration to the position being held during an exercise on the platform, certain case-specific movements can be performed in adjacent regions with the intention of actively enhancing the proprioceptive information being sent to the brain by those regions.

Successful enhancement of this proprioceptive communication is best measured by having the patient perform a simple region-specific proprioceptive exercise before and after exercising on the platform (i.e. pelvic clocks – #1 below or single leg balance exercises – #2 below)

#1

#1

#2

#2

What is even more exciting about this phenomenon is that, in some cases, the proprioceptive benefits are seen in regions located far from those being stimulated. In the articles to follow, I will discuss the 3rd and 4th phases of treatment as well as other areas that have peaked my interest and that of my patients as well.

Written by By Gabriel Ettenson, MS, PT

Comments

  1. John Weatherly says:

    Super information. For athletes (which is a different population)the neural potentiation of a vibration warmup can/may be beneficial. The old Soviet information I have also mentions vibration as warmup helps put the agonist muscles to work without a lot of antagonist activity which happens in beginners. In other words, according to this old Soviet information, it enhances coordination or the learning of movements. Great anecdotal information Gabriel. Hopefully, the scientists will prove all of this in the not to distant future.

  2. Thanks John,

    With a few of my higher level patients…those at the sports specific phase of their rehabilitation…I have begun to look at the post-vibration effect on their “standard” rehab exercise performance. In other words, I am assessing both their subjective reports of ease of performance on the exercuse as well as their movement efficiency with the exercise and general fatigue levels. It has been a bit unclear so far, but with several individuals, they reported feeling much more fluidity with the movement, increased ease of performance of the exercise and were able to tolerate HIGHER levels of resistance after coming off of the vibration platform.

    I think that improved motor unit recruitment and certainly improved proprioceptive feedback mechanisms must be at play here.

    I am meeting with a physician next week in an attempt to get him “on board” with an actual clinical study. We’ll see how it goes.

  3. John Weatherly says:

    I hope the doc comes on board and you are able to document things in a clinical study. I agree about motor unit recruitment and proprioception. Keep on sharing information with us here at vibrationtraining.net.

  4. My boyfriend has MS. I have heard of re-education by one therapist, but not in use with Vibration Therapy. Has any research been done with this therapy on a possible use for MS? If so, where can I find more information?

  5. Wendy,

    MS is a disease that attacks the central nervous system and reduces the speed at which nerve signals are trasmitted to the muscles. There are other components of the disease, but for the purposes of discussing vibration therapy, this is of most importance. In this case, the “re-education” process would be about trying to improve upon the speed and efficiency of the existing connections (those that have not been too severely effected). Hopefully though, there could also be some improvement upon the ones that are negatively influenced by the disease. The ultimate goal would be to improve communication and allow for the individual to have better motor control while improving strength and endurance at the same time. Keep in mind too that vibration therapy also has demonstrated a potential to allow for more intense exercise without potential for severe levels of fatigue (a big issue for the MS population trying to exercise regularly). A search on google for MS and whole body vibration should reveal quite a few studies, but be careful what you are reading. Look for reliable sites. If you want more info or have further questions, feel free to contact me at ptgde@hotmail.com.

  6. a pubmed.gov (US site) search will bring up a couple potentially supportive research studies. I am sure there is quite a bit more to come as a former colleague of mine who heads up the rehab department at the MS center here in NY City is just starting to use WBV with the patients and has found promising reults so far.

  7. John Weatherly says:

    I’m not aware of any PhD in vibration therapy. Sounds very bogus. It’s likely a misnomer from somebody getting a PhD and looking at vibration therapy as their dissertation.

  8. I think this is a great article

    The url has been deleted as advertising/marketing is not permitted in our comments.

  9. Dan Pelletier says:

    Vibes,

    That platform looks like one that would be used to provide therapy to horses. Man the weight capacity is large.

    Where are you from?

  10. Vibes,

    My friend Mike White, who is a breathing specialist, purchased two vibe plates and came over and tried a machine I have and was shocked how much weaker the vibrations are on the vibeplate.

    From what I can gather it is similar to the soloflex in that it is just a platform with a motor underneath.
    Though it is much larger and holds more weight.

    Is that the case? If not, please explain exactly how the vibrations are produced AND if there is any amplitude whatsoever on the edges.

    The soloflex is a platform with a vibrating motor creating the vibrations AND no amplitude on the edges.

    I personally have used the soloflex and was very unimpressed with how it worked.

    Thanks,
    Bryant

  11. P.S. I agree with Di Heap that blatant link spamming like Vibes submitted should not be permitted and all posts like that should be deleted by the moderator.

    If you are going to provide a link, at least give some valuable content pertaining to the thread.

    Bryant

  12. Gabriel says:

    Can we use this section to discuss science? Why even engage in conversation with this idiot.

  13. Hi Gabriel,

    Since Vibes posted a link, I DID want him to discuss the science of his product… Lets give him a chance to explain…

    Vibeplate is doing agressive advertising online and the feedback I have heard is not very good. It seems to be nothing more than a large platform with a motor underneath (like an oversized soloflex). Yes it can handle a lot of weight, but how are the vibrations produced? I think the public needs to know the truth about this product.

    Bryant

  14. Gabriel says:

    Bryant,

    I completely understand, but if you look at what’s being written it should be quite obvious that this guy/girl lacks the intelligence to discuss things maturely. Ultimately though, since I took a great deal of time to write this article, I’d rather choose to leave the dicussion here open to things pertaining to the article. I still hold on to the hope that a therapist might be out there to indulge me in a conversation on the therapeutic end of things.

  15. Dr. Samuels,

    Although clinical research for use of vibration training and MS is still in it’s early stages, this certainly seem like an intelligent investment. Like any investment though, you get what you pay for and if your goal is to improve your muscle function and therefore your quality of life, this is not the time to be looking to save money. You are investing in your well being…what is more valuable than that?

    The vibrogym is quite pricey. I believe that someone else would be better qualified to recommend a more reasonably priced platform that would suit your needs while not sacrificing quality. I do not believe that a pivotal system would be recommended over a lineal system however.

    Good luck.

  16. David Samuels says:

    Hi. Firstly, I cant thank enough the regular contributors to this site for their kindness and dedication. Your work has helped and will continue to help many. I am a Doctor working in Israel and Ive had MS for over 10 years. Fortunately for me the MS is relatively mild. I would like to get a vibration plate for home use and Im more than a little confused. Since vibration therapy is performed at lower freq,lower strengths, and may be given by pivitol or linear machines, would a cheaper pivitol machine have as much theraputic benefit for me as the much more expensive quality linear plates? I would like to be athletic but Id be overjoyed just to be able to walk further than 20 minutes (what I can just do now).The only vibration plate available to me here that seems to fit your criteria for a good vibration trainer is the ‘Vibrogym Domestic’ but it would cost me an arm and a leg to buy here (not so bad cause I dont use mine that much) and if a cheaper plate coupled with tradional exercise would be almost as good then maybe I could hold on to my limbs and use them too.
    Thanks

  17. I have numerous clients that suffer from MS and Fibromyalgia. We only run Vibrogym pros (lineal) at the moment but we combine infrared saunas prior to some sessions. The saunas help with the pain management,flexibilty and cardio. At home we recommend LOTS of stretching, good hydration and light weights for some (we suggest some home exercises). Massage therapy is another valuable tool for some. It really depends on each individuals limitations.

  18. David Samuels says:

    Hi,Thank you all for your kind advice. I will continue to refer interested health professionals I am in contact with to this site. I just wanted to clear a couple of things up. My reluctance in investing in a vibration ‘training’ machine has more to do with not trusting myself than not trusting the benefits of the technique. I am,by nature, a couch potatoe with a long history of unused gym memberships, and converting home fitness equipement into clothes hangers. For those of you on the frontlines, has client drop out been a problem ? After posting my first comment I had the oportunity to contact a former patient of our hospital who had been recieving privately some kind of vibration tx for his MS. He reported that he had great improvement in strength and mobility in the first month but no further progress over the following 5. He seemed to have give up. I found out latter a ‘cheap as’ machine is being used by his therapist. I will pass on the information to him and his therapist but, unfortunately, I am unaware of any reputable centre providing vibration training in this country and I think his therapists motivations lie elsewhere. (a tiny taste of your frustrations?)
    David

  19. Gabriel says:

    Curious to know for my own information…what is the rationale behind your concern about extended time being detrimental to the nervous system? Didn’t you, in a previous post, claim that there is little research behind use of vibration training and MS?

    Also, I am confused about why you would recommend a cheaper plate since your whole drive on this forum seems to be about quality and efficiency? The idea of “upgrading later” doesn’t make sense..especially when someone is concerned about their wellbeing and budget.

    I am not trying to be confrontational, but there seems to be quite a few contradictions here and I would like to understand as much as I can.

  20. Dan Pelletier says:

    Gabriel, PB for some reason is a double post. I (Deb) did not post the comment a day later under PB, not sure what happened there. (we’re in western canada)

    Anyway, in no way are we recommending a Vibrogym for Samuel. Frankly were not a big fan of the vibrogym domestic we simply use the pros (lineal) in our studio and relay usage comfort with lineal when used appropriately by individuals with MS or Fibro. (poses/speed and energy levels can be adapted to beginner levels for fitness or therapy). Frankly we refer to therapists to do theraputic work, thats there specialty not ours but theraputic benefits are enjoyed just staying within recommended programs & poses.

    I think to keep it simple, the subject is only for theraputic use, a low energy machine is a place to start without a large investment but over time will not challenge you enough and you’ll likely decide to move to a higher energy platform whether it be a pivotal or lineal unit. the rest, speeds, movement etc. are covered under articles written to date. As you improve you will likely want to go farther but will be limited by the low energy. (he’s even stated understanding you will be upgrading once you see the benefits)

    Everyone has a starting place, pivotal is just a little more affordable to most and geared via low energy to more of a theraputic response but can help condition an individual to move onto a higher energy platform to take them to next level. For those where budget is not a concern then yes, perhaps a larger investment in a machine that you will not plateau so quickly on would be a good recommendation. (if $$ is no concern then likely these types will try different machines until they find an appropriate match.

    Samuel, we like everyone here don’t want to sell you anything and contribute only to help.

    Within these energy levels and technical (lineal pivotal) differences there are definately some that will work to spec and some that won’t, this site helps guide consumers through the differences allowing more balance in there considerations.

    Contradictions, I’ve never really noticed any, cheap is cheap, quality is quality and you pay more for quality whether it be pivotal or lineal. This site and its contributors provide more knowledge (without condition) than any other out there that helps guide consumers and investors, again asking for nothing in return is why I enjoy and support this site. It speaks large volumes about the strong positive ethics of those who regularly contribute and wish to see longevity in this industry.

    John, I enjoy all your contributions, Gabriel hope we clarified our comment and Samuel all the best in your search! Our Best Regards.

  21. Gabriel says:

    Thanks for the thorough response. I have a few questions for you Deb if you would be so obliged to answer.

    1) You say that you let the therapists “do the therapeutic work”. How do you differentiate what you do with the platform for these clients from what a therapist would do with them?

    2) You state that pivotal is geared toward a more therapeutic response yet we have already seen numerous time here that the theoretical value of pivotal is questionable as MAY increase shearing forces and MAY contradict normal human biomechanical movement. How is that therapeutic?

    Also, you state “we simply use the pros (lineal) in our studio and relay usage comfort with lineal when used appropriately by individuals with MS or Fibro. poses/speed and energy levels can be adapted to beginner levels for fitness or therapy)”

    You are using lineal for therapy no?

    3) Your words, “Contradictions, I’ve never really noticed any, cheap is cheap, quality is quality and you pay more for quality whether it be pivotal or lineal.”

    Also, “So my advice….

    Buy a “cheap as” machine now, understanding you will be upgrading , but only after you see the positive effects of just the Therapy. I am quite sure by that stage the investment will not be questionable.”

    I don’t mean to be a pain in the ass, but even in your post that attempts to help avoid confusion, there seems to be even further contradiction. Time and time again, contradictions continue to raise confusion for me and I think it is important to clarify things to develop my own knowledge base so a response would be helpful.

    Thanks

  22. John Weatherly says:

    Dr. Samuels did mention about a cheaper untit combined with traditional exercise – that if this would be almost as good he’d consider this option.

    I too am a little confused though. Can you buy a cheaper unit (therapy unit) and know it will perform as it’s supposed to (i.e., be able to trust fq settings etc.)? Or, is this not important for “therapy?”

  23. I have numerous clients that suffer from MS and Fibromyalgia. We only run Vibrogym pros (lineal) at the moment but we combine infrared saunas prior to some sessions. The saunas help with the pain management,flexibilty and cardio. At home we recommend LOTS of stretching, good hydration and light weights for some (we suggest some home exercises). Massage therapy is another valuable tool for some. It really depends on each individuals limitations.

  24. Gabriel says:

    That is my exact question John and it seems Dr. Samuals supports the idea that a cheap machine may prove to be lacking the potential for long term progress.

    PB…where are you located?

  25. My response was a little long winded was’nt it. sorry about that all.

    Gabriel I think you need to take a little more time and review all the material available here. By all means you have a computer and access to the same tools as anyone so your learning can be as endless as you wish (warning may require “psychological therapy” afterwards) hehehe ;).

    Again, you have the choice to go where you wish to learn and to make your own choice as to how to utilize what you’ve learned.

    Academic learning would cost you and frankly is not available here at least, this is a free consumer site for everyone and is not driven by a sales team. Contributions by regular posters are ethical and made by well informed/practised individuals with integrity.

    Your comments seem a little agenda driven, especially point 2, shearing could occur with misuse on any vibration equipment or perhaps on a triplanar.

    I’m sure samuel will appreciate all of this information and advice considering his options but still his choice….

    General theraputic effects are in context with vibration machine use but you seem to want to push your agenda.

    What is your purpose here Gabriel?

  26. Gabriel says:

    Dan, Deb, PB…whoever you may be tonight,

    If you are unable to to answer the questions that I pose, which I feel were quite reasonable given your post, perhaps there are other ways to respond outside of an attack on my character and subtle insults.
    Can you say Passive-Agressive anyone?

    What is my agenda you ask? Well…if you have read any of the articles that I have done for the site (including the one that you are posting off of tonight) it would seem to the keen eye that I am a fellow vibration enthusiast with a considerable amount of “academic learning” whos purpose is to further explore the beneficial applications of vibration on the human body and develop further discussion of those benefits and how exactly they are achieved. This is how I define “therapy”. Being a Physio, I have been taught never to be a robot using protocols for each and every patient.

    I use a vibration platform every day with almost every one of my patients and quite a few training clients on top of that. Given my professional knowledge and experience in the field of physical therapy (almost 11 years now), I have seen quite a few things happen when Vibration is incorporated into a rehab program. Things, believe it or not, may differ from time to time from what has been written in previous articles. I have no interest in battling anyone on this site. I have a great deal of respect for his knowledge and contribution. I simply cannot just accept things when they seem to contradict other things I have read in other articles (all of which I have read by the way). If I am confused about something it should be quite easy to set me straight with an educated explanation.

    I know from the occasional dispute on this site that there are others like me out there and I encourage them to participate. This is the best forum available for the development of this science and I hope that in the future, if someone wants to engage in an intelligent discussion on a subject, they won’t have to worry about having their intentions questioned so abruptly.

    When you have an answer to my previous post, I’d love to hear back from you.

  27. Gabriel, our intenetion is not to attack your character, but we do not focus on therapy as you may define as it’s very broad (something we see lots of and don’t mean to pass on you).

    Sometimes writing is difficult.

    Getting specific responses to these types of questions is better left to a pro, my wife (Deb) was trying to be helpful to Samuel period if that helps clarify, PB is a mystery to us.

    Clients that we deal with either clear contraindicators or must be cleared for use by a medical professional period. What we do is general fitness and utilize basic massage and stretch poses that are simple yet effective to help improve strength and balance. Basic toe touch (ham stretch), lat stretch etc… theraputic is defined as massage based therapy vrs movement or other types of therapy that is left to you the pro’s. We hope more will step up to help the industry thrive.

    We do apologize, we made a classic mistake and spoke before we read, when we have bad days (today was a nightmare), we have bad days so again our apologies, and thanks for your contributions.

    “low” speed pivotal, due to the power they create feel very light when used, don’t create much pressure and I liken to a foot massage effect. They can be as cheap as couple to a few hundred dollars and if your goal is basic theraputic use it’s an affordable option to try the tech without spending thousands of dollars especially if not readily available. In this case we agree with him thats all. Responsible usage of the equipment and using the correct poses and excersizes designed for the type of equipment you use or being referred here does not hurt either. The theraputic response is more massage therapy oriented and restricted in poses and body exposure, ie no massaging the head, belly not to be placed on platform.. hope that makes sense.

    Lineal, only for the “massage” therapy or stretches and only on vibrogyms low (amp) setting for stretches (40hz), i use 35 from time to time, low or high (amp) for massage (40-50hz). But keep in mind the other benefits such as natural improvment in circulation, lymph stim. etc. If we noticed (we are with our clients the whole time) difficulty or problems we will always recommend a prof. to diagnos potential problems and treat them as they see fit hopefully the client will be able to return or can still pursue there fitness goals avoiding problem areas until ready.

    Sorry Gabriel (you can slap me if we ever meet, we deserve it and will take it like stand up people :))but you are the man and through your guidance and initiatives has helped us help others which is in the end the ultimate goal.

    Cheers.

  28. Gabriel says:

    Thank you both for responding. Through your responses you have helped me understand what has been quite a confusing term for me here. Many, many times, this term has been related to Physiotherapy. Whether it be in response to someone with a medical issue or a physiotherapist asking a question. I have been asked to write about “vibration therapy” because, presumably, I am a Physio. Therefore, the term “therapy”, in my mind, has been quite clearly a reference to usage for the purposes of rehabilitation. And to be honest, the article here on therapy vs. training quite clearly makes that connection.

    Here is my issue and perhaps, if it makes sense, it could help further clarify future discussions or perhaps allow me to redefine the title under which I write my articles.

    What Dan and Deb make clear is that they use their platforms for….

    “general fitness and basic massage and stretch poses that are simple yet effective to help improve strength and balance.”

    “Theraputic is defined as massage based therapy vrs movement or other types of therapy that is left to you the pro’s.”

    These words imply that this is not necessarily a physiotherapy patient, but rather someone, anyone, that may have the need for these physiological improvements that would participate in a “therapy” program no? For example, a yoga fanatic would benefit from a therapy machine while and athlete a training mcahine…neither one is a physiotherapy patient.

    A physiotherapy patient is someone with an impairment and honestly, strength improvement beyond the established limits of the muscle is at the absolute top of the list for 90% of physiotherapy patients.We always push to imaximize gains with a patient not just bring them back to baseline and maintain them there. The idea that phsyiotherapy, at least here in the US, is restricted to the old and infirm is obsolete. We, driven by health care issues, more often than not, are the ones who are turned to for more thorough expert analysis and treatment on all individuals.

    In NY, while I do have quite a few individuals who require the basic physiological responses listed in the previous post, I am often referred athletes, fitness freaks, and aged hypermobile dancers. All of whom have developed, amongst other things, including pain, muscle weakness and some level of reduced muscular endurance from a biomechanical dysfunction. Whether it is from training ignorance or degenerative compensation, for these individuals, a training platform would theoretically be of greater benefit.

    To summarize, is it asking too much, for the term “therapy” to be defined a bit better. It seems it would apply to the general public in need of specific changes vs. the true definition of a physiotherapy patient. Perhaps it is a difference in healthcare that has caused the confusion?

    On a side note, we are not allowed by certain insurances to perform PT one someone with a diagnosis of osteoporosis or general inflexibility.

    Anyway, just a thought. I would imagine that more and more US PT’s will be visiting the site and if they are going to drop quite a bit of money on a durable platform, their patient population needs to be considered first. Applying a “therapy” machine to an athlete in Physiotherapy could only serve to convince the patient that this is ineffective in the long term and therefore BS. Something that we are trying hard to avoid.

    Thanks for the podium.

  29. Gabriel says:

    As defined by wikipedia, “Physical therapy (physiotherapy in many English speaking countries) is a health care profession which provides services to individuals and populations to develop, maintain and restore MAXIMUM movement and functional ability throughout life.”

    The word “maximum” suggests that our responsibilities are to go beyond “baseline” and that includes strength training, endurance training etc. for all patients. That is what we are taught in school and that is the way we are supposed to practice. There is obviously a fine line between what is medically justifiable and what is considered “personal training” and certainly some individuals may have limitations in their tolerance to vibration. Also, to be clear, I by no means am suggesting that we bill insurance for gym memberships or what may be deemed personal training services.

    The point is that once we have brought a patient back to baseline, we have a responsibility to go beyond. This for most patients, may include what you define as vibration training. To take them all that way and them leave them at the mercy of a personal trainer or better yet their own judgement on what they need to do to go beyond and maximize their function would be irresponsible and more detrimental than beneficial. No offense to personal trainers, but their is no shortage of individuals who have been destroyed by personal trainers here in NY. Guess who cleans up the mess?

    So…the bottom line is that your limited training in the actual field of Physical Therapy may slightly limit your view on Vibration Therapy / Training and its applications to Physiotherapy…especially here in the US. I am not trying to insult you and I know I will be hated for this post by many, but I do wish you’d consider that when you make therapeutic suggestions in the future. Everyone, including myself, places a great deal of value on your advice and opinions and accuracy is very important when trying to establish legitamacy. I just feel it is important to keep an open mind and realize everything is not so simply marginalized.

    Perhaps some sort of a differentiation in terminology could help develop this science while not detracting from what you have already established.

  30. John Weatherly says:

    Gabriel,

    I have appreciated the excellent articles you have written and the many contributions you have made here. I hope you keep coming back and letting us know about your experiences and thoughts.

    I am trained from a performance perspective in sports physiology etc. which is different than a physical therapist. Strength and conditioning for athletes is my main area of interest. I respect physical therapists and the knowledge they have. I also feel a person such as myself probably has a little different perspective than most physical therapists in regard to peformance enhancement. Having said that, I just want us to get along and be able to integrate our knowledge and experiences.

    I think it’s great we have people such as Murray who obviously knows a heckuva lot about vibration on here along with others such as Gabriel. That’s what helps make this site what it is. So, please come back and share here Gabriel. Let’s not split hairs even though I shared your concerns about fq etc. being reliable on cheaper platforms for therapy in regard to Dr. Samuels question about combining vibration on a cheaper unit with traditional exercise etc.

  31. Gabriel says:

    John…quit your job and become the Secretary General of the UN immediately. You are always a reliable voice of reason and a great mediator. In fact, I was wondering this morning why we had not heard from you yet.

    I apologize if I was unlcear in my posts that I had no intention of “arguing” with you or anyone else on this forum. Also, I do not feel I have been condescending. referencing your profession was meant to emphasize your unfamiliarity with mine not to demean yours. If there is a Physio out there, I would love to have their point of view on the subject as they would likely understand the profession better and perhaps support OR reject the idea that it is not so cut and dry for us. We do have other roles when thoroughly rehabilitating our patients and those roles cover that grey area between therapist and trainer.

    You said in your post:

    We have Physios in N.Z. for our top sports teams and those same teams have strength and conditioning coaches ( they call them Trainers ). As is with all top teams in the U.S. But according to you they do the same job?”

    The answer is NO, but there is quite a grey area in between the two and many are capable of and do in fact work within that grey zone to the benefit of the patient/client etc.

    To maximize a patients rehab, the patient must complete the, let’s call it the “introductory training phase” (strengthening and conditioning to MAXIMIZE their potential progress in rehab) and it is 100% medically justified and reimbursable. The terms, “stable”, “basic level of function” etc. are straight up inaccurate terms to describe our “cut off point”. The word “maximize” is in the official American Physical Therapy Association definition of Physical Therapy. Perhaps not in New Zealand’s?

    You mention the “six pack” request. Is that what someone asks a strength and conditioning coach or an athletic trainer…I don’t believe so…maybe I am incorrect…John would know better. Nor do I feel that their role is targeting weight loss so that seems neither here nor their to me.

    As healthcare reimbursement has dwindled here, we are “cashing in” on our knowledge, experience, and expertise and “branching out” into Pilates, Yoga, Personal Training etc. My goal is to develop what you have developed, vibration training. Once these begin we are off of insurance and performing what you define as “training”, but it is introduced during the end stage of the therapy. That is how our patients step down from therapy with a strong knowledge base and safe understanding of the activity and how to progress. The other option is to send them to a gym and have them learn how to “shake off their fat” on the Powerplate. That’s what the trainers here say.

    The point is that all these things are still the role of the Physio and for that reason I asked my original question, “wouldn’t these factors need to be considered when recommending a machine to someone”. Clearly there are demands for dual purposes of the platform and having two platforms seems to costly and inefficient to be the only option. Perhaps your knowledge of construction makes it the only option. if so, tell me that.

    I truly feel that the difficulty that you, Di and Deb/Dan have understanding my point has to do a lot with differences between the US and NZ and the evolution of the Physio profession here..perhaps occurring faster in the US and perhaps something that most people outside of the profession are unaware of. Your beliefs on our roles are considered “old school” here. Not to insult you, but the honest truth.

    I may only represent a small to medium percentage of the Physio population following this path right now, but this is a change that will occur more rapidly in coming years and perhaps you, a respectable, knowledgeable, and experienced authority on vibration training/therapy, would find this info helpful and it could better prepare you for what, in the US at least, will be a future application of vibration training/therapy.

    I hope that makes things a bit clearer and if not, I will relent and continue to support this site in the best ways that I feel I can.

    Thanks

  32. Gabriel says:

    Like previous “debates” that I have posed on this site, my point has been totally missed and I am getting nowhere. Perhaps I am not clear enough? Perhaps it is because I am a Physio discussing the theory of my profession with a mortician? Either way, thanks for the replies and I believe it is time for me to just “move on”.

    For my own information, are there any Physiotherapists actually on this site?

    Thanks

  33. Gabriel says:

    Thanks for the replies. I feel we are getting closer to establishing clarity on this discussion, but I blame myself because some of my points have been missed. That’s neither here nor there though. I am just glad to put an end to things. I have never questioned your protocols and clearly they are what separates you from all these failing businesses.I have been following your protocol all along and it works…no questions about it.

    That’s kinda what I have been asking the whole time. If this is possible, why recommend therapy units only to therapists when, as I mentioned, they may have plans to do both as a normal progression of their rehab (end stages) and also for additonal future side business.

  34. This thread is starting to make my head spin. I am slightly confused as to what is the bottom line – is it:
    What is the difference between vibration training used for therapy and vibration training used for strength, inch loss, fitness etc?
    or
    Can a studio straddle the dual role of providing therapy and general purpose fitness?
    or
    Can a cheap unit be used for therapy?
    Quite hard to contribute without being clear about the nub! But for what it’s worth here’s my tuppence worth – apologies if I missed anyone’s point.

    The vast majority (about 95%) of the clients in our studio come because the want to be slimmer. That is their main reason. Added to this – yes they want to be stronger, more flexible, improved bone density and all the the other things but ulimately they want to look good in their bikini! However we have had in a number of clients who have come in for purely therapeutic reasons (stiffness, post operative healing, osteo-arthritis) and they have received great benefits too.
    In terms of running a business I would be closed in a month if I targeted this group – they simply would not ever be the bread and butter of what we do. If we were to move into this area – we would have to offer 1:1 sessions and charge around £50 a session for this to work.
    In terms of the safety programme that Vibra-train and I use – the more I do this and the busier I get – the more I value how well the programme works. Firstly it ensures that everyone gets a whole body workout rather than an unbalanced pick and mix of exercises. Secondly it ensures people get through the programme in the 20 min slot. However probably THE most important factor is getting them to learn how to do the set number of poses CORRECTLY. Whether all people in the UK are rubbish kinesthethic learners or whether this is a worldwide problem I don’t know. What I do know is that 80% of my clients have immense difficulty even getting themselves to stand with feet hip-width apart and parallel. It takes them an average of about 10-30 sessions (depending on their learning style) to learn how to hold these few poses precisely and believe it or not we have people who have been coming for months who still need constant reminding. The scale of wrong (and therefore potentially dangerous) positioning if we threw more positions in would be huge. Having the Vibratrain machines has really helped as their design fits the programme so it is much easier for our customers to hold positions correctly. The delay timer also means the trainer can give all their attention to ensuring positioning is correct and that people are being challenged to an appropriate level rather than acting as a machine programmer.
    Not sure if any of that helps.

  35. Mike Hair says:

    Hi Philippa,

    Don’t sweat it about how difficult it is for people to learn the poses, i have clients that have been coming to me for over 2 years now, that i still have to abuse for not taking their time and concentrating.

    You will find they often still swear at their most frequent customers, infact they are usually the ones that become too familiar and think they know it all.
    a little abuse goes a long way and you will find the customer…

    A: appreciates you for taking notice and correcting them or

    B: Thinks they are better than you and know more so probably won’t return

    9 times out of 10 they stay, as it is the 1 on 1 hands on approach that customers like and know they are getting value for money.

    Mike

  36. Gabriel says:

    My business has always been built on word of mouth. I take great pride in my work and have worked tirelessly to educate myself, provide one-on-one, hands-on care, and always keep up with newer trends in rehab and fitness. Your “business model explanation” makes complete sense, but having something that is in short supply in NY generates “buzz” and between physicians hearing about newer therapy tools that could, and does, benefit their patients to the continuous contact I receive from other individuals whom I have never met or have nothing to do with a physician referral asking to try vibration therapy/training (depending on who told them about me) is how I make up that 75% and justify the cost of a more expensive platform. One other thing to consider is that in NYC…people will pay! This city and the Upper East Side particularly (where I work) is built on both vanity, continuous functional independence and ambition to never age. There is quite a bit of money here and higher rates for services can be potentially higher.

    Anyway, what I realize is that I am perhaps the minority who approaches things in this particular fashion right now. I also realize that I have never put business over my work and maybe that makes me slightly idealistic. I trust that your protocols are the way to go as I learn, but I cannot 100% buy into the fact that any form of therapy or fitness can follow a protocol for every individual. I do appreciate though that you are trying to just get standards in place so legitamacy can be established. I have come away from this with a lot more helpful information. I appreciate all your feedback and look forward to continuing to contribute and of course, occasionally raising hell.

  37. Thanks guys – good to know it’s not just the Brits that are a bunch of rubbish malco-ordinated fools then! Yes I just keep chipping away and you are absolutely right Mike – 9/10 people do appreciate being kept safe and are quite reassured by my constant nagging! And yes we also have lost the odd one to Powerplae who wants to do a one handed plank and sit up up on the machines and is most put out when I tell them “No!”.

  38. David Samuels says:

    Hi, Thanks once again to everyone for your help. Most of what has been written makes good sense to me except for the occasional animosity which sneaks in. I continue to ask my egocentric questions in the hope that your answers will interest others as much as they do me. In particular, the advice on getting a ‘cheap as’ machine initially, made perfect sense to me. So much so that I am considering ignoring it and getting a ‘training’ machine. Which brings me, in my long winded way, to my 2 questions. Firstly, is Vibrogym Domestic (the only machine available to me for financial and geographic reasons) adequate for home vibration training and secondly, though I need no help in feeling physically inadequate and there is
    no shortage of people who would love to beat me with a rubber hose, I have as yet to find here a personal trainer experienced in vibration training. Keeping in mind that this is allways prefered, can I learn enough from the instructional DVD that comes with the machine and following the workout guidlines provided elsewhere, to get reasonably productive and safe vibration training at home?
    Thanks again,
    David

  39. I like it! Bootamp style vibration! Am off to the Farm shop now for a cattle prod. May stop off at an S&M shop too for a few whips and chains. Ve have Vays of making you stick to ze programme.

  40. Hi David
    Personally I wouldn;t rate Vibrogym domestics – they are not steel and not great. For that kind of budget I would recommend you look out for a second hand Vibrogym Pro, an second hand Bodyshaker Pro or Bodyshaker Junior, or you may be able to afford a new Bodyshaker Junior which retail at about £3,500 (similiar to the VG domestic price?)Re training – Vibrogyms own training posters have many many positions some of which I would not consider safe. Probably best thing to do is have some one who is body aware check you carefully on it for a number os sessions – it can be very hard to check yourself particularly on things like pelvic stability.

  41. Hi Ted
    No – didn’t get your email otherwise I would have responded. Try again : info@resonancevt.co.uk

  42. Gabriel says:

    Hi David. I think the difference there is that the delux is the newer design with a different panel. It can also be adjusted by 1 hz increments, from 1-60 hz. Whether the base is larger, which would be worth it if it is, is something you should ask Josh. I don’t think the frequency adjustment alone is worth it as lower frequencies are essentially useless. The original personal unit is a good machine and affordable. The vibrogym is much pricier no?

  43. Gabriel says:

    Unless you weigh 301 lbs or more, I cannot see the need to go to the newer platform. The settings recommended on this site are avail. on the older unit. Unless the technology has changed of course. I think they are both still the same basic systems.
    Good Luck.

  44. David Samuels says:

    Hi Guys,
    I will,once again, availe myself of your expertesse. Progress has been slow over here hunting down a domestic machine suitable both for therapy and training. To make a long story less long, I can get my hands on(with the banks help) a hypergravity machine, either the domestic or domestic delux model. I am not sure what the differance between them is in terms of performance but the price diff. will be $500+. I hope to speak with the sales rep/manager soon. I believe the Hypergravity Domestic model has been mentioned favourably elsewhere and I was wondering what your preference would be between the 2. The only other posability for a training machine would be a Vibrogym Pro, but there is a limit to the banks generosity…
    Thanks,
    David.

  45. David Samuels says:

    Hi Gabriel,
    Thanks so much for your prompt reply!, asspecially since Im dying to get started. As per add.,(still havent spocken to the rep yet) the Domestic has freq. settings from 25 to 60hz., increments not mentioned, timer settings from 15 to 120secs., and a max. load of 300lbs.. The Delux version has freq. settings from 15 to 73hz.,adjustable by 4hz. increments, timer settings from 0 to 190secs., and a max. load of 325lbs. It also has 6 automatic programs. Other than the above they seem roughly the same, including platform size. Worth the price diff.? The Vibrogym Pro is much more expensive than both, unfortunately.
    Ill let you know what the rep/manager has to add.
    Im so grateful for your continuing help.
    David

  46. David Samuels says:

    Thanks Gabriel. This is more like a chat line than a blog! The Manager/Owner? of Hypergravity just rang from California, Josh Hayon. Very nice man. He feels I would enjoy/benefit more from the Delux version because the control panel is better designed, the freq. settings go up to 73 in 1hz increments, they get great feed back from clients addicted to the auto programs, it looks better, and is a more sturdy build. It also weighs alot more (190lbs compaired to 110lbs).They subsidize its freight. Might the weight diff. make a diff. also in the transmitted force of the vibrations?
    David

  47. Philippa- Did you receive my email? I sent it a couple of weeks ago….I figured you would respond so just checking…cheers!

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