**6. Whole-body vibration exercise in patients with chemotherapy-induced neuropathy**

Cancer represents one of the main causes of morbidity and mortality worldwide [60]. Hopefully, the number of cancer survivors is increasing progressively due to the increasing ability to early detect and treat the conditions.

Chemotherapy-induced neuropathy (CIN) is a common side effect of cancer treatment with chemotherapy, with 68.1% of patients suffering from CIN in the first month after chemotherapy [61], 60% after 3 months and 30% after 6 months. The condition may express as sensoric and/or motor, and sometimes also autonomic dysfunction, leading to important limitations in activities of daily life [62, 63]. As other types of neuropathy CIN heavily impairs physical fitness due to the severe consequences of loss of peripheral somatosensory information on balance and locomotion [64, 65].

The relevance of WBV exercise in the management of cancer therapy-related morbidities has been addressed before [66], specifically its implications for cancer survivors suffering from CIN [67]. Evidence from high level of evidence primary studies suggest WBV to be a potentially effective intervention for cancer survivors with CIN. However, only two high level of evidence primary studies have analyzed


**Table 3.**

*WBV intervention characteristics of the studies including people with CIN.*

the effectiveness of WBV in this population, suggesting that WBV could prove useful to reduce pain [68], sensory ability and strength and function [62]. These information are pointed out in **Table 3**.

Although evidence of the relevance of WBV in people with neuropathy (diabetes- and chemotherapy-related) arises from high level of evidence studies, evidence from high methodological quality studies is on demand, considering some methodological issues in the studies. Therefore, high quality studies are needed to strengthen the existing body of knowledge regarding the effectiveness of WBV in people with neuropathy.

## **7. Whole-body vibration exercise in patients with Parkinson's disease**

Neurodegenerative disorders have an high impact for both individuals and society [69] and Parkinson's disease (PD) is among this type of conditions.

PD is a slowly progressive neurodegenerative disorder, which affects nearly 1 million north Americans [70, 71]. Apart from the classic motor symptoms, such as rigidity, bradykinesia, resting tremor and postural instability, usually associated with nigrostriatal system degeneration, other non-motor symptoms, with more complex etiology, including neuroendocrine and metabolic disturbances are present [72, 73].

The burden of PD to society, payers, patients, and health professionals is high and interventions to reduce PD incidence, delay disease progression, and alleviate the disease impact, may reduce the burden of the condition [71].

The benefits of WBV in this population has proven conflicting, with studies reporting greater effects in the WBV group and studies reporting a lack of real benefit when comparing with control groups.

Two studies [74, 75] compared the acute effects of a 1-session WBV program at different vibration frequencies on balance, gait or flexibility parameters in patients with PD. One of the studies [75] suggested that higher frequencies seem to produce more effective results but only reported significant effects in flexibility after a WBV session, when compared with the control group, and the other [74] showed that none of the vibration frequencies had better results than the placebo group.

Other studies have compared the benefits of a WBV program, over several weeks, with placebo [76, 77], with an aerobic exercise program [78], conventional balance training [79] and conventional therapy and combined (conventional + WBV) therapy [80]. When compared to placebo, one study [76] reported no advantage of WBV but the other study [77] reported significantly better results in the WBV group regarding balance and gait parameters. When compared to an aerobic exercise program, the oxygen consumption during exercise was similar and the WBV group did not required a long time of recovery and led to less feeling of fatigue. When compared to conventional balance training the results were positive in both groups, however, posturography parameters only improved in the WBV group. Similarly, when compared to conventional therapy, both groups evidenced an improvement in balance. The combined therapy group (conventional + WBV) achieved significantly better results than the conventional therapy group, but not the WBV group, suggesting that WBV could be a useful co-adjuvant intervention to increase balance in PD patients. These information are indicated in **Table 4**.

WBV seems to be a promising intervention in PD, as an independent or coadjuvant modality, but the existing result heterogeneity does not allow a confident recommendation. More good quality, placebo controlled, studies are needed to establish the clinical effectiveness of WBV in improving functional parameters in people with PD.

**23**

**8. Summary**

**Table 4.**

Corbianco et al. [78]

Ebersbach et al. [79]

Guadarrama-Molina et al. [80]

*Whole-Body Vibration Approaches in Neurological Disorders*

alternating

alternating

alternating

Side alternating

Side alternating

*WBV intervention characteristics of the studies including people with PD.*

**Study WBV type WBV frequency and peak-**

**to-peak displacement, or magnitude**

**Other aspects**

sessions/5 weeks

sessions/5 weeks

4 sessions/weeks for 4 weeks

15 min/session, 2 sessions/day, 5 days/week for 3 weeks

3 sessions/week

3, 6 or 9 Hz, 13 mm 5× 1 min bouts, 1 session

6, 12 or 18 Hz, 4 mm 5× 1 min bouts, 1 session

6 Hz, 13 mm 5× 1 min bouts, 12

26 Hz, 4 mm 20× 1 min bouts,

chemotherapy-related) and Parkinson's disease.

Whole-body vibration exercise is an exercise modality that induces musculoskeletal, endocrinological, vascular and neurologic responses, which are relevant in the context of neurological conditions. This intervention proved to be promising for people with multiple neurological conditions and its results have been discussed for people with stroke, cerebral palsy, spinal cord injury, neuropathy (diabetes- and

Gaßner et al. [77] Unknown 6 Hz, 3 mm 5× 1 min bouts, 12

25 Hz, peak-to-peak displacement or magnitude not reported

Vertical 20 Hz, 2 mm 8× 20 sec bouts, 20 sessions,

*DOI: http://dx.doi.org/10.5772/intechopen.97534*

Chouza et al. [74] Side

Dincher et al. [75] Side

Arias et al. [76] Side


### **Table 4.**

*Therapy Approaches in Neurological Disorders*

information are pointed out in **Table 3**.

people with neuropathy.

present [72, 73].

the effectiveness of WBV in this population, suggesting that WBV could prove useful to reduce pain [68], sensory ability and strength and function [62]. These

Although evidence of the relevance of WBV in people with neuropathy (diabetes- and chemotherapy-related) arises from high level of evidence studies, evidence from high methodological quality studies is on demand, considering some methodological issues in the studies. Therefore, high quality studies are needed to strengthen the existing body of knowledge regarding the effectiveness of WBV in

**7. Whole-body vibration exercise in patients with Parkinson's disease**

Neurodegenerative disorders have an high impact for both individuals and society [69] and Parkinson's disease (PD) is among this type of conditions.

PD is a slowly progressive neurodegenerative disorder, which affects nearly 1 million north Americans [70, 71]. Apart from the classic motor symptoms, such as rigidity, bradykinesia, resting tremor and postural instability, usually associated with nigrostriatal system degeneration, other non-motor symptoms, with more complex etiology, including neuroendocrine and metabolic disturbances are

The burden of PD to society, payers, patients, and health professionals is high and interventions to reduce PD incidence, delay disease progression, and alleviate

The benefits of WBV in this population has proven conflicting, with studies reporting greater effects in the WBV group and studies reporting a lack of real

Two studies [74, 75] compared the acute effects of a 1-session WBV program at different vibration frequencies on balance, gait or flexibility parameters in patients with PD. One of the studies [75] suggested that higher frequencies seem to produce more effective results but only reported significant effects in flexibility after a WBV session, when compared with the control group, and the other [74] showed that none of the vibration frequencies had better results than the placebo group. Other studies have compared the benefits of a WBV program, over several weeks, with placebo [76, 77], with an aerobic exercise program [78], conventional balance training [79] and conventional therapy and combined (conventional + WBV) therapy [80]. When compared to placebo, one study [76] reported no advantage of WBV but the other study [77] reported significantly better results in the WBV group regarding balance and gait parameters. When compared to an aerobic exercise program, the oxygen consumption during exercise was similar and the WBV group did not required a long time of recovery and led to less feeling of fatigue. When compared to conventional balance training the results were positive in both groups, however, posturography parameters only improved in the WBV group. Similarly, when compared to conventional therapy, both groups evidenced an improvement in balance. The combined therapy group (conventional + WBV) achieved significantly better results than the conventional therapy group, but not the WBV group, suggesting that WBV could be a useful co-adjuvant intervention to

increase balance in PD patients. These information are indicated in **Table 4**. WBV seems to be a promising intervention in PD, as an independent or coadjuvant modality, but the existing result heterogeneity does not allow a confident recommendation. More good quality, placebo controlled, studies are needed to establish the clinical effectiveness of WBV in improving functional parameters in

the disease impact, may reduce the burden of the condition [71].

benefit when comparing with control groups.

**22**

people with PD.

*WBV intervention characteristics of the studies including people with PD.*
