:dropcap_open:O:dropcap_close:steoporosis and obesity are important health concerns in the United States. Whole-body Vibration (WBV) therapy has the potential to make a significant impact upon musculoskeletal health and wellness in the coming decade.1,2 It also has the potential of causing significant musculoskeletal harm, and becoming a significant source of doctor liability, if improperly applied.
Many educated readers may recall the lawsuits that arose in the 1990’s regarding the use of decompression therapy in chiropractic clinics, who utilized the literature provided to them by the companies supplying the decompression therapy equipment and were, ultimately, found to be culpable in lieu of the company who wrote the recommendations for the equipment sold. In today’s litigious society, the buck stops at you, Doc.
:dropcap_open:It is the responsibility of the doctor to ensure that the equipment in the clinic is incapable of causing musculoskeletal harm.:quoteleft_close:
Whole-body vibration therapy equipment has this same potential to result in “open-and-shut” litigation in the 21st century chiropractic office. It is the responsibility of the doctor to ensure that the equipment in the clinic is incapable of causing musculoskeletal harm.
Unfortunately, there is a doctor reading this article who is providing their post-menopausal osteoporotic patients with a WBV device designed for healthy athletes. According to Rubin, this doctor—by following the manufacturer’s guidelines for using their equipment—is providing patients with WBV dosage that exceeds the safe limits for WBV exposure as established by the International Standards Organization (ISO), Section 2631-1.3
:quoteright_open:Research suggests bone remodeling occurs best within frequencies around 25-45 Hertz.:quoteright_close:
WBV is the perfect adjunctive therapy to chiropractic when applied properly. Be sure to ask the right questions when purchasing a WBV platform for your office: Is it safe? Is it effective? Just as an AM/FM radio must be “tuned-in” to the ideal settings for maximum musical enjoyment, so must WBV therapy be “tuned-in” to the ideal frequency and amplitude for the maximum targeted physiological benefit. As an example, to-date, research suggests bone remodeling occurs best within frequencies around 25-45 Hertz.4 If you are utilizing a WBV platform that operates outside these frequencies, your patients should not expect to achieve improvements in bone mineral density from their use of WBV therapy. Also, frequencies ≤ 20 Hz or ≥70 Hz may not be effective and may, in fact, be harmful; they should be avoided.5
Whole-body vibration has the potential to provide chiropractors with a significant source of professional revenue, while positively impacting their patients’ long-term outcomes. It also has the potential to expose doctors to liability for inflicting permanent musculoskeletal harm. Choose wisely!
Dr. A. Joshua Woggon, a 2010 Graduate of Parker College, is the Director of the CLEAR Scoliosis Treatment and Research Clinic in Dallas, Texas (www.clearscoliosisclinic.com), and the Director of Research for CLEAR Institute, a Non-Profit Organization dedicated to advancing chiropractic scoliosis correction (www.clear-institute.org). He can be contacted at [email protected]
Research & References
1) Rubin C., Recker R., Cullen D., Ryaby, J., McCabe and K. McLeod: Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. J. Bone Miner. Res. 19 (3) (2004), pp. 343–351.
2) V. Gilsanz, T.A.L. Wren, M. Sanchez, F. Dorey, S. Judex and C. Rubin: Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J. Bone Miner. Res. 21 (9) (2006), pp. 1464–1474.
3) Rubin: Contraindications and potential dangers of the use of vibration as a treatment for osteoporosis and other musculoskeletal diseases. April 2007.
4) Prisby, et al: Effects of whole body vibration on the skeleton and other organ systems in man and animal models: What we know and what we need to know. Ageing Research Reviews 2008;7:319-329.
5) Totosy de Zepetnek, Giangregorio & Craven: Whole-body vibration as a potential intervention for people with low bone mineral density and osteoporosis: A review. Journal of Rehab. Res. & Dev. 2009.