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Nonadiabatic effects on peptide vibrational dynamics induced by conformational changes.

Quantum dynamical simulations of vibrational spectroscopy have been carried out for glycine dipeptide (CH(3)-CO-NH-CH(2)-CO-NH-CH(3)). Conformational structure and dynamics are modeled in terms of the two Ramachandran dihedral angles of the molecular backbone. Potential energy surfaces and harmonic frequencies are obtained from electronic structure calculations at the density functional theory (DFT) [B3LYP/6-31+G(d)] level. The ordering of the energetically most stable isomers (C(7) and C(5)) is reversed upon inclusion of the quantum mechanical zero point vibrational energy. Vibrational spectra of various isomers show distinct differences, mainly in the region of the amide modes, thereby relating conformational structures and vibrational spectra. Conformational dynamics is modeled by propagation of quantum mechanical wave packets. Assuming a directed energy transfer to the torsional degrees of freedom, transitions between the C(7) and C(5) minimum energy structures occur on a sub-picosecond time scale (700...800 fs). Vibrationally nonadiabatic effects are investigated for the case of the coupled, fundamentally excited amide I states. Using a two state-two mode model, the resulting wave packet dynamics is found to be strongly nonadiabatic due to the presence of a seam of the two potential energy surfaces. Initially prepared adiabatic vibrational states decay upon conformational change on a time scale of 200...500 fs with population transfer of more than 50% between the coupled amide I states. Also the vibrational energy transport between localized (excitonic) amide I vibrational states is strongly influenced by torsional dynamics of the molecular backbone where both enhanced and reduced decay rates are found. All these observations should allow the detection of conformational changes by means of time-dependent vibrational spectroscopy.

Computer Simulation↗

Occupational musculoskeletal disorders in the neck and upper limbs of forestry workers exposed to hand-arm vibration.

An epidemiologic and clinical study of neck and upper limb musculoskeletal disorders was carried out on 65 vibration-exposed forestry operators using chain-saws and 31 comparable control subjects (maintenance workers) performing manual activity and not exposed to vibration. Upper limb function was evaluated by measuring finger and wrist circumference size, maximal hand grip strength and range of motion manoeuvres in both the controls and the exposed workers. Vibration from two chain-saws was measured, and vibration exposure for each forestry worker was assessed in terms of 4 h energy-equivalent frequency-weighted acceleration according to ISO 5349. Job analysis indicated a slight excess risk of upper extremity cumulative trauma disorders (CTDs) in the forestry operators compared with the control workers. After adjustment for age and body constitution, significantly higher prevalence rates of persistent upper limb pain, muscle-tendon syndromes and carpal tunnel syndrome were observed among the forestry workers than among the controls. In the forestry operators, the occurrence of upper limb musculoskeletal disorders increased with increasing vibration exposure. Upper limb function was found to be impaired in the forestry workers compared with the controls. Vibration exposure was significantly related to increased finger circumference size, diminished muscle force and reduced joint function. Even though it is difficult to establish the relative importance of vibration and ergonomic factors in the aetiology of CTDs, nevertheless the results of this study indicate that musculoskeletal impairment to the upper limbs was more severe in the forestry operators than in the controls who did solely manual work. This finding and the observed dose-effect relationships suggest that vibration stress is an important contributor to the development of musculoskeletal disorders in workers using hand-held vibrating tools.

Adult↗

Ventricular fold vibration in voice production: a high-speed imaging study with kymographic, acoustic and perceptual analyses of a voice patient and a vocally healthy subject.

Co-vibrations of the ventricular folds are a common finding in the clinical setting. It is not always obvious how much of the perceived voice change can be attributed to the presence of such vibrations. The aim of the present study was to describe laryngeal vibrations as observed by high-speed imaging in cases where ventricular fold vibrations had been observed. The findings at kymographic display of the recordings were correlated to perceptual measures and spectrographic observations. Two subjects, a 65-year-old man with chronic laryngitis and one vocally healthy man, were examined during pressed and breathy sustained phonation. Perceived roughness in the voice quality correlated to irregularities in true vocal fold vibrations as well as to irregular ventricular fold vibrations with large amplitude combined with sufficient closure. In none of the recorded sections did ventricular fold vibrations occur without simultaneous true vocal fold vibrations. Regular vibrations of the ventricular folds of the same frequency as those of the true vocal folds and with a reciprocal pattern did not contribute to any roughness in the perceived voice.

Adult↗

Whole-body vibration exposure: a comprehensive field study.

A comprehensive field study investigated whole-body vibration exposure levels experienced by the train operators of a large metropolitan subway system. The purposes of the study were to measure mechanical vibrations transmitted to the seated train operators, to calculate daily whole-body vibration exposure levels, and to compare these levels with maximum acceptable exposure levels recommended by the international standard on whole-body vibration (ISO 2631). The study also sought to identify factors that may influence mechanical vibrations transmitted to the operators and quantify their effects on the measured vibration levels. The study was carried out by dividing the subway system into subway lines, each line into southbound and northbound directions, and each direction into station-to-station observations. Triaxial measurements were made on all subway lines and for all car types used in the system. For each line, at least two round trips of data were collected. Time-weighted averages of the two sets of data were used for final presentation. A total of 48 round trips were made and more than 100 hours of vibration data was collected and analyzed. All phases of the study were carried out in accordance with the procedures outlined in ISO 2631. It was determined that 6 out of 20 subway lines had vibration levels higher than daily exposure limits recommended by ISO 2631. It was also determined that train speed was the most significant factor influencing vibration exposure levels.

Humans↗

Relation between vibration levels and perceptive and appreciative judgements of overhead crane operators.

The objective of the study was to determine what conditions of exposure to vibrations were responsible for the complaints by workers and what the maximum acceptable vibration levels should be. Vibration was characterized by the unweighted intensity exceeded during 10% of the time (L10) and by the global weighted equivalent intensity (Leqw) during displacement phases and phases involving successive starts and stops or successive hookings and unhookings of the load. The opinions of the workers concerning the intensities of vibration and of shock, and their appraisal of the vibration, were collected. Results show that workers hardly discriminate between vibrations and shocks, and appear more sensitive to horizontal (X and Y axes) than to vertical (Z axis) vibration. Perception as well as appraisal votes are slightly better correlated with intensities of vibration not weighted according to frequency than with weighted intensities, and more with peak intensities (L10) than with r.m.s. values. The vibration intensity weighted globally, which was normally encountered and unpleasant, appears to be about 115 dB(w), which corresponds to the limit value for the intermediate criterion (efficiency reduced by fatigue) proposed by ISO 2631 (1978).

Acceleration↗

Vibrations--discriminant models and possibilities for prognosticating specific and non-specific effects on the organism.

The present study involved 290 workers from branches of industry in which they were exposed to intense vibration and 102 patients suffering from disease due to vibration. Some specific (physiological) indices for exposure to vibration, such as the sensation of vibration, cold provocation test, Doppler-ultrasound, etc., and some non-specific (biochemical) indices, such as blood lipids, electrolytes and trace elements were studied. A discriminant analysis was made and 17 discriminant models (including different numbers of physiological and biochemical indices, age, and length of service) were elaborated. These models were used to predict the presence or absence of concomitant diseases, such as hypertension, coronary heart disease and arthritic lesions in persons exposed to vibrations; the stage of the vibration disease; the occurrence of exposure to vibration or of vibration disease. It was shown that physiological (specific) and biochemical (non-specific) indices affected by the exposure to vibration were interrelated, and that their estimation by means of the discriminant analysis revealed the distinction between the states mentioned above.

Adult↗

Vibration pain provocation can improve the specificity of MRI in the diagnosis of symptomatic lumbar disc rupture.

OBJECTIVE: The purpose of this study was to determine if vibration pain provocation could be combined with magnetic resonance imaging (MRI) to increase its specificity in identifying symptomatic disc disruption identified by discography. DESIGN: Prospective single-blind study. SETTING: Data were collected at a spine specialty clinic and at a diagnostic imaging center. PATIENTS: A total of 206 discs in 78 patients (41 males, 37 females; average age, 39.7 years; range, 18-73 years) were evaluated by MRI, spinous process vibration, and discography. INTERVENTIONS: A hand-held prototype vibrator was applied to the spinous process of each intervertebral disc level to be evaluated. The type of pain provoked with vibration as well as with discography was recorded as painless, dissimilar to clinical pain, or similar/exact reproduction of clinical pain. The discograms and MRI scans were scored on a 0-4 scale. A system was defined for combining the vibration results with MRI. OUTCOME MEASURES: The results of the vibration and MRI were compared with the results of computed tomography/discography to determine how well the results of the evaluations agreed. RESULTS: Vibration pain provocation agreed with discographic pain provocation in 70.9% of the discs. The specificity of MRI compared with discographic findings was only 55.7%. However, this figure improved significantly to 81.3% when relying on the vibration pain provocation in discs with mild or moderate disruption. The sensitivity of the combined evaluation was 85.9% and the accuracy 83.0%. CONCLUSIONS: A small hand-held vibrator could produce pain provocation results similar to those obtained by discography. Results of this noninvasive pain provocation method can improve the specificity and accuracy of MRI in identifying symptomatic disc lesions.

Adolescent↗

The effects of a whole-body vibration program on muscle performance and flexibility in female athletes.

OBJECTIVE: This randomized controlled study was designed to investigate the short-term effects of an 8-wk whole-body vibration protocol on muscle performance and flexibility in female competitive athletes. DESIGN: Twenty-six young volunteer female athletes (ages 21-27 yrs) were randomized to either the vibration group or control group. The vibration intervention consisted of an 8-wk whole-body vibration 3 times a week employed by standing on a vertical vibration platform. As outcome measures, three performance tests (counter-movement jump, extension strength of lower extremities with an isokinetic horizontal leg press, and a sit-and-reach test for flexibility) were performed initially and after 8 wks. RESULTS: A total of 24 athletes completed the study properly. In the vibration group (n = 13) whole-body vibration induced significant improvement of bilateral knee extensor strength (P < 0.001), counter-movements jump (P < 0.001), and flexibility (P < 0.001) after 8 wks of training. No significant changes were found for all the outcome measures for the control group (n = 11). CONCLUSIONS: Whole-body vibration is a suitable training method to improve knee extension maximal strength, counter-movement jump, and flexibility in a young female athlete if it is properly designed. Not only do the optimal frequency, amplitude, and g-forces need to be identified but also the level of muscle activation that would benefit more from vibration stimulation. The improvement of flexibility is important not only for performance but also for the prevention of muscle-tendon injury.

Adult↗

Sleep disturbances caused by vibrations from heavy road traffic.

The influence of whole-body vibrations, noise, and a combination of the two, caused by heavy road traffic (150 events/night) on sleep, subjectively experienced sleep quality, and performance was investigated under controlled laboratory conditions for male and female subjects 20-35 years of age. A room was built above a vibrator table, with the legs of the bed mounted directly on the table through holes in the floor. Vertical vibrations were found to be attenuated by the mattress with 20-40 dB for frequencies greater than 10 Hz, whereas horizontal vibrations were slightly amplified. It could be concluded that when traffic noise [50-dB (A) peak level] is accompanied by vibrations with peak levels of 0.24 m/s2 vertically and 0.17 m/s2 horizontally as measured on the frame of the bed (stimulus duration approximately 2 s, dominant frequency approximately 12 Hz), sleep is more disturbed than is the case when noise alone occurs. The amount of REM sleep, which was significantly reduced for the vibration level mentioned above, was even more disturbed when a higher exposure level, 0.34 m/s2 vertically and 0.24 m/s2 horizontally, was applied. The subjectively rated sleep quality was lower for the higher than for the lower vibration level. Performance in the morning was only influenced for the higher vibration level. It could be concluded that vibration exposure levels near the recommendation made in ISO-standard 2631 for the awake state disturb sleep in man.

Adult↗

Dose-response patterns for vibration-induced white finger.

AIMS: To investigate alternative relations between cumulative exposures to hand-transmitted vibration (taking account of vibration magnitude, lifetime exposure duration, and frequency of vibration) and the development of white finger (Raynaud's phenomenon). METHODS: Three previous studies have been combined to provide a group of 1557 users of powered vibratory tools in seven occupational subgroups: stone grinders, stone carvers, quarry drillers, dockyard caulkers, dockyard boilermakers, dockyard painters, and forest workers. The estimated total operating duration in hours was thus obtained for each subject, for each tool, and for all tools combined. From the vibration magnitudes and exposure durations, seven alternative measurements of cumulative exposure were calculated for each subject, using expressions of the form: dose = summation operator a(m)(i)t(i), where a(i) is the acceleration magnitude on tool i, t(i) is the lifetime exposure duration for tool i, and m = 0, 1, 2, or 4. RESULTS: For all seven alternative dose measures, an increase in dose was associated with a significant increase in the occurrence of vibration-induced white finger, after adjustment for age and smoking. However, dose measures with high powers of acceleration (m > 1) faired less well than measures in which the weighted or unweighted acceleration, and lifetime exposure duration, were given equal weight (m = 1). Dose determined solely by the lifetime exposure duration (without consideration of the vibration magnitude) gave better predictions than measures with m greater than unity. All measures of dose calculated from the unweighted acceleration gave better predictions than the equivalent dose measures using acceleration frequency-weighted according to current standards. CONCLUSIONS: Since the total duration of exposure does not discriminate between exposures accumulated over the day and those accumulated over years, a linear relation between vibration magnitude and exposure duration seems appropriate for predicting the occurrence of vibration-induced white finger. Poorer predictions were obtained when the currently recommended frequency weighting was employed than when accelerations at all frequencies were given equal weight. Findings suggest that improvements are possible to both the frequency weighting and the time dependency used to predict the development of vibration-induced white finger in current standards.

Adult↗

Effect of vibration on a canine cutaneous artery.

Vibration of rings of isolated canine saphenous arteries depressed contractions induced by potassium chloride, prostaglandin F2 alpha, and activation of the adrenergic nerve endings by electrical stimulation. Peak contractions to exogenous norepinephrine were not significantly affected by vibration, being augmented, unchanged, or depressed, whereas contractions during the stable plateau phase were depressed. The calcium entry blocker diltiazem reduced the peak response but not the stable plateau phase of the contraction to norepinephrine; in the presence of diltiazem, vibration still depressed the latter. When vibration was applied during the steady state of contractions evoked by electrical stimulation, the depression was immediate, and its extent increased with both the amplitude (0.025-0.10 mm) and the frequency (30-150 Hz) of vibration. In arteries labeled with [3H]norepinephrine, vibration (120 Hz, 0.1 mm amplitude) during electrical stimulation induced a slight but significant increase in the release of labeled transmitter. It is suggested that the depression of contractions to potassium ions, prostaglandin F2 alpha, sympathetic nerve stimulation, and the plateau phase of the response to exogenous norepinephrine are caused by vibration depressing the force-generating process in vascular smooth muscle. Failure of vibration to significantly depress the peak contraction to norepinephrine may be explained by the facilitation by vibration of the influx of extracellular calcium ions.

Animals↗

Effects of mechanical vibration on left ventricular diastolic properties during global ischemia.

To examine the effect of mechanical vibration on ventricular relaxation and diastolic chamber stiffness under global ischemia, we studied eight coronary perfused, isolated, isovolumic canine left ventricles (LV). To produce varying degrees of impaired relaxation, graded coronary flow reduction and paced tachycardia were imposed. A mechanical 50-Hz, 2-mm-amplitude vibration was applied during diastole and was turned off during systole. Without diastolic vibration, the relaxation time constant of LV pressure (tau) increased with the severity of ischemia. The chamber stiffness index (K) from the diastolic pressure-volume relationship showed a slight increase during ischemia; tau decreased with diastolic vibration. The change in tau with vibration increased with ischemia and was dependent on vibration amplitude but not heart rate. The ratio of tau to the diastolic interval (DI, the time from peak negative rate of LV pressure change to end diastole) always decreased with vibration and was linearly correlated with K (r = 0.93; P less than 0.01). K decreased with vibration when tau/DI was greater than 0.3. We conclude that diastolic vibration improves impaired relaxation and chamber stiffness under myocardial ischemia.

Analysis of Variance↗

Intra-airway gas transport during high-frequency chest vibration with tracheal insufflation in dogs.

High-frequency external chest vibration with tracheal insufflation (high-frequency vibration ventilation) has previously been shown to be an effective mode of artificial ventilation in experimental animals. To investigate the intra-airway gas mixing during high-frequency vibration ventilation (frequency 30 Hz, amplitude 0.4 cm), we used an analysis of the single-breath washout curve that gives the vibration-induced mixing coefficient distribution relative to the no-vibration situation. Data from four anesthetized dogs were collected during constant-flow insufflation at six rates (0.05-0.4 l.min-1.kg-1), at three insufflation durations (2, 4, and 7 s), and with the insufflation catheter outlet at three positions (carina, trachea, and a bronchus) while the vibration was on and off. Vibration enhanced intra-airway gas mixing 14.1 +/- 3.9-fold, with the peak of the enhancement distribution located 125 +/- 29 ml from the airway opening and a distribution width of 121 +/- 29 ml. As insufflation flow increased, the position of the peak enhancement shifted toward the alveolar zone and diminished in peak amplitude. Changing the insufflation duration and the catheter position did not affect the intra-airway mixing induced by vibration. External chest vibration causes a substantial increase of intra-airway gas mixing, bringing alveolar gas to central airways. This leads to overall increased pulmonary gas transport when fresh gas is insufflating the tracheal carina area.

Animals↗

The hemorheologic effects of hand-transmitted vibration.

Vibration white finger (VWF) is an ischemic condition of the hands that is associated with long-term exposure to hand-held vibration tools. The pathophysiology of VWF remains unknown. The aim of this study was to assess the hemorheologic effect of acute hand-transmitted vibration. This study investigated 52 men divided into two groups: VWF = 29, mean age 46.9 years (range twenty-two to sixty-six); Controls = 23, mean age 42.8 years (range twenty to sixty-four). Each subject gripped a vibrating handle for seven minutes thirty seconds at a vibration frequency of 120 Hz with an amplitude of displacement of 0.25 mm. Venous blood was analyzed before and after acute vibration to determine the hematocrit, the plasma hemoglobin concentration, plasma viscosity, and red cell deformability, expressed as red cell transit time (RCTT). At rest, there was no significant difference in RCTT, plasma viscosity, hematocrit, and plasma hemoglobin concentration between the VWF group and controls. Acute vibration did, however, significantly increase the red cell transit time in the VWF group but not in the control group. In both groups vibration resulted in a significant increase in plasma viscosity, hematocrit, and plasma hemoglobin concentration in hand venous blood. Moreover, in each group there was a highly significant correlation between the change in plasma viscosity and the change in the hemoglobin concentration and the hematocrit. The authors conclude that hand-transmitted vibration is associated with hemoconcentration.

Adult↗

Cutaneous nerve fibre depletion in vibration white finger.

Vibration white finger or hand-arm vibration syndrome is the episodic blanching of the fingers in response to cold occurring in those who work with hand held vibrating tools. Clinically the condition differs from primary Raynaud's phenomenon as persistent paraesthesiae and pain are common in the hands and arms and these occur independently from the 'white attacks'. Symptoms can become severe enough to warrant a change of occupation. Industrial compensation may be awarded for vibration white finger but, at present, no simple or reliable objective diagnostic test is available. Calcitonin gene-related peptide (CGRP) is a neuropeptide with powerful vasodilator properties. A deficiency of immunoreactive CGRP nerve fibres has been previously demonstrated in the digital cutaneous microvasculature of patients with primary and secondary Raynaud's phenomenon with the distribution and quantity of other types of nerve fibres not being significantly altered. To determine if the innervation of the cutaneous microvasculature in vibration white finger was also abnormal skin biopsy samples from the fingers of 15 patients with vibration white finger, six healthy age matched controls who worked with vibrating machinery and 26 healthy age matched controls who were heavy manual workers without exposure to vibrating machinery were examined by immunohistochemistry. To try to correlate any histological abnormalities with clinical neurological deficit sensory nerve conduction studies have so far been performed in six patients with vibration white finger.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

Effects of prolonged vibration on motor unit activity and motor performance.

Excitatory input to the alpha motor neuron pool from Ia afferents is enhanced by brief vibration, yet is depressed when vibration is applied for prolonged periods. The purpose of this article is to synthesize recent findings from several studies on the effects of prolonged vibration on motor unit activity and motor performance during maximal and submaximal contractions in humans. Prolonged vibration does not alter voluntary drive during maximal contractions, but it does reduce Ia afferent input to alpha motor neuron pools and discharge rate of motor units in the vibrated muscles, leading to a reduction in maximal voluntary contraction force. Alterations in the activity of the motor unit pool may be variable across synergistic muscles due to potential neural connections between synergistic muscles. Prolonged vibration reduces the force fluctuations during submaximal steady contractions, presumably due to a depression of group Ia feedback from leg muscles. When prolonged vibration evokes a tonic vibration reflex in a hand muscle, the mean discharge rate of motor units during a submaximal force-matching contraction increases, leading to an increase in the associated force fluctuations. In summary, prolonged vibration modulates Ia feedback and motor unit activity, which leads to reduced peak force during maximal contractions and altered force fluctuations during submaximal contractions.

Humans↗

Acute effects of a vibration-like stimulus during knee extension exercise.

PURPOSE: This study was conducted to test whether a low-frequency vibration-like stimulus (rapid variable resistance) applied during a single session of knee extension exercise would alter muscle performance. METHODS: Torque, knee joint angle, EMG activity of rectus femoris (RF) and vastus lateralis (VL) muscles, and VL muscle oxygenation status (near-infrared spectroscopy) were recorded during metronome-guided knee extension exercise. Nine healthy adults completed four trials exercising at contraction intensities of 35% (L) or 70% (H) of one-repetition maximum (1RM) in control (no vibration, Vb-) or vibrated condition (superimposed 10-Hz vibration-like stimulus, Vb+). Maximum voluntary contraction and 1RM were tested pre- and postexercise. RESULTS: During 1RM tests, muscle dynamic strength (P=0.02) and power (P=0.05) were significantly higher during vibrated rather than nonvibrated trials, and strength was significantly higher post- than preexercise (P=0.002), except during LVb- trial. Median spectral frequency of VL and RF EMG activity was significantly higher during postexercise than preexercise 1RM test in the vibration trials but unchanged in the control trials (P<0.02). The rate of muscle deoxygenation was 58% faster during H than L exercise (P=0.001), and vibration superimposition tended to speed muscle deoxygenation rate (P=0.065, 36% effect size) particularly during L trials. CONCLUSION: Vibration superimposition during knee extension exercise at low contraction intensity enhanced muscle performance. This effect appears to result from adaptation of neural factors such as motor unit excitability (recruitment and firing frequency, conduction velocity of excitation) in response to sensory receptor stimulation. Muscle vibration may increase the training effects derived from light-to-moderate exercise.

Adolescent↗

Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study.

UNLABELLED: High-frequency mechanical strain seems to stimulate bone strength in animals. In this randomized controlled trial, hip BMD was measured in postmenopausal women after a 24-week whole body vibration (WBV) training program. Vibration training significantly increased BMD of the hip. These findings suggest that WBV training might be useful in the prevention of osteoporosis. INTRODUCTION: High-frequency mechanical strain has been shown to stimulate bone strength in different animal models. However, the effects of vibration exercise on the human skeleton have rarely been studied. Particularly in postmenopausal women-who are most at risk of developing osteoporosis-randomized controlled data on the safety and efficacy of vibration loading are lacking. The aim of this randomized controlled trial was to assess the musculoskeletal effects of high-frequency loading by means of whole body vibration (WBV) in postmenopausal women. MATERIALS AND METHODS: Seventy volunteers (age, 58-74 years) 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). The WBV group and the RES group trained three times weekly for 24 weeks. The WBV group performed static and dynamic knee-extensor exercises on a vibration platform (35-40 Hz, 2.28-5.09g), which mechanically loaded the bone and evoked reflexive muscle contractions. 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. Hip bone density was measured using DXA at baseline and after the 6-month intervention. Isometric and dynamic strength were measured by means of a motor-driven dynamometer. Data were analyzed by means of repeated measures ANOVA. RESULTS: No vibration-related side effects were observed. Vibration training improved isometric and dynamic muscle strength (+15% and + 16%, respectively; p < 0.01) and also significantly increased BMD of the hip (+0.93%, p < 0.05). 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. CONCLUSION: These findings suggest that WBV training may be a feasible and effective way to modify well-recognized risk factors for falls and fractures in older women and support the need for further human studies.

Aged↗