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Assessment of disc injury in subjects exposed to long-term whole-body vibration.

Long-term exposure to whole-body vibration is known to increase the risk of low back problems. The chain of events leading from repeated loading of the lumbar spine to back complaints and the exact nature of the vibration-induced damage are, however, obscure. Fluid in- and outflow as well as viscoelastic deformation are important aspects of the physiological function of the lumbar disc. Precision measurement of stature, termed 'stadiometry', has previously been applied in healthy subjects to document changes in disc height in relation to the load on the lumbar spine. The purpose of this study was to explore the relation between spinal loading and stature in a cohort of 20 subjects with long-term exposure to whole-body vibration. If the change of stature (and thus the change of disc height) caused by changes in spinal loading differed between exposed and normal subjects, this would point to vibration-induced changes in structure and material properties of the discs. For this purpose, four hypotheses were tested: (1) the viscoelastic deformation and fluid exchange of intervertebral discs during phases of spinal loading and unloading differs from normal; (2) the water content of lumbar discs of subjects exposed to long-term whole-body vibration deviates from normal; (3) the mean disc height of the lumbar spine depends on the total time of vibration exposure; (4) repeated loading influences trabecular bone density of vertebrae in the lumbar spine. A cohort of 20 operators of heavy earth-moving machinery was enrolled. Back complaints suspected to be due to long-term exposure (mean 17.6 +/- 2.1 years) to whole-body vibration and application for early retirement were the selection criteria used. Change of stature during a regular 8-h shift and change of stature in standing, carrying and sitting activities were measured. The stadiometric investigations were supplemented by magnetic resonance imaging (MRI) of the lumbar spine to assess whether the water content of the discs exhibited deviations from normal. In addition, quantitative computed tomography (QCT) was performed to assess whether the trabecular bone density of the third lumbar vertebra deviated from normal. The results showed no significant difference in change of stature while standing, carrying or sitting between exposed machine operators and non-exposed operators. Likewise, MRI examinations revealed no significant differences in the water content of the discs averaged over the lumbar spine. In addition, QCT examinations revealed no significant difference in the trabecular bone density of the third lumbar vertebra. The study thus revealed no significant difference between a cohort with long-term exposure and non-exposed controls with respect to viscoelastic properties of discs as determined by stadiometry, average water content of lumbar discs and trabecular bone density of L3.

Adult↗

Increased left ventricular function as an adaptive response in vibration disease.

Vibration disease results from the long-term use of vibrating tools. Vibration, noise, and cold are stressors that impair the human body, inducing vibration disease. From echocardiographic methods, the left ventricular ejection fraction in vibration disease was 79 +/- 4%, a significantly higher value than that in control subjects (75 +/- 6%) (p less than 0.01). The increase in ejection fraction appeared to be due mainly to an increase in left ventricular end-diastolic dimension. The value of the ejection fraction was proportional to the activity of the autonomic nerves. The stroke volume index in patients with vibration disease was also significantly larger than that in the control subjects (p less than 0.001). Electrocardiograms revealed a significantly lower heart rate at rest and an increase in the ratio of T waves to R waves in precordial lead V6. These data suggest that the cardiovascular system in patients with vibration disease provides an adaptive response to the stressors.

Adaptation, Physiological↗

Effect of vibration of the ankle stretch reflex in man.

Vibration at frequencies above 50 Hz applied to the tendon of the extensor muscles of the ankle joint produce the tonic vibration reflex (TVR) which increases when the vibration frequency is increased. The TVR affects a joint's mechanical response to sinusoidal and random oscillations in a manner similar to that seen with tonic voluntary contraction. Although the myotatic reflex is suppressed by vibration, repeated stretches of sinusoidal oscillation produce an average EMG response which is not different in magnitude from the no vibration case. Either polysynaptic mechanisms at the spinal cord level of mechanisms involving higher centers (and possibly both) are able to overcome the inhibitory mechanisms at the Ia-alpha motoneuron level in producing a stretch evoked resonance near 6 Hz. The degree of inhibition of the myotatic component of the stretch reflex is proportional to the vibration frequency. This is in contrast to the facilitation of the myotatic reflex produced by tonic voluntary contraction. Vibration does not seem to influence the post-myotatic component (> 100 msec) of the stretch reflex. These results indicate that the post-myotatic responses to limb perturbation are not only different in their latency but also in their functional dependence upon peripheral influences.

Adult↗

Assessment of tibial stiffness by vibration testing in situ--II. Influence of soft tissues, joints and fibula.

The influence of soft tissues and joints on the vibration of the human tibia was examined by modal analysis on amputated lower limbs, where the soft tissues and the fibula were dissected gradually. Measurements were made in two different set ups, IFR and BRA, which were both designed to monitor fracture healing. In IFR, vibrations are generated by hammer impact on a relaxed hanging lower leg, with the knee flexed. Resonant frequencies are determined by a computer Fourier transform procedure. In BRA, a steady state vibration is induced in a lower leg, supported near the ankle and the tibial tuberosity, using an electromagnetic shaker. Resonant frequencies are determined from the maxima in vibration amplitudes. In both set ups the soft tissues have a similar influence on the vibration of the tibia: the skin hardly influences the determined modal parameter. The mass of the muscles influences both the resonant frequency and the damping. The fibula has a stiffening effect on the tibia. The influence of the joints is small in the IFR-set up: the tibia vibrates in conditions close to those for the free-free vibration. In the BRA-set up, the supports determine the boundary conditions.

Biomechanical Phenomena↗

Influence of age, temperature, sex, height and diazepam on vibration perception.

Vibration perception was quantitatively examined in 92 healthy volunteers (46 females, 36 males, aged 10-71 years). Vibration perception thresholds, vibration disappearance thresholds and vibration thresholds were assessed at the second metacarpal bone, styloid process of ulna, lateral epicondyle of humerus, first phalanx of the big toe, first metatarsal bone, medial malleolus and proximal part of the tibia bilaterally. Vibration sensitivity was found to be age-dependent. Under the age of 60, the correlation was linear. Vibration thresholds depended on body site but they were not related to sex or body side. Temperature and diazepam affect the perception of vibration considerably. Small interindividual variability was found in measurements repeated in 3 consecutive days, after 4 weeks and after a year.

Adolescent↗

Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.

This randomized controlled trial investigated the effects of a 12 month whole body vibration training program on postural control in healthy older adults. Two hundred and twenty people were randomly assigned to a whole body vibration group (n=94), a fitness group (n=60) or a control group (n=66). The whole body vibration and fitness groups trained three times a week for 1 year. The vibration group performed exercises on a vibration platform and the fitness group performed cardiovascular, strength, balance and stretching exercises. Balance was measured using dynamic computerized posturography at baseline and after 6 and 12 months. Whole body vibration training was associated with reduced falls frequency on a moving platform when vision was disturbed and improvements in the response to toes down rotations at the ankle induced by the moving platform. The fitness group showed reduced falls frequency on the moving surface when vision was disturbed. Thus, whole body vibration training may improve some aspects of postural control in community dwelling older individuals.

Accidental Falls↗

Vibration training: benefits and risks.

The main results of our recent several studies, i.e. the measurements of vibration training results for single case and group studies as well as the cardiovascular parameter measurements during vibrations and the corresponding hydrodynamic analysis, are summarized. Our studies and previous work all confirm that vibration training is an effective training method in order to improve maximal strength and flexibility as well as various other factors if the training is properly designed. Some recommendations regarding the proper ranges of frequencies, amplitudes and exposure duration of vibration training are made based on the existing vibration training practice and mechanism analysis, although much work remains to be carried out in order to set up clear rules for various groups of people so that maximal training results could be expected and in the meantime potential dangerous effects could be avoided. Cardiovascular parameter measurements confirm that total peripheral resistance (TPR) to the blood flow is increased during body vibration. Hydrodynamic analysis offers the mechanism for the increase of TPR through the deformation of vessels. As a reaction of compensation, more capillaries are probably opened in order to keep a necessary level of cardiac output needed for the body, resulting in more efficient gas and material metabolism between the blood and muscle fibres. This might be one of the reasons for the various potential beneficial effects of vibration training.

Adult↗

Vibration energy absorption (VEA) in human fingers-hand-arm system.

A methodology for measuring the vibration energy absorbed into the fingers and the palm exposed to vibration is proposed to study the distribution of the vibration energy absorption (VEA) in the fingers-hand-arm system and to explore its potential association with vibration-induced white finger (VWF). The study involved 12 adult male subjects, constant-velocity sinusoidal excitations at 10 different discrete frequencies in the range of 16-1000 Hz, and four different hand-handle coupling conditions (finger pull-only, hand grip-only, palm push-only, and combined grip and push). The results of the study suggest that the VEA into the fingers is considerably less than that into the palm at low frequencies (< or = 25 Hz). They are, however, comparable under the excitations in the 250-1000 Hz frequency range. The finger VEA at high frequencies (> or = 100 Hz) is practically independent of the hand-handle coupling condition. The coupling conditions affect the VEA into the fingers and the palm very differently. The finger VEA results suggest that the ISO standardized frequency weighting (ISO 5349-1, 2001) may underestimate the effect of high frequency vibration on vibration-induced finger disorders. The proposed method may provide new opportunities to examine VEA and its association with VWF and other types of vibration-induced disorders in the hand-arm system.

Arm↗

Quantification of mechanical vibration during diffusion tensor imaging at 3 T.

Subjects sense clear mechanical vibrations during diffusion tensor imaging (DTI). These vibrations, likely resulting from diffusion-sensitizing gradients, have been assumed to be of the same strength and phase in all parts of the magnetic resonance imaging (MRI) scanner so that they could be ignored. However, our measurements, carried out from several parts of the MRI scanner and its surroundings using an optical laser-based interferometer, demonstrate an uneven distribution of mechanical vibrations within the scanner. The measurements were performed during DT scanning at 3 T, with various diffusion-weighting parameters, by positioning a phantom in the head coil and/or a human subject on the patient bed. The vibration-related movement was caused by the diffusion-sensitizing gradients and was maximally 0.5 mm with typical settings used in brain imaging. The compensation for eddy currents, done with gradients in our DTI sequence, increased the vibration level by a factor of 1.5 or more with diffusion-weighting parameter b = 1000 s/mm(2) and by a factor of 3 or more with b = 3000 s/mm(2). Mechanical vibrations stayed at an acceptable level with b < or = 1000 s/mm(2), resulting in additional signal losses of 5-17%. Vibration levels might be reduced by adjusting imaging parameters, by modifying the gradient waveforms in the DTI sequence, and by redesigning the mechanics of patient bed to effectively dampen the movements.

Animals↗

Needle tip localization using stylet vibration.

Power Doppler ultrasound is used to localize the tip of a needle by detecting physical vibrations. Two types of vibrations are investigated, lateral and axial. The lateral vibrations are created by rotating a stylet, whose tip is slightly bent, inside a stationary cannula while the stylet is completely within the cannula. The minute deflection at the needle tip when rotated causes tissue motion. The axial vibration is induced by extending and retracting a straight stylet inside a stationary cannula. The stylet's tip makes contact with the tissue and causes it to move. The lateral vibration method was found to perform approximately the same under a variety of configurations (e.g., different insertion angles and depths) and better than the axial vibration method. Tissue stiffness affects the performance of the lateral vibration method, but good images can be obtained through proper tuning of the ultrasound machine.

Animals↗

Hand-transmitted vibration from the steering wheel to drivers of a small four-wheel drive tractor.

The paper presents research results of the vibration transmitted from the steering wheel of the small tractor with a 4-wheel drive to the driver's hands. The vibration measurements were carried out on the tractor randomly chosen from the producer's store-house. Before testing the tractor was examined and adjusted following the producer's recommendations. The vibration levels were measured at idling and at full load. The vibration level on the steering wheel was measured and analyzed and the frequency spectra for the chosen working conditions were obtained. The frequency-weighted acceleration, given in m/s(-2), was calculated. The vibration total value was defined as the root-mean-square of the three component values. The obtained values are graphically represented in accordance with ISO/DIS 5349-1979 and ISO5349-1-2001. The vibration exposure for the predicted 10% prevalance of vibration-induced white finger in accordance with Annex C of the same standard was also tested.

Acceleration↗

Some observations regarding the vibrational environment in child safety seats.

A growing issue in the area of vehicular ride comfort is that of child safety seats. Postural, thermal and vibrational comfort considerations are finding their way into child seat design. This paper makes some observations regarding the current state of child safety seat design, then goes on to present the results of vibration tests performed over two road surfaces using two child seats and two children. The vibration levels measured at the interfaces between the children and their seats were found to be higher than the vibration levels between the driver and the driver's seat. Calculated power spectral densities and acceleration transmissibility functions showed that the vibration transmission characteristics of the coupled system consisting of the automobile seat, child seat and child were different from those of the driver/seat system. Whereas, automobile seats normally reduce vibrational disturbances at most frequencies, the child seats tested amplified vibration at most frequencies up to 60 Hz.

Acceleration↗

The effect of altering jaw position on the transmission of vibration between the skull and teeth in humans.

The forces that develop in the human temporomandibular joint during function have never been directly measured, yet many patients exhibit excessive localized wear and tear of the joint, suggesting that at times these forces exceed tissue tolerance. The purpose here was to gain insight into vibration transmission between the cranium and mandible in healthy humans during variations of jaw position. In 13 normal healthy adult men (age 25-40 years) with normal dentitions, vibration (around 400 Hz, sine wave) was applied to the skull vertex and changes in the intensity of the vibration signal were measured using several small linear accelerometers cemented to the buccal surfaces of mandibular first molars and the labial surfaces of maxillary central incisors. The jaw was opened, protruded and moved laterally by the individual participant and vibration signal intensities were tested (lower first molar signal/upper incisor signal) for change at each mandibular position by ANOVA. The results showed the vibration signal changed significantly with opening and less so on protrusion and laterotrusion. The vibration signal during opening could be categorized into three types: (1) signal increased continuously with increased opening; (2) signal increased, then reached a plateau during last third of opening; (3) signal increased, then decreased when the individual moved from 40 mm to maximum opening. These findings show that as the jaw moves laterally, and especially as it opens, the magnitude of the vibration signal increases substantially compared with the near-closed position.

Acceleration↗

A systematic study of the vibrational free energies of polypeptides in folded and random states.

Molecular vibrations, especially low frequency motions, may be used as an indication of the rigidity or the flatness of the protein folding energy landscape. We have studied the vibrational properties of native folded as well as random coil structures of more than 60 polypeptides. The picture we obtain allows us to perceive how and why the energy landscape progressively rigidifies while still allowing potential flexibility. Compared with random coil structures, both alpha-helices and beta-hairpins are vibrationally more flexible. The vibrational properties of loop structures are similar to those of the corresponding random coil structures. Inclusion of an alpha-helix tends to rigidify peptides and so-called building blocks of the structure, whereas the addition of a beta-structure has less effect. When small building blocks coalesce to form larger domains, the protein rigidifies. However, some folded native conformations are still found to be vibrationally more flexible than random coil structures, for example, beta(2)-microglobulin and the SH3 domain. Vibrational free energy contributes significantly to the thermodynamics of protein folding and affects the distribution of the conformational substates. We found a weak correlation between the vibrational folding energy and the protein size, consistent with both previous experimental estimates and theoretical partition of the heat capacity change in protein folding.

Amino Acid Sequence↗

Absorption of energy during vertical whole-body vibration exposure.

Absorbed power (PAbs) during exposure to vertical whole-body vibration in a sitting posture was measured on 15 male and 15 female subjects. Different experimental conditions were applied, such as vibration level (0.5-1.4 m s(-2)) and frequency (2-100 Hz), body weight (54-93 kg) and, relaxed and erected upper body positions. Results show that PAbs was strongly related to the frequency of the vibration, peaking within the range of 4-6 Hz. The peak was predominantly located in the lower end of this range for females and for the relaxed sitting position. PAbs increased with acceleration level and body weight. Almost a ten-fold increase in PAbs was observed at the critical frequency when the vibration exposure was raised from 0.5 to 1.4 m s(-2). If risk assessment is based on the assumption that the amount of PAbs, independent of the frequency of the vibration, indicates a hazard, then the ISO-standard 2631 under- and overestimates the risk at frequencies below and above about 6 Hz, respectively. The results also indicate a need for differentiated guidelines for females and males. Many types of vehicles produce whole-body vibration with frequencies which coincide with the range where the highest PAbs was observed. PAbs is a 'new' concept for measurement of whole-body vibration exposure. Although not yet thoroughly evaluated, this measure may be a better quantity for risk assessment than those specified in ISO 2631 since it also takes the dynamic force applied to the human body into account.

Absorption↗

Design of an active vibration dummy of sitting man.

OBJECTIVE: The determination of vibration transmission through vehicle seats today is still performed with small groups of test subjects. This method suffers from several severe disadvantages, in particular poor repeatability and objectivity due to varying test conditions and limited group sizes. Replacing test persons with a vibration dummy helps to solve this problem. DESIGN: The active vibration dummy simulates the dynamic behaviour of sitting man expressed in terms of the driving point impedance for arbitrary body masses and excitation signals. METHODS: The dummy is realized as a mechatronic system basing on a single degree of freedom setup. A real-time control loop of mass accelerations (and thus acting forces) fits the active dummy to the desired driving point impedance data set. Model and controller parameters are determined by a parameter-identification technique giving meaningful results for arbitrary impedance data sets. RESULTS: The prototype shows excellent agreement with the target data under laboratory conditions. Body mass and excitation level can be varied over the full range of car seat test requirements. RELEVANCE: The determination of vibration transmission through vehicle seats should be possible without human experiments. An active vibration dummy with adjustable vibration behaviour expressed by the vertical driving point impedance covering the entire scope of car seat tests (masses/excitation intensities) is presented. With the dummy, improved seat test procedures could be established, leading to design improvements and therefore to prevention of whole-body vibration injuries.

Acceleration↗

Accurate diagnosis of hip prosthesis loosening using a vibrational technique.

OBJECTIVE: To examine the potential role of vibration testing as a non-invasive method of diagnosing loosening of total hip replacements in the clinical setting. DESIGN: Single blind cohort study in two hospitals. BACKGROUND: Diagnosing loosening of total hip replacements is heavily dependent on investigative techniques that are unreliable. Previous studies into the use of vibration testing have produced conflicting results. METHODS: Comparison of vibration testing and radiographs in patients with a total hip replacement experiencing hip pain symptomatic of loosening, with patients showing evidence of a secure prosthesis. RESULTS: Vibration testing has a sensitivity of 80% and a specificity of 89%. The positive predictive value was 92% and the negative predictive value was 73%; it was unable to produce a definitive diagnosis in 8% of patients. When compared with radiographs from the same patients, vibration testing was shown to be 20% more sensitive and able to diagnose 13% more patients. CONCLUSIONS: Vibration testing can deliver more accurate information on the stability of total hip replacements than radiographs in the clinical setting, despite being in the early stages of development. Relevance. This study shows that 70 more patients may be provided with the correct diagnosis and 46 fewer patients may be undiagnosed each year, when using vibrometry as opposed to radiographs. In view of the relative disparity between the level of development between the two techniques and the encouraging results hitherto presented, it is felt that by improving vibration testing it may supersede radiographs in the detection of prosthesis loosening.

Adult↗

Biomechanical responses of the intervertebral joints to static and vibrational loading: a finite element study.

OBJECTIVE: This study was performed to investigate the time-dependent responses of the intervertebral joint to static and vibrational loads. DESIGN: A poroelastic finite element model was established to analyse the fluid flow, stress distribution and deformation of the intervertebral disc. BACKGROUND: Long-term exposure to whole body vibration is highly associated with disc degeneration and low back pain. It is hypothesized that moderate vibrational loading may increase the efficiency of fluid and nutritional transport of the intervertebral disc while prolonged static and excessive vibrational loading may have deleterious effect. METHODS: A three-dimensional finite element model was established using the actual geometry of the L4-L5 lumber motion segment. Nonlinear poroelastic properties were assigned to the intervertebral disc and cancellous bone. Static and vibrational loads were applied and the responses of fluid flow and stress distributions were analysed. RESULTS: The finite element model showed that the loads carried by the annulus and the facets increased with time under static loading. The fluid flow and deformation of the intervertebral disc were dependent on the loading frequency. CONCLUSION: Vibration loading may be able to enhance disc fluid exchange via the fluid pumping mechanism. RELEVANCE: The predicted responses implied that vibrational motion may be important in facilitating fluid and metabolic transport of the intervertebral disc.

Biomechanical Phenomena↗