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Assessment of autonomic nervous activity in hand-arm vibration syndrome patients using time- and frequency-domain analyses of heart rate variation.

OBJECTIVES: The aim of the present study was to non-invasively assess autonomic nervous activity, using time- and frequency-domain analyses of heart rate variation (HRV), and to investigate the relationship between indices of HRV and duration of exposure to vibration (DEV), time since retirement from work involving vibration (TR) and time undergoing treatment (TT) in a group of patients with hand-arm vibration syndrome (HAVS). SUBJECTS AND METHODS: Twenty one HAVS patients who were no longer exposed to vibration and were undergoing standard treatment for HAVS, and 10 healthy control subjects, similar to the patients in age, height, weight and number of current smokers and drinkers, volunteered for this study. Indices of HRV [time-domain indices (the mean of R-R intervals, standard deviation and coefficient of variation) and normalized units of frequency-domain indices [low frequency (LF) and high frequency (HF) components], indicating parasympathetic nervous activity, were calculated from 2 min electrocardiographic data recorded during spontaneous breathing by subjects in supine rest. RESULTS: The LF and HF components of the patients were significantly lower than those of the healthy controls (P < 0.05). When Pearson correlation analysis was applied for the patient group, using indices of HRV with age, weight, height, DEV, TR and TT, the LF components positively related to TR and TT (P < 0.01). The patients were thus divided into three groups as follows, according to TR: group A (</=1 year), group B (>1 to <5 years) and group C (>/=5 to </=10 years), or according to TT: group X (</=1 year), group Y (>1 to <5 years) and group Z (>/=5 to </=10 years). The LF components of the groups A and X were significantly lower than that of the healthy controls (P < 0.01). The HF components of the groups A and X were also significantly lower than that of the healthy controls (P < 0.05). CONCLUSIONS: The findings of the present study indicate decreased cardiac parasympathetic activity in the HAVS patients in comparison to the healthy controls. The TT and TR significantly influenced the HRV results in these patients; however, the DEV did not. The findings also indicate that treatment and cessation of exposure to vibration might have a beneficial effect on the cardiac parasympathetic activity in HAVS patients.

Aged↗

Effect of cold ambient temperature on palmar sweating response to vibration stress.

We investigated the effect of cold ambient temperature on the palmar sweating response to vibration stress. Ten healthy, male subjects were exposed to eight ambient temperatures (5, 7, 10, 14, 18, 22, 24 and 28 degrees C). At each ambient temperature, each subject gripped the handle of a vibration generator with his left hand with a grasp strength of 49 N. This hand was then exposed to a 125-Hz sinusoidal vibration with an acceleration of 50 m/s(2) (rms) for 3 min at each ambient temperature. Palmar sweating and skin temperature were measured simultaneously on the palm and the fourth finger, respectively, of the subjects' right palm. The palmar sweating response showed a significant change among eight ambient temperatures. The palmar sweating measured at an ambient temperature of 5 degrees C was found to be significantly larger than those measured at 10, 14, 18, 22, 24 and 28 degrees C. Vibration exposure caused a significant increase in the palmar sweating response. Our results suggest that a cold environment plays a significant role in the palmar sweating response to vibration stress.

Adult↗

Short-term effects of whole-body vibration on maximal voluntary isometric knee extensor force and rate of force rise.

Whole-Body vibration (WBV) may lead to muscle contractions via reflex activation of the primary muscle spindle (Ia) fibres. WBV has been reported to increase muscle power in the short term by improved muscle activation. The present study set out to investigate the acute effects of a standard WBV training session on voluntary activation during maximal isometric force production (MVC) and maximal rate of force rise (MRFR) of the knee extensors. Twelve students underwent a single standard WBV training session: 5x1 min vibration (frequency 30 Hz, amplitude 8 mm) with 2 min rest in between. During vibration, subjects stood barefoot on the vibration platform with their knees at an angle of 110 degrees. At 90 s following vibration, maximal voluntary knee extensor force was reduced to 93 (5)% [mean (SD), P<0.05] of baseline value and recovered within the next 3 h. Voluntary activation remained significantly depressed (2-4%). Neither the electrically induced MRFR nor voluntary MRFR were significantly affected by WBV. In addition, six WBV training sessions in 2 weeks ( n=10) did not enhance either voluntary muscle activation during MVC [99 (2)% of the baseline value] or voluntary MRFR [98 (9)% of the baseline value]. It is concluded that in the short term, WBV training does not improve muscle activation during maximal isometric knee extensor force production and maximal rate of force rise in healthy untrained students.

Adult↗

Characterization of vibration and acoustic noise in a gradient-coil insert.

High-speed switching of current in gradient coils within high magnetic field strength magnetic resonance imaging (MRI) scanners results in high acoustic sound pressure levels (SPL) in and around these machines. To characterize the vibration properties as well as the acoustic noise properties of the gradient coil, a finite-element (FE) model was developed using the dimensional design specifications of an available gradient-coil insert and the concentration of the copper windings in the coil. This FE model was then validated using experimentally collected vibration data. A computational acoustic noise model was then developed based on the validated FE model. The validation of the finite-element analysis results was done using experimental modal testing of the same gradient coil in a free-free state (no boundary constraints). Based on the validated FE model, boundary conditions (supports) were added to the model to simulate the operating condition when the gradient-coil insert is in place in an MRI machine. Vibration analysis results from the FE model were again validated through experimental vibration testing with the gradient-coil insert installed in the MRI scanner and excited using swept sinusoidal time waveforms. The simulation results from the computational acoustic noise model were also validated through experimental noise measurement from the gradient-coil insert in the MRI scanner using swept sinusoidal time waveform inputs. Comparisons show that the FE model predicts the vibration properties and the computational acoustic noise model predicts the noise characteristic properties extremely accurately.

Acoustics↗

Physiological characteristics of responses of wide dynamic range spinal neurones to cutaneously applied vibration in the cat.

Extracellular single-unit recordings were made from wide dynamic range neurones in the lumbar dorsal horn of anaesthetized or decerebrated cats. Vibration applied to the skin at a frequency of 80 Hz could evoke 3 distinct types of response--excitation, depression or a biphasic response consisting of excitation followed by depression. By applying vibration at different sites, a given neurone was found to show more than one type of response. Parametric studies of the depressant and biphasic responses were made because previous studies indicated that adenosine mediates the depression in these types of response. Thus, amplitude- and frequency-response relationships were determined at individual stimulation sites: amplitude was varied from 0.001 to 1.0 mm (frequency, 80 Hz) and the frequencies studied were 10, 20, 40, 80, 120 and 240 Hz (amplitude, 0.15 mm). Vibration at amplitudes greater than 0.15 mm caused a decrease in the rate of discharge during the period of stimulation, the magnitude of this decrease varying directly with amplitude; at amplitudes of 0.15 mm and less vibration had no statistically significant effect. With regard to the frequency-response relationship, a decrease in discharge rate occurred at frequencies of 120 and 240 Hz, with the more pronounced effect at 240 Hz; excitation occurred at 40 Hz and there was no statistically significant effect at other frequencies. Amplitude- and frequency-response relationships for the depressant and the biphasic responses were analyzed separately. In the case of depressant responses, the magnitude was monotonically related to the amplitude of stimulation and depression occurred only at frequencies of 80 Hz or greater, with higher frequencies being more effective. The biphasic responses appeared to consist of 2 subtypes termed biphasic-1 and biphasic-2 responses. For biphasic-1 responses, the amplitude- and frequency-response curves were similar to those of depressant responses. Biphasic-2 responses differed in that the response was biphasic when the stimulation frequency was 80 Hz or greater and the amplitude was 0.3 mm or more, yet, at lower frequencies and/or amplitudes vibration evoked excitation. The similarities in the amplitude- and frequency-response relationships of depressant and biphasic-1 responses raise the possibility that these responses might be mediated by a single class of primary afferent. Both depressant and biphasic responses were evoked when stimulation parameters (2 microns, 240 Hz) were used which selectively activate Pacinian corpuscle afferents. Depression with 240-Hz stimulation was attenuated by administration of caffeine (60 mg/kg i.v.) suggesting that the depressant and biphasic-1 responses may be mediated by afferents from Pacinian corpuscles.

Action Potentials↗

Effects of tonic vibration reflex on motor unit recruitment in human wrist extensor muscles.

Tonic vibration reflex was used to investigate the effects of muscle spindle Ia afferent activation on motor unit (MU) recruitment in human wrist extensor muscles. The MU force recruitment threshold recorded in the extensor carpi radialis muscles were quantitatively compared under two experimental situations: (1) during tonic isometric reflex contractions induced by mechanical tendon vibration and during voluntary contractions performed at the same velocity; (2) during two voluntary imposed ramp contractions (0.25 N.s-1) performed the one immediately before, and the other immediately after a tonic vibration reflex. In the first situation, it was observed that the Ia afferents activated by tendon vibration exerted a strong homonymous facilitatory action on their bearing muscles (extensor carpi radialis longus and brevis), while their heteronymous action on the synergistic muscle (extensor carpi ulnaris) was very weak. The MU recruitment thresholds in the extensor carpi radialis muscles were therefore significantly lower during the tonic reflex contraction than during the voluntary contraction. In the second situation, the tonic vibration reflex induced a facilitatory after-effect which decreased the MU recruitment thresholds during the subsequent voluntary imposed ramp contraction. It is suggested that this post-vibratory effect may have been due either to a postsynaptic potentiation of the motoneurones or to a reflex sensitization of the muscle spindles increasing their response to voluntary isometric contraction and consequently, increasing their facilitatory reflex action on the motoneurone pool.

Adult↗

The influence of vibration on the excitability of alpha motoneurones.

Transcranial magnetic brain stimuli were delivered to 6 healthy subjects at different time intervals after the beginning of muscle vibration. Vibration of 6 sec duration in 4 subjects and of 100 msec duration in 6 subjects was applied to the right abductor digiti minimi muscle using an electromagnetic mechanical stimulator. The responses to brain stimuli were enhanced in this muscle when vibration began 9 msec before the transcranial stimulus, i.e., when the descending volley and the monosynaptic afferent Ia volley arrived simultaneously at the anterior horn cell. With long lasting vibration an enhancement of responses to brain stimuli was seen, which began after 120 msec and continued for up to 5 sec after the onset of vibration. This is consistent with a tonic, probably polysynaptic, excitatory Ia influence on homonymous alpha motoneurones, as well as the well known monosynaptic effect.

Action Potentials↗

Vibration stimulus induced EEG bursts in isoflurane anaesthesia.

The EEG and heart rate reactions to vibration stimulus were studied in 14 patients during moderately deep surgical isoflurane anaesthesia, at a level when EEG showed a burst suppression pattern. Vibration applied to the palm of the hand induced bursts in EEG in 12 patients, usually with a latency of about 0.5 sec from the onset, or from the end of the 3 sec stimulus. Increases in heart rate were seen at bursts related to both vibration onset and offset, as well as at spontaneous bursts. With spontaneous bursts, an initial positive wave was frequently seen. In 6 patients the vibration induced bursts were different in shape from the spontaneous bursts; no initial positive wave was seen before the negative DC shift in Cz-Fz recording. We conclude that EEG bursts can be evoked by a non-noxious stimulus such as vibration in patients during isoflurane anaesthesia.

Adult↗

Effect of muscle tendon vibration on the perception of force.

The effect of vibrating the biceps muscle tendon on the perception of forces exerted by the elbow flexor muscles was examined during briefly maintained, submaximal contractions. Subjects were required to estimate the perceived magnitude of isometric forces exerted by the elbow flexor muscles under normal conditions and during vibration of the right biceps tendon. The matching forces produced by the unperturbed left arm provided an estimate of the perceived intensity of the reference arm contraction. Both force and the brachial biceps and triceps EMGs were recorded from each arm. In comparison with the matching forces produced under normal conditions, there was a significant overestimation of the forces exerted by the vibrated biceps muscle. This increase in the perceived intensity of the reference force was associated with an increase in the EMGs of the biceps and triceps muscles of the reference arm. It appeared that during vibration the triceps muscle was cocontracting presumably as a means of controlling the reference force. The overestimation of the forces exerted by the vibrated muscle could therefore reflect either the enhanced excitatory drive required to overcome the antagonist activity, or the concomitant increase in the force generated by the agonist muscle. Previous results suggest that the former is the more probable explanation.

Adult↗

Trunk muscle electromyography and whole body vibration.

By measuring the electromyographic (EMG) activity of the paraspinal muscles, we have estimated the average and peak-to-peak torque imposed on the spine during whole body vibration. Six subjects had surface electrodes placed on their erector spinae muscles at the L3 level. The EMG-torque relationship was estimated by having each subject perform isometric horizontal pulls in an upright seated posture. The subject was then vibrated vertically and sinusoidally in a controlled, flexed, slightly lordotic seated posture, in 1 Hz increments from 3 to 10 Hz at a 0.1 g RMS seat acceleration level. Between vibration readings taken at each frequency, a static reading was also taken with the subject maintaining the same posture. The entire vibration-static 3-10 Hz test was repeated for reliability purposes. Specialized digital signal processing techniques were developed for the EMG signals to enhance the measured cyclic muscle activity and to allow automatic measurement of the time relationship between the mechanical displacement and the estimated torque. We found significantly more average and peak-to-peak estimated torque at almost all frequencies for vibration vs static sitting.

Acceleration↗

Limitations of the standard linear solid model of intervertebral discs subject to prolonged loading and low-frequency vibration in axial compression.

The purpose of this study was to answer the following questions: (1) Can the standard linear solid model for viscoelastic material simulate the influence of disc level and degeneration on the ability of a disc to withstand prolonged loading and low-frequency vibration? (2) How well does the SLS model explain the relationship between the ability of a disc to resist prolonged loading and its ability to resist dynamic loads and dissipate energy when subjected to low-frequency vibration? Responses of human thoracic and lumbar discs were measured in axial compression under a constant load, and for cyclic deformations at three frequencies. Parameters of the SLS model for each disc were determined by a least-squares fit to the experimental creep response. The model was subsequently used to predict the disc's response to cyclic deformations. The SLS model was able to qualitatively simulate the effects of disc level and degeneration on the ability of an intervertebral disc to resist both prolonged loading and low-frequency vibration. However, the model underestimated the stress relaxation, dynamic modulus and hysteresis of thoracic and lumbar discs subjected to low-frequency vibration. The SLS model was unable to explain the relationship between the ability of a disc to resist prolonged loading and its ability to resist dynamic loads and dissipate energy when subjected to low-frequency vibration. Although in the lumbar discs the steady-state predictions of the SLS model were significantly correlated to the experimental response, the strength of model predictions decreased with increasing frequency, particularly for hysteresis.

Adult↗

Effects of temperature on cutaneous microcirculation in vibration syndrome.

In order to clarify the role of cold on the cutaneous microcirculation in vibration syndrome, groups of rabbits vibrated at 4 degrees and room temperature served as the subjects of this study. A cold provocation test, capillary microscopy, and laser-Doppler flowmetry were used to evaluate the microcirculations of the test rabbits. The results indicated that vibration-induced impairment of the microcirculation was more prominent in the 4 degrees vibration group than in the room temperature group. The severities of the microcirculatory disturbances were dose-effect correlated. Vibration induced not only functional disturbances but also structural destruction of the capillaries. Furthermore cold temperatures enhanced these abnormalities of the blood vessels.

Animals↗

Inhibitor effect of acupuncture on the vibration-induced grasp reflex in man.

The effect of acupuncture on the grasp reflex caused by mechanical vibrations of fingers produced by a cylinder-type vibrator (120 Hz) was studied in healthy man. As the hand grasped the vibrator during vibration, the volar surface of all fingers was simultaneously stimulated, resulting in a gradually increased force of the grasp, the vibration-induced grasp reflex (VGR). The VGR was inhibited by acupuncture with needles inserted into three acupuncture points (Shou Sanli, Chicheng and Szutu), but not into other sites in the hand.

Acupuncture Therapy↗

Postural responses to vibration of neck muscles in patients with unilateral vestibular lesions.

Postural responses to vibration applied unilaterally to dorsal neck muscles were recorded with a sway platform in nine patients with unilateral vestibular lesions and 19 normal subjects. In normals, the vibration induced a forward postural deviation. In patients, vibration of the neck contralateral to the lesion induced normal forward sway, whereas ipsilateral vibration resulted in sway of lower amplitude than normal and predominantly in the direction of the lesion or backwards. It is suggested that the proprioceptive error signal introduced by the neck vibration combined with an asymmetrical vestibular input due to a unilateral vestibular lesion provoked an erroneous representation of head position in patients resulting in a redirection of their body sway.

Humans↗

Peripheral vibration causes an adenosine-mediated postsynaptic inhibitory potential in dorsal horn neurons of the cat spinal cord.

We have previously reported a vibration-induced, adenosine-mediated inhibition of nociceptive dorsal horn neurons in the cat spinal cord. The present study was conducted to investigate the mechanisms of this inhibition. In vivo intracellular recording was obtained from dorsal horn neurons in the lower lumbar segments of the anaesthetized cat. Vibration (80-250 Hz for 2-3 s every 15-20 s) was applied to the glabrous skin of the toes of the hind foot using a feedback-controlled mechanical stimulator. In 32 of 43 neurons tested, vibration produced a pronounced hyperpolarization of the membrane potential. This hyperpolarization peaked at -10 mV and decayed throughout the period of the application of vibration. It was associated with a decrease in membrane resistance, had a reversal potential negative to the resting membrane potential and was Cl(-)-independent, suggesting that it was due to an increase in a K+ conductance, properties typical of the response to adenosine. This inhibitory postsynaptic potential was unaffected by intravenous administration of bicuculline, strychnine and naloxone but was blocked by iontophoretic administration of 8-sulphophenyltheophylline, a P1-purinergic receptor antagonist. These results confirm our previous finding that vibration-induced inhibition of nociceptive dorsal horn neurons is mediated via the release of an endogenous purine compound and further suggests that this inhibition involves a postsynaptic inhibitory mechanism.

Adenosine↗

Vibration exposure and conditioning lesion effect in nerves: an experimental study in rats.

The effects of controlled vibrations of defined frequency (80 Hz), acceleration (32 m/s2 root mean square), and duration (5 hours daily, 2 or 5 days) induced to the hind limb of rats on the regeneration potential in the sciatic nerve after a test crush lesion were determined. Exposure to vibration induced a marked and significant increase in outgrowth length of axons from the crush injury as evaluated after 3 and 6 days with the pinch reflex test. This effect was still observed 1 month but not 3 months after exposure to vibration. Even such a short duration of vibration exposure as 2 days induced an increased length of outgrowth. Such a conditioning effect may be due to local changes in the environment of the axons or to changes in the nerve cell bodies in the dorsal root ganglion. The results indicate that an alarm reaction exists in the nerve at a time point where no structural changes are observed in the nerve. By inducing such a conditioning lesion to nerve tissue, vibration represents a trauma corresponding to a crush lesion or transection of the nerve.

Animals↗

Interferometric measurement of the amplitude and phase of tympanic membrane vibrations in cat.

The amplitude and phase of the tympanic membrane and malleus vibrations were measured over a wide frequency range with a homodyne interferometer. When sound pressure was maintained constant near the tympanic membrane, the malleus frequency response followed the typical pattern up to 10 kHz as measured by previous investigators. At higher frequencies the response changes dramatically. Instead of decreasing with frequency, between 10 and 20 kHz the vibration amplitude oscillates around a value which is only about 20 dB lower than the low frequency plateau level. Measurements of malleus vibration at several points along its length indicate that its mode of vibration changes at high frequencies, and no longer consists of a simple rotational component. All points on the tympanic membrane vibrate in phase with the malleus up to a frequency of 1 kHz. Above 5 kHz discrete resonances are observed, and the response varies strongly with position on the tympanic membrane.

Animals↗

Influence of tyre inflation pressure on whole-body vibrations transmitted to the operator in a cut-to-length timber harvester.

The influence of tyre inflation pressure on whole-body vibrations transmitted to the operator during the movement of a cut-to-length timber harvester was evaluated. Vibration measurements were taken in three orthogonal (x, y, z) axes at tyre pressure settings of 138, 345 and 414 kPa. Vibration was predominant in the vertical (z) direction with the peak rms acceleration value for the operator seat (0.281 ms(-2)) occurring at approximately 3.2 Hz. The corresponding peak value for the operator cabin chassis was 0.425 m s(-2) at 4 Hz. At 414 kPa, there was potential health risk on the operator for exposures above 8h duration. The vibration total values recorded for the operator seat at the maximum tyre inflation pressure setting were classed as "fairly uncomfortable" (ISO standard 2631-1), and vertical seat vibration transmissibility was highest between 4 and 8 Hz at the 345 kPa tyre pressure setting. The recorded values of WBV were significantly reduced by a reduction in tyre inflation pressure which may therefore be used to moderate the magnitude of WBV on wheeled timber harvesters.

Air Pressure↗