Effect of balance exercise in combination with whole-body vibration on muscle activity of the stepping limb during a forward fall in older women: A randomized controlled pilot study

This study investigated the effects of balance exercise combined with whole-body vibration (WBV) on step performance and lower limb muscle activity during simulated forward falls using the tether-release method in older women. Twenty older women were assigned to either a WBV plus balance exercise group (WBV, n = 10) or a balance exercise without vibration group (standard balance exercise group [STE], n = 10). WBV performed weight-bearing exercises on a WBV platform combined with other balance exercises as a home program, whereas STE performed the same exercises without WBV. The exercise volume was equal in both intervention groups (3×/week for 12 weeks × 30 min/session). The EMG and kinematic data of the stepping leg from the balance recovery step were examined before and after the intervention. While both groups extended step length during forward falls after the intervention, only WBV increased step velocity. EMG analysis of the balance recovery step showed that both groups increased peak EMG of knee flexor and extensor muscles after intervention. After intervention, WBV increased peak EMG of the plantar flexors, which are used to exert the push-off forces just before the leg swing. Balance exercise in older women resulted in significant improvements in the balance recovery step after a simulated forward fall. WBV also had the additional benefit of improved step velocity, which was reflected in increased activity of the plantar flexors in the stepping leg.