A. For the musculoskeletal system: 1. Vibration activation of the muscle spindle (muscle spindle receptor) directly affects complex muscle-tendon and surrounding muscle tissue. 2. Continuous stimulation of the muscles, so that almost all the movement units in the muscle are activated at the same time. The vibrational excitation impulse of the motor nerves to the skeletal muscles is rapid and continuous, and the skeletal muscles are completely tonic and contracted, which can improve the body muscles and enhance muscle endurance. 3. High-frequency low-amplitude vibration treatment can produce non-physiological mechanical stress, stimulate bone formation and reconstruction, and increase bone mineral density (BMD).

B. Circulatory system: The increase in fluid transport in the body is due to the activation of alternating muscle contraction and relaxation enhancement caused by stretch reflex and vibrational reflex. The result is better metabolic performance, increased oxygen and oxygen transport, and enhanced venous return. Improves lymphatic flow, and the nutrient transmission of the deepest cells is activated, removing toxins and improving the immune system. 2 During and after the vibration training, the perfusion of the surrounding tissue of the body increases, the average blood flow velocity increases, the resistance index of blood flow velocity decreases significantly, and the blood circulation of the body is promoted; and at the same vibration frequency, the higher the amplitude, the higher the average blood flow velocity The sooner.

C: Feel the motor system: While the active muscle and the synergistic muscle contract quickly and forcefully, the excitement of the sputum can make the antagonist muscle relax in time and fully, thus improving the efficiency of muscle contraction. Experiments have shown that while the vibration strength training increases the flexor strength, the extensor strength is also enhanced accordingly.

D: Endocrine system: The body can produce a large amount of growth hormone (GH), insulin-like growth factor, etc. in a short time (8-12 minutes) vibration and through different vibration training prescriptions such as: control of exercise frequency, amplitude and rest ratio can be   Achieve increased hormonal secretion while achieving endocrine dynamic stability of cortisol and “stress hormone” responses.

E: Impact on pain:

1. When pain is transmitted, it is almost always accompanied by musculoskeletal dysfunction. Once the pain begins, the feeling is transmitted to the spinal cord and brain with two types of nerve fibers. (One set of transmission pathways stimulates large and rapid mechanoreceptors (muscle spindles); the other group stimulates smaller, slower pain receptors.)

2. One way to make pain less sensitive or to reduce pain is to stimulate mechanoreceptors. Studies have shown that stimulation of larger diameter mechanoreceptors (eg, muscle spindles and Golgi organs) can reduce the rate of effective signaling of pain receptors. 3. Muscle vibration can reduce chronic myogenic pain and increase pain threshold.

3. Vibration training may provide an unconscious "close" switch for the muscles and ischemic areas of the tendon to relieve pain.

4. Other effects: Stimulation of the lymphatic system clears the pain neurotransmitters, anabolic hormones and neurotransmitters.

•  

• The advantages of sonic vibration training in rehabilitation training:

• Increase pain threshold and suppress pain feedback: mechanoreceptor feedback is used to suppress pain feedback (pain threshold theory); activates dormant muscle spindle (sports) receptors; vibration training promotes "neural-muscle re-education" (Neuro-Muscular Re-education) ), re-education must be active training (negative recovery is beneficial for relieving pain, but not conducive to restoring nerve function).

•  
• Whole body vibration training for the torso of stroke patients:
• 1. Whole body vibration activates muscle spindle and  Iα afferent fibers, which are mediated by vibrating muscles to increase cerebral cortex excitability [14], we hypothesize that this process may modulate the function of the bridge reticular spinal cord in patients with anterior flexor torso and contribute to brain function Reconstruction and further promote the recovery of limb function in patients.
• 2. Whole body vibration repeatedly stimulates the afferent fibers of the erector spinae muscle spindle, especially the excitability of the primary muscle spindle fiber, which leads to the accelerated frequency and intensity of γ motor neurons, and the excitation of γ motor neurons can further cause vertical ridges. Muscle spindle muscle contraction and maintain the afferent induction of erector spinae muscle spindle, feedback increases the intensity of stretch reflex and motor neuron output, thereby increasing erector spinae muscle strength [15], while vibration stimulation reduces cross-inhibition and Inhibition on the spinal cord reduces the activity of the antagonistic muscles, thereby reducing the abdominal muscle tension and achieving the ability to coordinate and balance the abdominal muscles and the erector spinae [14].
• 3. Whole body vibration stimulation can induce presynaptic inhibition to reduce abdominal muscle tension by activating the abdominal muscles  Iα inhibits neurons [16], while reducing the release of motor neurotransmitters, resulting in a decrease in monosynaptic reflex [14], resulting in inhibition of abdominal muscle excitation and reduced muscle tone.

Whole Body Vibration Training is an emerging rehabilitation technology for the treatment of degenerative diseases of the muscle-skeletal system in the elderly, improving osteoporosis, enhancing skeletal muscle strength, improving balance and gait function, and metabolism in the elderly. A unique advantage in the rehabilitation of syndromes, osteoarthritis and sarcopenia. This article reviews the efficacy and safety of its application to the muscle-skeletal-joint system rehabilitation of the elderly population.

1. Osteoporosis (osteoporosis) For elderly women with osteoporosis, high-frequency low-frequency whole body vibration training as a biomechanical intervention can significantly increase the lumbar spine bone density, delay the proximal femur bone loss [10], reduce the incidence of falls and fractures, It is an effective method for prevention and treatment of primary osteoporosis and its complications, especially for elderly patients with overweight and obesity [11-12]. For patients with senile osteoarthrosis, the lumbar spine, femoral neck bone density and femoral neck anti-fracture ability are increased after whole body vibration training [13]. The mechanism of whole body vibration training for osteoporosis is that the stress generated by mechanical vibration directly or indirectly acts on the bone tissue through the compressive force and shear force generated by muscle conduction, and the local effective mechanical stress is sufficient to cause deformation of the bone tissue. At this time, the osteoprogenitor-osteoblast activity can be stimulated, and the osteolysis process can be inhibited, thereby promoting the increase of bone density [17]. On the other hand, during the vibration process, the frequent contraction of skeletal muscle increases the blood supply to the muscles, increases the blood flow of the cortical bone, maintains the internal environment of the bone tissue, and accelerates the supply of calcium ions and other nutrients. And absorption, promote bone formation [18]. Studies have also shown that moderate-intensity mechanical vibration stimulation increases serum levels of testosterone, growth factors and other proliferative hormones, promotes proliferation and differentiation of bone marrow stromal stem cells into osteoblasts, increases collagen and bone matrix synthesis, and thereby increases bone density. [19].

2. Senile muscle strength decline and skeletal muscle reduction : The process of human aging is accompanied by a gradual decline in the structure and function of the neuromuscular system, called sarcopenia, referred to as sarcopenia [20], which is a decrease in muscle mass, volume, and muscle strength. The main characteristics of the middle-aged and elderly population are high-risk [21]. in  70   Prevalence among the elderly under the age of  13%~ 24%,80  The prevalence of older people over the age of more than  50%. The clinical consequences of sarcopenia are to make the elderly more debilitated, with abnormal gait and decreased balance function; the decline of lower limb muscle strength is directly related to the decline of the elderly's exercise [22-23], so that the elderly walk, sit, etc. Difficulties in completing daily activities, increasing the risk of falling, maiming, and loss of self-care ability [24-25].

3 . Balance and motor dysfunction: Balance refers to the state of motion, movement, and external forces.

The ability to automatically adjust and maintain posture stability. Balance and motor function (mo-bility) are the basic preconditions for maintaining daily activities. The dysfunction will not only seriously affect the quality of life of the elderly, but also increase common diseases such as hypertension, diabetes, osteoporosis and falls. The risk of accidents creates a heavy burden on the elderly, their families and even society as a whole [31]. Comprehensive rehabilitation includes muscle strength training, balance training, gait training, massage, joint passive exercise, and activities of daily living (ADL) training. All of the above methods can effectively delay balance and motor function decline. However, for the elderly, it is difficult to grasp due to exercise load and strength, and there is also a certain risk of injury, and the conventional training method takes a long time, and the rehabilitation effect needs to be improved [32]. Therefore, seeking a safer and more effective training method is of great significance to the elderly, especially the elderly who already have certain motor dysfunction. The whole body vibration training can meet this demand to a certain extent.

4. Obesity and metabolic syndrome: Metabolic syndrome is a clinical syndrome with some high-risk environmental factors as the starting factor, abdominal obesity as the main pathogenesis, insulin resistance as an important pathogenic link, and cardiovascular damage as a serious consequence. It is common in the elderly. Disease and frequently-occurring disease are also important risk factors for cardiovascular and cerebrovascular diseases and one of the main causes of disability and death in the elderly. It has become a worldwide public health problem.

The safety and advantages of whole body vibration training in the elderly population:

The biggest feature of whole body vibration training is that it can achieve effective exercise with less load, without causing excessive cardiopulmonary burden, and has less impact on vital organs such as cardiovascular and nervous system. Moreover, while strengthening muscle strength, it also has a positive impact on multi-system functions such as balance, muscle strength, bone density, motor function and blood hormone levels. Whole body vibration training also enhances neuromuscular coordination while improving the function of the flexor and extensor muscles, avoiding muscle strain caused by uneven development of flexor-extensor muscle strength. Whole body vibration training also has the advantages of simple operation and short training time, so it is more suitable for elderly people with impaired motor function, prolonged bed rest, braking or disability [49]. It is confirmed that whole body vibration training provides a simple and effective new method for treating musculoskeletal diseases and enhancing rehabilitation in the elderly.