If you’ve been exploring ways to improve your bone health or reverse osteoporosis, you might have come across vibration plates as a potential option. But are they safe, especially if you have undergone hip replacement surgery or have other pre-existing medical conditions? Margaret Martin, physical therapist and renowned osteoporosis expert in the United States, provides her expert insights in collaboration with the manufacturer of the Marodyne Low Intensity Vibration (LiV) plate to address common concerns and questions on the potential risks associated with various conditions.
Disclaimer: The information in this post does not constitute medical advice. It is for informational purposes only. If you have a medical condition and want to use vibration therapy, you should consult with your physician or another licensed healthcare professional before using this or any other modality.
Does Low Intensity Vibration affect Cancer?
A question I frequently get is how low intensity vibration therapy affects cancer. Specifically, some readers want to know if the LiV can benefit people with cancer, and others want to know if the LiV can cause a recurrence of cancer.
Let’s address the question of cancer recurrence first and then follow with a discussion of the potential benefits of LiV for people with cancer.
LiV and Cancer Recurrence
Nobody really understands why cancer may occur in the first place, much less why it might reappear. However, Marodyne points to two low intensity vibration studies where the research team had to address questions regarding cancer recurrence.
LiV and Leukemia
In one study1, the research team explored the potential of LiV to build up bone in children recovering from leukemia (i.e., while the disease was in remission). The study was performed at St. Judes Hospital in Memphis.
Before conducting the study, the research team had to demonstrate to the hospital IRB (internal review board) that the LiV was safe to use with the population. To address this concern, the research team launched two preclinical animal studies.
In the first preclinical trial, a mouse model highly susceptible to ovarian cancer was used to determine if LiV would promote the cancer. In addition, the research team wanted to see if the LiV would compromise longevity.
This one-year study showed that LiV use did not stimulate the onset of the disease. Indeed, the longevity curve suggested that those subjected to the LIV were healthier.
The LIV group showed pronounced and statistically significant preservation of bone quality and quantity. They had better trabecular connectivity, bone mass, and morphology. They also demonstrated less porosity in the cortices.
The physician IRB (internal review board) used this information to determine that it was safe to subject children in remission to the LiV signal.
That one year clinical study showed that kids in the LiV group improved bone endpoints faster than the sham control group, with no evidence whatsoever of provoking the disease.
LiV and Myeloma
The second preclinical study was designed to show that mice with myeloma (i.e., not susceptible to it but with the cancer) would not accelerate the disease if subjected to LiV. The study showed that the LiV slowed the tumor progression. The LiV treatment also suppressed the maturity of the tumors in the marrow. Bone outcomes showed that bone quality and quantity were both preserved and protected by LiV.
These data were sufficient for the St. Judes IRB to allow the clinical study to commence. The study is ongoing. A DSMB (data safety monitoring board) regularly reviews the study. They are looking for any signs of cancer that are being fostered by LiV. There has not yet been an adverse event.
LiV Benefits for People with Cancer
Recently, research teams started two separate studies on patients with cancer. The first is a pilot study on women with breast cancer (at the University of Indiana), and the second is on chemotherapy-induced cancer-induced peripheral neuropathy (at the Oregon Health & Science University). Both studies had to go through a robust review by their respective IRBs (internal review boards), and both used the St. Judes preclinical and clinical data as evidence that it was safe to move forward.
The breast cancer study at the University of Indiana has just begun. It is encouraging to see that a preclinical study there shows that with the use of aromatase inhibitors (a standard approach to treatment of breast cancer, but which ravages bone), the quality of bone is somewhat protected by Zoledronate (a bisphosphonate) and by LiV. However, together they are a powerful combination therapy for the protection of bone quality and quantity.2
Based on this research, Marodyne believes that LiV is safe for helping preserve bone quantity and quality in patients who are fighting cancer. It is a surrogate for osteoporosis exercise, and there are no studies that show that exercise might promote the progression of cancer. In fact, the great majority of physicians would agree that exercise is a critical factor in the prevention of the disease.
Can You Use a Vibration Plate After Hip Replacement or Other Joint Replacement?
A reader asked if he could use the low intensity vibration plate after hip replacement surgery.
I have treated many clients who have had a hip replacement and am very familiar with the procedure and its implications. The last thing you want is to have your implant come loose after completing your rehabilitation and recovery. I asked BTT to look into this issue and to broaden the scope to include other joint replacement procedures, including knee replacements. Their response follows.
Vibration Plate for Bone Healing: Hip Implant Study
The Marodyne team pointed to a study where the members of the study group had implants in the hip. The study lasted eighteen months, and there were no adverse events reported.
A research team at the Chinese University of Hong Kong recruited a group of patients with unilateral trochanteric fractures to see if they could use a low intensity vibration plate for bone healing.3 The candidates were aged 65 years or older, and all were fixed with a dynamic hip screw or Gamma nail.
Over a six month period, the vibration group followed a protocol of twenty minutes a day and seven days a week of low intensity vibration, in addition to the standard post-fracture rehabilitation. The control group received standard rehabilitation programs only.
The post-treatment assessments showed that the vibration group had significant improvement in quality of life and early enhancement in range of motion of the hip joint at the second month when compared with the control group.
By the sixth month, the vibration group showed a trend with a higher hip bone mineral density (BMD) increase in the wards triangle region and less bone loss in the femur neck as compared with the control group.
The functional assessment also indicated no adverse events with the vibration group, meaning that the daily use of the vibration therapy did not affect the orthopedic hardware in any way.
Because the vibration is dissipated as it traverses your body, the signal is low when it reaches the joint with the implant, whether that is the knee, hip, or other area. As a result, Marodyne suggests that the LiV is safe to use if you have had joint replacement surgery.
You should consult with your orthopedic surgeon regarding the use of the LiV or any other modality.
Bony Ingrowth With Implants Study
In 1994 Dr. Clinton Rubin and Dr. Kenneth McLeod4 examined the effect of vibration on bony ingrowth into implants. This is referred to as osseointegration.
The study showed that transcortical sintered bead implants (in a turkey ulna) that remained in disuse experienced fibrous tissue growth from the bone surface into the implant. This is an early harbinger of failure. However, if the ulnae were briefly loaded with low frequency (walking, 1 Hz) signals, there was some initiation of bone formation.
In other words, low intensity vibration signals stimulated marked ingrowth into the implants.
While low intensity vibration may not cause your implant to be better integrated with your bones, it should not cause any harm.
Can You Use a Vibration Plate with Scoliosis?
I have had a number of readers and clients contact me and ask if it is safe to use the Marodyne low intensity vibration plate if they have scoliosis. Several people wonder if their scoliosis of the spine will block or reduce the effectiveness of the vibration signal to their osteoporotic spine. Here is an example of one email I received.
Do any of your osteoporotic post-menopausal women have scoliosis and use the Marodyne LiV? If so, does the LiV appear to be beneficial for these women? I’m wondering if the scoliosis curve blocks the benefit in the same way that having bent knees while using the plate interferes with the transmission of the vibration signal.
Scoliosis of the Spine and Vibration Therapy
There are very few studies looking at vibration therapy and scoliosis. One study5 assessed home-based vibration therapy and showed an improvement in hip and lumbar spine bone mineral density (BMD).
Every scoliosis curve is as unique as the individual with the curve. You will only know if the vibration transmits up your spine by standing on a platform, placing your hand at the top of your head, and feeling for the transmission. You can also check by placing your hands over your jaw joints (TMJ) and feeling for the vibration.
If you do proceed with a unit, I suggest you start with a dose of a minute. Progress by a minute or two a day until you are able to do the entire recommended 10 minute workout comfortably. I would be very interested in knowing how it goes for you.
Can You Use a Vibration Plate If You Have Had Eye Lens Replacement Surgery?
A reader asked if the low intensity vibration plate is safe to use after eye lens replacement surgery for cataracts.
The Marodyne states that the LiV is safe after cataract surgery. They provide several reasons supporting their claim.
Transmission of Vibration
First, the “transmissibility” (the percent of the vibration delivered) to different regions of your body dissipates as it traverses your body. The Marodyne LiV generates 0.4g (the intensity of the LIV plate) at a clock rate of 30Hz (the cycles/sec that it runs). This delivers approximately 80% of the original signal to the hip, and 75% is efficiently transmitted to the spine (i.e., approximately 0.3g).
By the time it reaches your cranium (head), less than 0.1g can be measured through a bite bar instrumented with an accelerometer. These signals are far less than the vibration in your cranium during driving, and less than reaches your head during walking. Consequently, the signal is low (but can be felt).
Serious Adverse Event and Low Intensity Vibration
Second, in all the clinical trials that have been run, all of which have been reviewed and approved for safety by an university or hospital IRB (internal review board), and in follow up reports to the DSMB (data safety monitoring board), there has never been a SAE (serious adverse event) that was reported, and no reports regarding the eye or irritation to it.
The results, however, are very different when someone uses a high magnitude whole body vibration plate. There have been reports of detached retinas in the peer-reviewed medical literature from people standing on a high magnitude (7g and above, or twenty times higher than the Marodyne LiV).
Marodyne considers its LiV safe for people who have had cataract surgery.
Does a Low Intensity Vibration Plate Affect Heart Health?
A reader asks if there is data on how the device might affect the heart. She states that since using Marodyne, she has experienced minor heart flutters. She points out that she experienced these flutters a few times in the past 5 years, before using the Marodyne LiV. The heart flutters may be coincidental, but she wonders if the LiV plate may be disturbing the electrical impulses in her heart. The reader is under the care of a cardiologist and being tested for causes.
The reader is doing the right thing by bringing the issue to the attention of her cardiologist. The cardiologist is in a much better position to determine the reason she is experiencing heart flutters.
A Data Safety Monitoring Board, a hospital safety oversight board, has supervised all the clinical trials. There has never been any reported serious adverse event (SAE) related to heart health, respiratory health, or any other dimension of health. These include trials with all age groups, from children to the frail elderly.
Considerations
However, if the flutters persist, Marodyne suggests that the reader rethink the use of the LiV, at least for a temporary period, to see if there are any changes in the heart flutters. The flutters may be coincidental or correlational, rather than causal.
At the same time, Marodyne considers the signal from the LiV to be safe. They explain that the vibration intensity at the floor is 0.4g, and by the time it reaches the thoracic cavity (where the heart resides), it is half of that. They point out that this is the amount of signal in the spine, and not the signal through the fluid and air-filled cavities of the torso (which would attenuate it even more). The heart is located in the torso cavity and is, therefore, subject to a very low vibration signal.
These low intensity signals are much smaller than the accelerations and decelerations you endure during mild activities such as walking (where the heel strike is a 1.2g signal). Therefore, you should not be concerned with the use of the LiV but you should take the necessary precautions and speak to your cardiologist.
LiV, Heart Rhythm and Heart Implants
Marodyne also receives questions regarding the safe use of LiV when there are concerns with heart rhythm (Atrial fibrillation or AFib), as well as implants (including pacemakers, loop recorders, and cardioverter defibrillator).
If you have these reservations, the company recommends that you do the following before buying and using a LiV device.
- Ask your specialist, cardiologist, or electrophysiologist, to discuss LiV and heart health.
- Marodyne can provide documents as requested. The operation manual has the EMF emissions data for the device.
- Marodyne recommends that the patient contact the implant manufacturer for their comments on use of a LiV device.
Can You Use a Vibration Plate If You Have Stress or Micro Fractures in the Tibia?
A reader recently developed stress fractures in both tibias (near the knees) when she was hiking. She asked if she should wait until her bones heal before using the Marodyne low intensity vibration plate. She also wondered what would be the effect of using the Marodyne LiV on existing micro fractures.
Stress fractures are often considered a product of repeated damage to the bone material, to the point of fracture. It is similar to repeatedly bending a coat hanger back and forth. Eventually, the wire will snap.
However, the reader is encouraged to consider stress fractures from a very different perspective, specifically the real life application of the effects of physical training during Army boot camps. As many as 1.5% of male army recruits, and 6% of female army recruits abandon boot camp because of stress fractures. These stress fractures often appear within ten days of starting bootcamp.
The more interesting statistic is that more than 95% of army recruits, doing the exact same mechanical challenge to the skeleton, do not suffer stress fractures.
Why is that?
Bone Remodeling and Stress Fractures
Mild stress fractures can be considered part of a bone remodeling phenomenon6. When you increase your activity level through hiking, running, or other activities, this stimulates focal bone turnover. The area of rarefaction (thinning of bony tissue) displayed on an x-ray is caused by local bone resorption, as well as an active replacement of bone by bone formation. When your physician examines your x-ray, she will likely conclude that the bone in that area has lucency (or is less dense).
In some cases, stress fractures can be dangerous. Extreme athletes who suffer from stress fractures can have a high stress concentration at the remodeling site, which can lead to an unwanted fracture.
In the more typical case, however, a stress fracture is less threatening. You may have started jogging, hiking more aggressively, or playing tennis and that has elevated bone turnover, creating periosteal (bone surface) point pain. Your physician sees the bone lucency in the x-ray and concludes that you have a microfracture. However, the area of lucency is likely a focal area of bone turnover and not a microfracture.
A conservative strategy is recommended. Rest, take a break from the intense activity that caused the stress fracture, and let the bone turnover finish its bone replacement.
Further, there is strong evidence that low intensity vibration plates can accelerate and augment bone turnover. The LiV performs the task without causing microdamage because the loads are too small to cause damage. The low intensity vibration recruits cells to the area more quickly and activates them more robustly.
Can You Use a Vibration Plate When You Have Compression Fractures?
Individuals with, or at risk of, compression fractures need to take extra precautions when they move or exercise. I encourage you to consult with your physician or surgeon before you start or resume an exercise program. It is important that the fracture be healed.
Is a low intensity vibration plate safe to use when you have a compression fracture? Again, you should consult with your physician and get their clearance.
However, the vibration signal from the LiV plate is a fraction of the gravitational force created by walking. Why? Because the vibration signal at the plate becomes weaker as it travels up the spine.
The LiV has been shown to accelerate and augment bone repair and remodeling7. As a result, the LiV might benefit those with compression fractures.
One of the biggest challenges I hear from individuals with compression fractures when using the device is the amount of contiguous time spent standing. Marodyne recommends a dosage of 10 minutes per treatment session. However, you should begin with what you can tolerate and build up your treatment time.
To make it easier, I recommend that you take the weight of your arms off your back. You can do this by using lengthened walking or Activator Poles. Alternatively, you can place a tall chair on each side of the Marodyne with the backs turned towards the platform. Resting your hands will help you maintain your posture, as well as provide support and stability throughout your session.
Will Low Intensity Vibration Help You Avoid Osteoporosis Medications?
Many of my clients want to avoid taking osteoporosis medications because of the potential side effects. This is an understandable concern. A number of clients and readers have asked me if they can avoid taking osteoporosis medications by using a low intensity vibration plate coupled with an exercise and nutrition program for bone health.
Unfortunately, I cannot provide a general answer to this question, as every person’s medical profile is different. What works for one person will probably not work for the next.
Still, it is worth looking into a specific client situation and seeing if we can draw some useful lessons. Here is an inquiry from Elizabeth (not her real name).
LiV and Osteoporosis Medications
I am a 75 year old female with a recent T score of -4.1 on the DEXA. I am about to start Evenity but am concerned about the long-term effects of these medications to prevent a rebound. Low intensity vibration therapy seems like a good adjunct to my overall bone density improvement program. Do you think I can avoid the pharmacological options and just do low intensity vibration therapy, exercise, diet, and supplements?
With a T-score of -4.1, Elizabeth is at very serious risk of fracture. She should follow her physician’s advice and be very proactive to protect the bone that she has, and ideally build it back through diet and exercise.
Elizabeth should also consider her physician’s recommended pharmaceutical intervention. These are FDA-approved treatments for osteoporosis, and should always, particularly in a fragile situation, be considered first.
However, Elizabeth’s hesitancy to take a drug is understandable. The premise of low intensity vibration plate therapy is to provide a surrogate for exercise and, in Elizabeth’s case, serve as an adjunct to all the other things she is doing.
The LiV can be used with bone medications following discussion with her health care provider. Marodyne suggests that Elizabeth follows both modalities. Elizabeth could incorporate daily doses of low intensity vibration plate therapy and use Evenity. Neither the drug nor LiV is magic, but together they may truly help keep her skeleton strong.
Does the Marodyne LiV Cause Hearing Problems Such as Tinnitus?
A reader submitted the following email. Individuals are naturally concerned if vibration plates are bad for their brain, hearing, or any other part of the cranium. (The email has been edited for brevity reasons.)
I am an active 69-year-old with osteoporosis. In February 2021, I purchased a LifePro Turbo Vibration Plate (a high intensity vibration plate) because I could not go to the gym during Covid, and thought it might make home workouts more interesting and useful. There is mild neuropathy in my feet, and I thought the plate might help.
However, after using the plate at the lower levels for a few weeks, I developed tinnitus. I have been evaluated by an ENT specialist (ear, nose, and throat doctor) and an audiologist. They confirmed I have lost hearing at the very highest level of sound and have tinnitus.
I am now leery of using the LifePro plate. I have always easily experienced dizziness. Feeling dizzy easily is a sign there is a weakness in my auditory system.
The tinnitus is very distressing. I definitely do not want to make it any worse.
Low Intensity Vibration Plates and Hearing Loss
I asked Marodyne to comment on this issue and explain if the Marodyne LiV could cause tinnitus. Their response:
Concern for damage to the eye and ears is real and motivated the International Standards Organization to publish ISO-2631 (Evaluation of human exposure to whole-body vibration). Chronic high intensity vibration can cause blurred vision, disrupt hearing (tinnitus), cause back pain, and interfere with blood flow (white finger disease).
In fact, the levels of vibration delivered at the lowest setting for some devices (e.g., PowerPlate, LifePro) can be as high as 8g, which would be considered dangerous—particularly for non-healthy adults—for even a few seconds per day.
However, the vibration intensities that Marodyne LIV delivers (0.4g, peak to peak, at 30Hz), are considered safe by ISO-2631 for exposures of four hours per day. The 0.4g is delivered to the plantar (bottom) surface of the foot. About 80% of that reaches the hip, 75% reaches the spine, and a negligible amount (<0.1g) reaches the cranium, well below the vibration caused by the impact of walking.
Is a Low Intensity Vibration Plate Bad for Your Pelvic Floor?
A number of women have reached out to me and asked if the Marodyne LiV plate is safe to use if they have pelvic floor issues, specifically pelvic prolapse. They are also curious if the device will benefit their pelvic floor.
The impact on the LiV on the pelvic floor has not been studied by Marodyne. Recognizing this, I wanted to share my experience using the LiV platform.
Let’s start with the safety question first.
Pelvic Prolapse and Low Intensity Vibration
Pelvic floor rehabilitation was not generally available when I had my children. Several years ago I was diagnosed with a Stage 3 prolapse. Today, I cannot jump without leaking so I use a pessary to manage pelvic floor pressure.
As Marodyne points out, the signal from the Marodyne plate attenuates as it traverses your body. The signal is weaker by the time it reaches your pelvic region.
But unlike a spontaneous strong laugh or cough, the vibration from the Marodyne never causes me to leak.
In the meantime, I encourage you to consult with a pelvic floor Physiotherapist/Physical Therapist, or a Gynecologist to ensure that you keep your pelvic floor in good condition.
Benefits of Low Intensity Vibration for Pelvic Health
The benefit of low intensity vibration is you do not impact on the pelvic floor the way you would by jumping or doing heavy lifts. I find that many people do not coordinate their breath and pelvic floor activation to protect their prolapse when doing vigorous exercises.
If your prolapse is noticeable to you or you have been told that it is a grade four, you should ask your gynecologist or pelvic floor Physical Therapist to fit you for a pessary.
Low intensity vibration is more gentle on your pelvic floor than walking.
Conclusion
This article should address many of your questions regarding the safety of Marodyne low intensity vibration plate. It covered a wide range of concerns, including whether you can use a low intensity vibration plate after hip replacement, and if vibration plates are bad for your brain, your kidneys, your knees and many more parts of your body.
Marodyne LiV is available exclusively from Rehacare. To purchase the device, or for any questions please contact Marodyne LiV Australia on 1300 653 522.
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[2] Guise, TA et al. Low-Magnitude Mechanical Signals Combined with Zoledronic Acid Reduce Musculoskeletal Weakness and Adiposity in Estrogen-Deprived Mice. March 2023.
[3] Leung, KS, et al., Low-Magnitude, High-Frequency Vibration Enhances Fracture Healing and Rehabilitation in Elderly with Intertrochanteric Fractures, The Chinese University of Hong Kong, 2008.
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[5] Langensiepen S, et al., Home-based vibration assisted exercise as a new treatment option for scoliosis – A randomised controlled trial. Journal of Musculoskeletal and Neuronal Interactions. 2017 Dec 1;17(4):259-267.
[6] Jones BH, et al. Exercise-induced stress fractures and stress reactions of bone: epidemiology, etiology, and classification Exercise Sport Science Rev. 1989:17:379-422.
[7] Goodship, A et al, Low-magnitude high-frequency mechanical signals accelerate and augment endochondral bone repair: preliminary evidence of efficacy. Journal of Orthopaedic Research. 2009 Jul;27(7):922-30. doi: 10.1002/jor.20824.