Deleterious effects of whole-body vibration on the spine:A review of in vivo,ex vivo,and in vitro models

Occupational exposure to whole-body vibration is associated with the develop-ment of musculoskeletal,neurological,and other ailments.Low back pain and other spine disorders are prevalent among those exposed to whole-body vibration in occupational and military settings.Although standards for limiting exposure to whole-body vibration have been in place for decades,there is a lack of understanding of whole-body vibration-associated risks among safety and healthcare profession-als.Consequently,disorders associated with whole-body vibration exposure remain prevalent in the workforce and military.The relationship between whole-body vibra-tion and low back pain in humans has been established largely through cohort stud-ies,for which vibration inputs that lead to symptoms are rarely,if ever,quantified.This gap in knowledge highlights the need for the development of relevant in vivo,ex vivo,and in vitro models to study such pathologies.The parameters of vibrational stimuli(eg,frequency and direction)play critical roles in such pathologies,but the specific cause-and-effect relationships between whole-body vibration and spinal pa-thologies remain mostly unknown.This paper provides a summary of whole-body vibration parameters;reviews in vivo,ex vivo,and in vitro models for spinal patholo-gies resulting from whole-body vibration;and offers suggestions to address the gaps in translating injury biomechanics data to inform clinical practice.