Occupational Exposure to Whole Body Vibration Among U.S. Military Veterans: Acute and Chronic Contributions to Musculoskeletal Disorders and Spine-Area Pain

Part of paid clinical trials in Milwaukee, Wisconsin.

Sponsor
Milwaukee VA Medical Center
Study ID
NCT07367139
Status
Not Yet Recruiting

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Conditions

  • Spine Degeneration
  • Spine Health
  • Spine Injuries and Disorders
  • Whole Body Vibration

Eligibility Criteria

Sex
ALL
Age
20 Years - 45 Years
Healthy Volunteers
Accepted

Interventions

  • Water — OTHER
    Aim 3 will evaluate the effect of hydration and dehydration on acute whole body vibration response of the lumbar spine endplate and intervertebral disc.

Study Details

Significance to VA: There is a lack of prospective longitudinal studies investigating the relationship between risk factors to Veterans and development and progression of musculoskeletal (MSK) spine injury and pain. Military operational exposure to whole body vibration (WBV) is known to contribute to MSK disorders and pain. Our preliminary studies identified accelerated lumbar and cervical spine degenerative changes in military fighter pilots and helicopter aircrew compared to age- and sex-matched civilian controls. Those changes were likely associated with WBV that military aircrew experience during flight training, primarily affected intervertebral discs (IVDs) and endplates, were associated with neck and back pain symptoms and reduced functional capacity, and are likely to lead to lifelong spine-related issues. Therefore, these aircrew, and other military personnel that experience occupational WBV, are likely to enter the VA Healthcare system with pre-existing degenerative changes and spine-related pain symptoms that can progress over time. Similarly, many Veterans enter civilian occupations that involve WBV such as truck drivers and heavy equipment operators that may also have detrimental effects to the spine and lead to spine-related pain. Development of informed interventions and treatment protocols requires a mechanistic understanding of how the spine is acutely and chronically affected by occupational WBV from both structural and physiological perspectives. Innovation and Impact: Novel multi-parametric application of noninvasive magnetic resonance imaging (MRI) techniques such as arterial spin labeling (ASL), T2\* decay from ultra short TE, and diffusion MRI can provide early objective indications of endplate degenerative state and IVD hydration and perfusion, and novel application of upright MR imaging allows for gravitational loading of the IVD while observing segmental and region IVD fluid distribution and transport patterns. Specific Aims: The goal of the proposed effort is to characterize the effects of previous military and current civilian occupational WBV on IVD and endplate health and degeneration (Aim 1), and segmental and regional IVD fluid distribution and transport differences (Aim 2). The endplates contain vasculature that permits IVD fluid exchange and may be linked to IVD fluid dynamics. We propose looking for connections between segmental and regional IVD fluid dynamics, degenerative state of the associated endplates, and WBV exposure (acute-controlled and longitudinal-occupational). Finally, we propose evaluating the impact of body hydration state on IVD fluid distribution and transport following acute (30 min) controlled WBV (Aim 3). Cumulatively, these results inform population-specific preventative measures to preserve endplate health for Veterans in occupations that present with WBV and identify potential areas for further research and targeted treatment of MSK disorders and MSK pain. Methodology: This study will explore acute and chronic changes to the structure and physiology of the spine by enrolling Veterans with prior military or current civilian occupation that involves daily WBV. Advanced MRI sequences will identify endplate sclerosis and physiological changes including disc hydration and perfusion. Acute effects of WBV will be assessed using pre/post MRI scans with experimental WBV. Path to translation/Implementation: Our existing relationships with VA clinicians, including spine surgeons, physical medicine and rehabilitation, and pain medicine, will ensure VA patient applicability of these findings and will help to translate any outcomes from this research and future studies directly into patient care.

Key Dates

Start date
Jul 1, 2026
Status verified
Jan 2026
Primary completion
Jun 30, 2030
Completion
Jun 30, 2030

Study Design

Enrollment
112 participants (estimated)
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION

Arms

  • No Intervention: Longitudinal effects of current or prior whole body vibration.
    Determine the impact of acute and longitudinal WBV on lumbar spine endplate health. The objective is to perform a repeated measures study using multi-parametric MRI to assess Veteran endplate health. Veterans will participate in pain assessments and MRI scans annually for three years to track the progression of whole body vibration-related changes in the lumbar spine endplates and intervertebral discs. Current and prior whole body vibration characteristics will be correlated to pain scores and MRI changes.
  • No Intervention: Determine how lumbar disc fluid flow is acutely affected by whole body vibrati
    The objective is to perform a repeated measures study to quantify changes in lumbar spine T2 relaxation times and volumetric MRI data following acute experimental vibrational exposure to determine fluid transport patterns and morphological changes. Veterans will participate in pain questionnaires, and receive Upright MRI scans prior to and immediately following 30 minutes of low magnitude whole body vibration. This unique protocol will allow us to assess acute changes in MR metrics and structural dimensions of the lumbar spine following exposure to WBV by comparing measurements obtained immediately following experimental WBV to pre-WBV measurements.
  • Experimental: Effect of hydration on lumbar spine response to whole body vibration
    This arm will determine whether individual hydration state influences IVD water dynamics following acute vibrational exposure. The objective is to assess the impact of hydration on IVD fluid distribution and transport in response to acute vibration utilizing multi-parametric MRI analysis. This will allow for evaluation of hydration as a potential factor for rehabilitation, treatment, and prevention of early degeneration related to WBV. MRI scans will be obtained under two conditions: hydrated and dehydrated. For the hydrated MRI scans, research subjects will be asked to consume a minimum of 2.7 liters of fluid per day for three days leading up the MRI date. For the dehydrated MRI scans, research subjects will be asked to consume about 1.3 liters of fluid per day for three days leading up to the MRI date. WBV induced changes to IVD water dynamics will be compared within subjects for the hydration, dehydration and control conditions.

Primary Outcome Measure

Occupational Whole Body Vibration History [ Time Frame: Whole body vibration questionnaires will be provided at the time of enrollment and immediately prior to each MRI scan. ]

Central Contacts

Locations (1)

FacilityCityStateZIPSite coordinators
Zablocki Veterans Affairs Medical CenterMilwaukeeWisconsin53295-

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Zablocki Veterans Affairs Medical Center· Milwaukee, WI

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