Whole body vibration therapy: a novel potential treatment for type 2 diabetes mellitus

The effects of local calf vibration on balance, blood flow, and nerve conductivity in patients with diabetic peripheral neuropathy: a pilot study

OBJECTIVES

This study aimed to evaluate the effects of local calf vibration on balance, blood flow, and nerve conductivity in patients with diabetic peripheral neuropathy (DPN).

METHODS

An open-label controlled trial was designed. Patients with confirmed diagnoses of type 2 diabetes and DPN were enrolled in the study and underwent ten sessions of local calf vibration therapy for the dominant leg. The other leg was considered the control. Balance evaluation, nerve conduction studies, and color Doppler ultrasound were performed before and after the treatment course. The Wilcoxon signed rank test and the Mann-Whitney test were used to evaluate the differences between the test results before and after the intervention and between the intervention and control legs.

RESULTS

Seventeen patients with a mean age of 60.3 ± 5.6 years (11 males) participated in the study. Mean Brief BESTest total scores were significantly improved (14.06 vs. 17.35; P = .01, Cohen's d = 0.743). There were no significant differences between the treated and control legs regarding the nerve conduction and color Doppler ultrasound parameters before and after the intervention (P ≥ .054). Changes in the parameters were also not significantly different between legs (P ≥ .078), except for common peroneal nerve conduction velocity, for which there was a higher increase in its value in the treated legs compared to the control legs (4.17 vs. 0.9, P = .002).

CONCLUSION

Local calf vibration may positively affect balance and lower extremities nerve conduction in patients with DPN, and the findings of this study can be a basis for studies evaluating the efficacy of local calf vibration for treating DPN.

Assessing the anti-inflammatory effects of whole-body vibration: a meta-analysis based on pre-clinical and clinical evidences

BACKGROUND

Whole-body vibration (WBV) is a commonly used physical exercise for disease prevention and rehabilitation. Recent studies indicated the beneficial mechanism of WBV may be associated with its anti-inflammatory potential, however, its regulatory roles on different inflammatory mediators remained controversial. The aim of this study was to perform a meta-analysis to re-confirm the effects of WBV exercise on various inflammatory factors.

METHODS

The PubMed, EMBASE and Cochrane Library databases were searched up to September 2023 to collect all articles comparing WBV with control (or post-pre trials). The effect size was expressed as the standardized mean difference (SMD) and 95% confidence intervals (CI).

RESULTS

A total of 31 eligible studies were included, including 14 pre-clinical and 17 clinical studies. The meta-analysis of pre-clinical studies showed that compared with the control group, WBV exercise could significantly reduce the level of IL-6 (SMD: -1.03, 95% CI: -1.93, -0.13), TNF-α (SMD: -1.36, 95% CI: -2.54, -0.17) (for disease subgroup), IL-1β (SMD: -2.20, 95% CI: -3.24, -1.15), IFN-γ (SMD: -1.91, 95% CI: -2.71, -1.12), IL-4 (SMD: -0.71, 95% CI: -1.39, -0.03) and IL-17 (SMD: -1.32, 95% CI: -2.05, -0.59) overall. Pooling of clinical studies revealed WBV exercise significantly reduced the level of TNF-α (WBV vs control: SMD: -1.11, 95% CI: -2.16, -0.06; post vs pre: SMD: -1.29, 95% CI: -1.91, -0.67), CRP (SMD: -3.59, 95% CI: -6.36, -0.82, P = 0.011) and enhanced the level of IL-10 (WBV vs control: SMD: 2.90, 95% CI: 1.10, 4.71; post vs pre: SMD: 1.75, 95% CI: 0.64, 2.87) and IL-6 (SMD: 0.91, 95% CI: 0.31, 1.52) (healthy subgroup).

CONCLUSION

WBV may be an effective prevention and rehabilitation tool for inflammatory diseases.

Prevention of bone deterioration by whole-body vibration in a rat model of pre-type 2 diabetes

OBJECTIVES

To examine effects of whole-body vibration (WBV) on bone properties in pre-type 2 diabetes mellitus (T2DM) rats.

METHODS

Six-week-old male Hos:ZFDM-Lepr fa, fa/fa (DM) and Hos:ZFDM-Leprfa,fa/+ (CON; untreated non-DM) rats were used in the experiments. Half of DM rats were subjected to WBV (45 Hz, 0.5 g, 15 min/day, 5 days/week) for 8 weeks (WBV group), and the other half was not (DM group).

RESULTS

Bone mass, trabecular bone microstructure (TBMS), and cortical bone geometry (CBG) parameters were worse in the DM and WBV groups compared with the CON group. Maximum load was significantly decreased in the DM group compared with the CON group, and the break point was significantly higher in the WBV group compared with the DM group. Serum levels of bone specific alkaline phosphatase were significantly lower in the WBV group compared with the CON group. Glycemic control was not worse in the WBV group compared with the DM group, but not the same levels as the CON group.

CONCLUSIONS

These findings suggest that WBV can potentially delay the decrease in maximum load, although it does not prevent the deterioration of bone mass, TBMS, and CBG parameters.

Brain Injury and Neurodegeneration: Molecular, Functional, and Translational Approach

Recently, we have achieved substantial progress in our understanding of brain injury and neurodegeneration [...].

Whole body vibration training improves depression-like behaviors in a rat chronic restraint stress model

Major depressive disorder (MDD) is a prevalent psychiatric disorder that brings great harm and burden to both patients and society. This study aimed to examine the effects of whole-body vibration (WBV) training on a chronic restraint stress (CRS) induced depression rat model and provide an initial understanding of related molecular mechanisms. Adult Sprague-Dawley male rats were randomly divided into the following three groups: a) control group, b) depressive disorder group, and c) depression with WBV training treatment group. Daily food intake, body weight, sucrose preference test, open field test, elevated plus maze, forced swimming test, and Barnes maze task tests were performed. Immunofluorescence staining and ELISA analysis were used to assess neuronal damage, synaptic proteins, glial cells, and trophic factors. The data of behavioral tests and related biochemical indicators were statistically analyzed and compared between groups. Rats undergoing CRS showed increased anxiety-like behavior and memory impairment, along with synaptic atrophy and neuronal degeneration. WBV could reverse behavioral dysfunction, inhibit the degeneration of neurons, alleviate the damage of neurons and the pathological changes of glial cells, enhance trophic factor expression, and ameliorate the downregulation of dendritic and synaptic proteins after CRS. The effect of WBV in rats may be mediated via the reduction of hippocampal neuronal degeneration and by improving expression of synaptic proteins. WBV training exerts multifactorial benefits on MDD that supports its use as a promising new therapeutic option for improving depression-like behaviors in the depressive and/or potentially depressive.

The Impact of Exercise on Bone Health in Type 2 Diabetes Mellitus-a Systematic Review

PURPOSE OF REVIEW

Type 2 diabetes mellitus (T2DM) is associated with an increased fracture risk. Weight loss in T2DM management may result in lowering of bone mass. In this systematic literature review, we aimed to investigate how exercise affects bone health in people with T2DM. Furthermore, we examined the types of exercise with the potential to prevent and treat bone fragility in people with T2DM.

RECENT FINDINGS

Exercise differs in type, mechanical load, and intensity, as does the osteogenic response to exercise. Aerobic exercise improves metabolic health in people with T2DM. However, the weight-bearing component of exercise is essential to bone health. Weight loss interventions in T2DM induce a loss of bone mass that may be attenuated if accompanied by resistance or weight-bearing exercise. Combination of weight-bearing aerobic and resistance exercise seems to be preventive against excessive bone loss in people with T2DM. However, evidence is sparse and clinical trials investigating the effects of exercise on bone health in people with T2DM are warranted.

Whole Body Vibration Triggers a Change in the Mutual Shaping State of Intestinal Microbiota and Body's Immunity

Whole body vibration (WBV) is a non-invasive physical therapy that has recently been included in the hospital's patient rehabilitation training catalog, but its health effects have not been sufficiently studied. In the present study, to examine the possible effects of WBV on immune cell differentiation, the IFN, IL-4,−17, F4/80 and CD3,−4,−8,−11b,−11c,−19 markers were used to characterizing the cells in mouse spleen. The results showed that the CD4 and CD25 positive lymphocytes in the spleen were significantly increased in the WBV group, and the population of Treg cells was enhanced significantly in response to WBV. Since the differentiation in immune cells is usually associated with microbiota, therefore the intestinal flora was characterized in mice and human individuals. The results indicated that WBV significantly reduced the α-diversity of mouse intestinal microbiota. Moreover, the principal coordinate analysis (PCoA) results indicated that the β-diversities of both mice and human fecal microbiota increased after WBV. Analysis of the bacterial composition indicated that the contents of a variety of bacteria changed in mice upon the stimulation of vibration, such as Lactobacillus animalis in mice, and Lactobacillus paraplantarum and Lactobacillus sanfranciscensis in human. The succeeding correlation analysis revealed that some bacteria with significant content variations were correlated to the regulatory T cell differentiation in mice and physical characteristics in human. Our research will provide the basis for future non-invasive treatment of microbial and immune related diseases.

Biomechanical Factors in Psoriatic Disease: Defective Repair Exertion as a Potential Cause. Hypothesis Presentation and Literature Review

Joining main clinical manifestations of psoriatic skin disorder are inflammatory arthritis and nail lesions. Repetitive microdamage has been postulated as a main triggering factor in lesions of psoriatic arthritis. This concept of psoriatic disease might also be admissible for triggering nail lesions because the nail is a frequently traumatized structure. Here, we aimed to describe the conjectural injury mechanisms of nail complex with regard to acting biomechanical factors. Tissue repair response to physical microdamage may be altered in psoriatic disease. It is plausible to consider that a defective repair process in the dysregulated prepsoriatic tissue may lead to innate immune activation and further development of autoinflammatory lesions, although excessive inflammation is known to impair wound healing. Recently published data have revealed the importance of mechanosensitive Wingless-type (Wnt) signaling in the pathophysiology of psoriasis and ankylosing spondylitis. The Wnt signaling system is involved in morphogenesis, repair, and regeneration as a biologic process main regulator. Wnt5a seems to be a dominating mediator in both psoriatic plaques and during the spondylitis process that might also be a linking molecule of psoriatic response to mechanical stress. Future studies should focus on complex responsive interactions of tissue repair regulators regarded in psoriatic disease.

Whole Body Vibration-Induced Omental Macrophage Polarization and Fecal Microbiome Modification in a Murine Model

Human nutrient metabolism, developed millions of years ago, is anachronistic. Adaptive features that offered survival advantages are now great liabilities. The current dietary pattern, coupled with massively reduced physical activities, causes an epidemic of obesity and chronic metabolic diseases, such as type 2 diabetes mellitus. Chronic inflammation is a major contributing factor to the initiation and progression of most metabolic and cardiovascular diseases. Among all components of an innate immune system, due to their dual roles as phagocytic as well as antigen-presenting cells, macrophages play an important role in the regulation of inflammatory responses, affecting the body’s microenvironment and homeostasis. Earlier studies have established the beneficial, anti-inflammatory effects of whole body vibration (WBV) as a partial exercise mimetic, including reversing the effects of glucose intolerance and hepatic steatosis. Here for the first time, we describe potential mechanisms by which WBV may improve metabolic status and ameliorate the adverse consequences through macrophage polarization and altering the fecal microbiome.

Effects of Whole-Body Vibration in Older Adult Patients With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

OBJECTIVES

The aim of this systematic review and meta-analysis was to determine the effects of whole-body vibration training on metabolic abnormalities, mobility, balance and aerobic capacity in older adult patients with type 2 diabetes mellitus.

METHODS

We searched PubMed, Cochrane Library, PEDro, LILACS and SciELO (from the earliest date available to March 2018) for controlled trials that evaluated the effects of whole-body vibration on the health-related outcomes of patients with type 2 diabetes. Two reviewers independently selected the studies and performed statistical analyses of the studies. Weighted mean differences, standard mean differences and 95% confidence intervals (CIs) were calculated.

RESULTS

In total, 7 studies, involving 279 patients who had type 2 diabetes, that compared whole-body vibration with other exercises and/or controls were included. Individual studies suggested that whole-body vibration was associated with improvements in pain levels, blood flow in the legs, glycated hemoglobin levels and fasting blood glucose levels. Whole-body vibration improved mobility weighted mean differences (-.24 seg; 95% CI -2.0, -0.5; n=96); balance standard mean differences (2.34; 95% CI 1.16, 3.5; n=57); and aerobic capacity standard mean differences (0.7; 95% CI 0.2, 1.3; n=59).

CONCLUSIONS

Whole-body vibration could be a useful strategy in the management of the symptoms and disabilities associated with type 2 diabetes; however, it is necessary to perform further studies to reinforce the reported findings.

Acute Whole Body Vibration Decreases the Glucose Levels in Elderly Diabetic Women

Type II diabetes (TIIDM) is characterized by high levels of blood glucose followed by excessive insulin release so that the target cells become less sensitive, developing insulin resistance and maintaining hyperglycemic levels. Physical activity is the strongest element to prevent and to manage the TIIDM, and the majority of patients do not remain in regularly active levels, because the premature fatigue in these patients decreases the adherence to the training. Contrastingly, the whole body vibration (WBV) training may improve the glucose metabolism in diabetic patients, reducing the peripheral blood sugar, decreasing the physical discomfort and perceived exertion. Therefore, the purpose of the study was to determine the effect of an acute WBV session as therapy to promote fasting decreases in insulin levels in peripheral blood in TIIDM when compared to healthy elderly. For this, fifteen healthy elderly women and fourteen diabetic elderly women, all sedentary, were allocated in diabetic or control groups, and we made an acute whole body session composed of 10 bouts lasting 2 minutes each one, separated by a 30-second rest period. The WBV was executed in a triaxial platform MY3 Power Plate® at 35 hertz and has been chosen a peak-to-peak displacement of 4 millimeters. After the protocol, both groups decreased the glycemic levels and increased lactate production in relation to the basal levels and when compared diabetic and control, where the most important results have been shown in diabetic women. This study revealed that WBV training in TIIDM has had significant beneficial effects on the control of glucose levels, still in an acute session. So that, the complete training probably will show better results about glycemic control and this finding could be especially important when prescribing exercise for elderly who are unable or unwilling to use traditional loads or who show poor exercise compliance.