Whole body vibration to attenuate reduction of explosive force in chronic kidney disease patients: a randomized controlled trial

Does whole-body vibration improve risk of falls, balance, and heart rate variability in post-COVID-19 patients? A randomized clinical trial

INTRODUCTION

Whole-Body Vibration (WBV) can be a therapeutic recovery strategy for patients hospitalized for COVID-19.

OBJECTIVES

To evaluate the effects of a 36-session WBV protocol on the risk of falls, balance, mobility and heart rate variability (HRV).

STUDY DESIGN

A randomized clinical trial.

METHODS

13 patients affected by COVID-19, trained with WBV, 3×/week on alternate days, totaling 36 sessions, were evaluated before and after the intervention.

RESULTS

WBV training at 2 mm and 4 mm amplitude resulted in a reduction in the risk of falls when compared to Sham (p = 0.023), with effect size of 0.530. No changes were observed for mobility and balance outcomes (p = 0.127) or for any of the HRV variables (p = 0.386).

CONCLUSION

WBV training reduced the risk of falls in post-COVID patients. No changes were observed regarding balance and mobility, nor for HRV.

Effects of whole-body vibration exercise on physical function in patients with chronic kidney disease: a systematic review and meta-analysis

BACKGROUND

The current state of knowledge regarding the efficacy of whole-body vibration (WBV) training for individuals with chronic kidney disease (CKD) is limited. To address this gap, the present study seeks to undertake a comprehensive systematic review and meta-analysis of clinical trials to evaluate the impact of WBV on physical function and quality of life outcomes in CKD patients.

METHODS

A systematic search was performed on the PubMed, Embase, Web of Science, and Scopus databases from inception to March 2023 and updated in June 2023. The inclusion criteria comprised randomized controlled studies, quasi-experimental studies, and single-arm trials that evaluated the impact of WBV on physical function, encompassing cardiopulmonary fitness, muscle strength, mobility, and balance, in CKD patients. Adverse events that were included in the study reports were recorded. The pooled evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method.

RESULTS

Nine studies were identified, of which seven were included in the meta-analysis. The results of the meta-analysis indicated a statistically significant improvement in upper (mean difference: 3.45 kg; 95% confidence interval 1.61 to 5.29) and lower (standardized mean difference: 0.34, 95% confidence interval 0.08 to 0.59) extremity muscle strength in patients with CKD who underwent WBV training compared to baseline (low-level evidence). Furthermore, WBV training favored improved cardiorespiratory fitness, mobility, and balance function, but no statistical difference was observed. The impact of WBV training on quality of life in patients with CKD requires further validation. Notably, only one adverse event (nausea) was reported in the included studies.

CONCLUSIONS

WBV has demonstrated efficacy and feasibility in enhancing muscle strength among patients with CKD. However, further investigation is warranted to determine its potential for improving cardiorespiratory adaptations, mobility, balance function, and quality of life. Additionally, future research should prioritize comprehensive reporting of WBV protocols to establish an optimal training regimen for the CKD population.

Effects of whole-body vibration exercise in patients with chronic kidney disease: a systematic review

PURPOSE

Chronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial. This systematic review was conducted to assess effects of whole-body vibration exercise (WBVE) in individuals with CKD.

MATERIALS AND METHODS

It was conducted electronic searches in Pubmed, Embase, Scopus, Web of Science databases on May 2021. Records were identified and irrelevant studies were excluded based in eligibility criteria.

RESULTS

Five studies were included with a mean methodological quality score of 9, considered high quality in PEDRo scale. The studies have shown that the WBVE intervention, when applied low intensity was well tolerated, and no adverse effects; was able to improve the motor performance and strength in frail people, which could benefit the prevention of falls events. However, did not improve the quality of life, and the heart rate variability; and not altered cardiorespiratory parameters.

CONCLUSIONS

WBVE intervention promotes a better response in parameters of the motor performance and muscular strength, and interaction bone-muscle. Nevertheless, more studies are needed with this intervention to improve physiological responses, and to understand your recommendation to prevent and reduce the complications and symptoms of the CKD, promoting an active life to these patients.

PROTOCOL STUDY REGISTRATION

PROSPERO (CRD42020203295).IMPLICATIONS FOR REHABILITATIONChronic kidney disease (CKD) is a clinical condition that promotes a decline in the overall health status of individuals affected, including parameters physical, functional, and psychosocial.WBVE program possibility, of good acceptance, efficient as well tolerated by physically deconditioned patients who present difficulty to perform any type of exercise.WBVE protocol can promote changes in the patient with CKD lifestyle and benefits for this population because is an exercise without fatigue, impact, stress, or discomfort.

A Randomized Controlled Trial of Whole-Body Vibration on Gait Ability and Balance among Older Hemodialysis Patients

BACKGROUND

Gait abnormality is a serious problem among hemodialysis patients. Whole-body vibration is a simple exercise that induces sustained muscular contractions through mechanical vibrations. This training improved gait ability in older adults. We aimed to investigate the effect of whole-body vibration on balance and gait ability in older hemodialysis patients.

METHODS

We conducted a 12-week, open-label, multicenter, randomized controlled trial of 98 hemodialysis patients, who were aged ≥65 years, from three dialysis centers in Japan. Those who had difficulty walking alone or dementia were excluded. Patients were randomly allocated to the whole-body vibration group or control group. The training was performed for 3 minutes thrice a week on dialysis days. The primary outcome was the Timed Up and Go test. The secondary outcomes were the single-leg stand test and 30-second chair stand test.

RESULTS

The mean (SD) age of the participants was 76 (7) years. The mean (SD) Timed Up and Go test was 12.0 (6.6) and 11.8 (7.0) seconds in the whole-body vibration and control groups, respectively. During the 12-week study period, 6 (12%) of 49 patients in the whole-body vibration group and 3 (6%) of 49 patients in the control group dropped out. In the whole-body vibration group, 42 (86% of the randomly allocated patients) completed the training according to the protocol. The mean (SD) changes in the Timed Up and Go test were -1.1 (4.0) and -1.4 (4.4) seconds in the whole-body vibration and control groups, respectively (change, 0.3 seconds in the whole-body vibration group; 95% confidence interval, -1.4 to 2.0; P=0.71). The changes in the single-leg stand test and 30-second chair stand test did not differ significantly between groups. There were no musculoskeletal adverse events directly related to this training.

CONCLUSIONS

Whole-body vibration did not improve balance and gait ability.

CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER

Effect of Whole Body Vibration on Walking Performance in Elderly Hemodialysis Patients NCT04774731.

Muscle power and physical dysfunction: A model for tailoring rehabilitation in chronic kidney disease

INTRODUCTION

Chronic kidney disease (CKD) is characterized by adverse physical function. Mechanical muscle power describes the product of muscular force and velocity of contraction. In CKD, the role of mechanical muscle power is poorly understood and often overlooked as a target in rehabilitation. The aims of this study were to investigate the association of mechanical power with the ability to complete activities of daily living and physical performance.

METHOD

Mechanical muscle power was estimated using the sit-to-stand-5 test. Legs lean mass was derived using bioelectrical impedance analysis. Physical performance was assessed using gait speed and 'timed-up-and-go' (TUAG) tests. Self-reported activities of daily living (ADLs) were assessed via the Duke Activity Status Index. Balance and postural stability (postural sway and velocity) was assessed using a FysioMeter. Sex-specific tertiles were used to determine low levels of power.

RESULTS

One hundred and two non-dialysis CKD participants were included (age: 62.0 (±14.1) years, n = 49 males (48%), eGFR: 38.0 (±21.5) ml/min/1.73m² ). The mean relative power was 3.1 (±1.5) W/kg in females and 3.3 (±1.3) W/kg in males. Low relative power was found in 34% of patients. Relative power was an independent predictor of ADLs (β = .413, p = .004), and TUAG (β = -.719, p < .001) and gait speed (β = .404, p = .003) performance. Skeletal muscle mass was not associated with any outcomes.

CONCLUSION

Knowledge of the factors that mediate physical function impairment is crucial for developing effective interventions. Incorporation of power-based training focusing primarily on movement velocity may present the best strategy for improving physical function in CKD, above those that focus on increasing muscle mass.

Effects of Individualized Ischemic Preconditioning on Protection Against Eccentric Exercise-Induced Muscle Damage: A Randomized Controlled Trial

BACKGROUND

The effects of ischemic preconditioning (IPC) versus a deceptive sham protocol on indirect markers of exercise-induced muscle damage (EIMD) after the application of individualized occlusion pressure were examined. The goal of using a sham protocol is to control for the potential effect of placebo.

HYPOTHESIS

IPC would surpass the sham protocol in protecting against EIMD.

STUDY DESIGN

A randomized, double-blinded, clinical trial.

LEVEL OF EVIDENCE

Level 1.

METHODS

Thirty healthy young men were randomly assigned to an eccentric exercise for the knee extensor muscles preceded by IPC (4 × 5 minutes of individualized total occlusion pressure) or sham protocol (4 × 5 minutes using 20 mm Hg). Maximal voluntary isometric torque (MVIT), rate of torque development, muscle soreness, pressure pain threshold, knee range of motion, thigh girth, and creatine kinase (CK) activity were assessed before IPC or sham protocol and up to 72 hours after the eccentric EIMD. Affective valence and perceived exertion were also evaluated.

RESULTS

MVIT decreased 17.1% in the IPC and 18.1% in the sham groups, with no differences between groups. Differences from baseline were observed in the sham group for muscle soreness at 48 hours (P < 0.001) and 72 hours (P = 0.02), and for CK activity at 72 hours (P = 0.04). Muscle soreness was reduced in the IPC group at 48 hours compared with the sham group (∆ = 15.8 mm; P = 0.008) but without achieving the minimal clinically important difference. IPC induced a smaller perceived exertion than the sham protocol (∆ = 1.1 a.u.; P = 0.02). The remaining outcomes were not statistically different in both groups.

CONCLUSION

IPC does not surpass the sham protocol to protect against mild EIMD of the knee extensors muscles.

CLINICAL RELEVANCE

Although IPC is a noninvasive, low-cost, and easy-to-administer intervention, the IPC effects can, in part, be explained by the placebo effect. In addition, individualized IPC promotes attenuation in perceived exertion during eccentric exercise.

Does whole body vibration exercise improve oxidative stress markers in women with fibromyalgia?

The objective of this study was to investigate the effect of whole body vibration (WBV) exercise on oxidative stress markers in a group of women with fibromyalgia (FM) compared to a group of healthy women (CT). Twenty-one women diagnosed with FM and 21 age- and weight-matched healthy women were enrolled the study. Plasma oxidative stress markers (primary outcomes) were evaluated at rest and after WBV, and included thiobarbituric acid reactive substances (TBARS), iron reduction capacity (FRAP), superoxide dismutase antioxidant enzymes activity (SOD), and catalase (CAT). At rest, the FM group had higher TBARS (P<0.001) and FRAP (P<0.001), and lower CAT (P=0.005) compared to the CT. In the CT group, the WBV had no effect on TBARS (P=0.559) and FRAP (P=0.926), whereas it increased both SOD (P<0.001) and CAT (P<0.001). In the FM group, the WBV reduced TBARS (p <0.001), FRAP (P<0.001), and CAT (P=0.005), while it increased SOD (P=0.019). There was an interaction effect (moments vs groups) in the TBARS (effect size=1.34), FRAP (effect size=0.93), CAT (effect size=1.45), and SOD (effect size=1.44) (P<0.001). A single trial of WBV exercise improved all oxidant and antioxidant parameters towards a greater adaptation to the stress response in FM women.