Whole-body vibration improves functional capacity and quality of life in patients with severe chronic obstructive pulmonary disease (COPD): a pilot study

Effects of whole-body vibration exercise on functional capacity, muscle strength, and quality of life in individuals with severe chronic obstructive pulmonary disease: a systematic review and meta-analysis

BACKGROUND

Whole body vibration (WBV) exercise is a therapy used for individuals with low tolerance to conventional exercises, such as patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the impact of WBV exercise on the functional capacity, muscle strength, and health-related quality of life (HRQoL) in severe COPD patients.

METHODS

Studies published until March 2024 were reviewed, encompassing randomized clinical trials (RCTs) without temporal or linguistic constraints, comparing WBV exercise with other interventions. The PubMed/MEDLINE, Scopus, Cochrane Airways Trials Register, and CINAHL databases were queried. The Revised Cochrane risk-of-bias tool for randomized trials 2.0A was employed for quality assessment.

RESULTS

Among 351 screened studies, 7 met the criteria, totaling 356 participants (WBV group, n = 182; control group, n = 174). Meta-analysis revealed a significant mean difference of 41.36 m [95%CI (13.28-69.44); p = .004] in the 6-minute walk test distance favoring the WBV group for functional capacity. Lower limb muscle strength improved in 57.14% of included studies. HRQoL meta-analysis demonstrated a 1.13-point difference [95%CI -1.24-3.51; p = .35] favoring WBV, although group differences were not significant. A mean difference of 2.31 points favored the control group in health condition [95%CI (-1.32-5.94); p = .021].

CONCLUSION

WBV exercise is recognized as a promising therapeutic modality for severe COPD patients, notably enhancing functional capacity. Although heterogeneous study protocols weaken the evidence for clinically relevant outcomes, improvements in lower limb muscle strength and HRQoL were also observed, differences between groups were not significant.

Vibroacoustic therapy in the treatment of patients with COVID-19 complicated by respiratory failure: a pilot randomized controlled trial

Introduction

Coronavirus infection is a dangerous airborne disease that can lead to serious lung damage. Data on the effectiveness of low-frequency chest vibrations in the treatment of lung diseases are available; however, not so many of them exist. Vibroacoustic pulmonary therapy is a component of physiotherapy that improves lung perfusion and drainage without requiring active patient participation. This study aimed to increase statistical efficiency through maximizing the relevant information obtained from the clinical data. Calculating the sample size to determine the power of subsequent studies was also necessary.

Research methods

A pilot randomized parallel trial involving 60 patients was conducted. The patients were divided into two equal groups, where they received sessions of vibroacoustic pulmonary therapy using the "VibroLung" device in two modes "acute respiratory distress syndrome (ARDS)" and "Pneumonia," with identical treatment. The patients were > 18 years old with detected COVID-19 by PCR and grade 2 and 3 lung lesions detected by computer tomography (CT). Blood sampling was performed in the morning at the same time before and after the hardware massage to determine PaO2, PaCO2, and P/F.

Results

As a result of the test, the following data were obtained: on the first day in the group using the "ARDS" mode, PaO2 indicators averaged 65, CI 95% [58.6-73.2] and on average 77.5, CI 95% [69.8-85.2], "before" and "after," respectively, which indicates improved oxygenation after the procedure. However, in the second group with the "Pneumonia" mode after its use, PaCO2 was higher after the session, on average 48.7, CI 95% [40.8-56.6], whereas before that, the following indicators had, on average 43.6, CI 95% [37.2-50].

Conclusion

Thus, the data obtained yielded ambiguous results, which are the basis for further study in future randomized controlled trials. As the treatment of coronavirus infection has no etiological treatment, even small shifts in the therapy of this category of patients can be significant.

Clinical trial registration

ClinicalTrials.gov, identifier NCT05143372.

Mapping the global research landscape and hotspot of exercise therapy and chronic obstructive pulmonary disease: A bibliometric study based on the web of science database from 2011 to 2020

Background: The application of exercise therapy (ET) in chronic obstructive pulmonary disease (COPD) is generating increasing clinical efficacy and social-economic value. In this study, research trends, evolutionary processes and hot topics in this field are detailed, as well as predictions of future development directions.

Methods: Search for literature in the field of COPD and ET and analyze data to generate knowledge graphs using VOSiewer and CiteSpace software. The time frame for the search was from 2011 to January 2021. Then we extracted full-text key information (such as title, journal category, publication date, author, country and institution, abstract, and keyword) and obtained the co-citation analysis. Use hierarchal clustering analysis software developed by VOSviewer to map common citations, and use Citespace software to plot trend networks.

Results: The United States topped the list with 27.91% of the number of articles posted, followed by the UK at 25.44%. Imperial College London was the highest number of article publications in institutions, followed by Maastricht University and the University of Toronto. The Royal Brompton Harefield NHS Foundation Trust was one of many research institutions and currently holds the highest average citations per item (ACI) value, followed by Imperial College London and the University of Leuven. Judging from the number of publications related to ET and COPD, it is mainly published in cell biology, respiratory pulmonary diseases, and rehabilitation experiments study medicine. The European Respiration Journal is the most widely published in this field, followed by the International Journal of Chronic Obstructive Pulmonary Disease and Respiratory Medicine.

Conclusion: COPD combined with ET is widely used in clinical practice and is on the rise. A distinctive feature of the field is multidisciplinary integration. Rehabilitation research for COPD involves multidisciplinary collaboration, tissue engineering, and molecular biology mechanism studies to help patients remodel healthy breathing. Multidisciplinary rehabilitation measures provide a solid foundation for advancing clinical efficacy in the field of COPD.

The role of exercise in rehabilitation of discharged COVID-19 patients

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly caused pneumonia and pulmonary fibrosis through upper respiratory tract infection, which resulted in acute respiratory distress syndrome (ARDS) and multiorgan damage of cardiovascular, nervous, digestive, and genitourinary systems. Although the virus test turned negative after the patient recovered, the damage to multiorgan caused by SARS-CoV-2 may irreversible. Therefore, the health status of the recovered patients has gradually become the focus of people's attention. Whether coronavirus disease 2019 (COVID-19) patients can receive exercise rehabilitation training after discharge? and what's the basis? We try to analyze and answer these questions, will provide some ideas about the patients to develop a reasonable and effective exercise rehabilitation program.

C. R. Twelve Weeks of Whole Body Vibration Training Improve Regucalcin, Body Composition and Physical Fitness in Postmenopausal Women: A Pilot Study

(1) Background: Regucalcin or senescence marker protein 30 (SMP30) is a Ca2+ binding protein discovered in 1978 with multiple functions reported in the literature. However, the impact of exercise training on SMP30 in humans has not been analyzed. Aging is associated with many detrimental physiological changes that affect body composition, functional capacity, and balance. The present study aims to investigate the effects of whole body vibration (WBV) in postmenopausal women. (2) Methods: A total of 13 women (aged 54.3 ± 3.4 years) participated in the study. SMP30, body composition (fat mass, lean mass, and bone mass) and physical fitness (balance, time up and go (TUG) and 6-min walk test (6MWT)) were measured before and after the 12 weeks of WBV training. (3) Results: The WBV training program elicited a significant increase in SPM30 measured in plasma (27.7%, p = 0.004) and also in 6MWT (12.5%, p < 0.001). The WBV training also significantly reduced SPM30 measured in platelets (38.7%, p = 0.014), TUG (23.1%, p < 0.001) and total body fat mass (4.4%, p = 0.02). (4) Conclusions: There were no significant differences in balance, lean mass or bone mass. The present study suggests that 12 weeks of WBV has the potential to improve SPM30, fat mass, TUG and 6MWT in postmenopausal women.

Potential Application of Whole Body Vibration Exercise For Improving The Clinical Conditions of COVID-19 Infected Individuals: A Narrative Review From the World Association of Vibration Exercise Experts (WAVex) Panel

COVID-19 is a highly infectious respiratory disease which leads to several clinical conditions related to the dysfunction of the respiratory system along with other physical and psychological complaints. Severely affected patients are referred to intensive care units (ICUs), limiting their possibilities for physical exercise. Whole body vibration (WBV) exercise is a non-invasive, physical therapy, that has been suggested as part of the procedures involved with pulmonary rehabilitation, even in ICU settings. Therefore, in the current review, the World Association of Vibration Exercise Experts (WAVEX) reviewed the potential of WBV exercise as a useful and safe intervention for the management of infected individuals with COVID-19 by mitigating the inactivity-related declines in physical condition and reducing the time in ICU. Recommendations regarding the reduction of fatigue and the risk of dyspnea, the improvement of the inflammatory and redox status favoring cellular homeostasis and the overall improvement in the quality of life are provided. Finally, practical applications for the use of this paradigm leading to a better prognosis in bed bound and ICU-bound subjects is proposed.

Psychosocial Interventions for Patients with Severe COPD-An Up-to-Date Literature Review

Background and Objectives: Chronic obstructive pulmonary disease (COPD) is a life limiting condition with a long list of serious psychosocial consequences, aggravating with illness progression. In advanced stages, chronic respiratory failure often develops, which might undermine mental health and reduce activity. The study objective was to review the recent studies concerning psychosocial interventions dedicated to patients with severe COPD. Materials and Methods: The PubMed database was searched for terms, such as ‘COPD and long-term oxygen therapy, non-invasive ventilation, severe or respiratory failure’ and ‘psychological or psychosocial or mental health and intervention.’ Studies were included that described patients with stable, severe COPD and the outcomes of psychosocial interventions. Results and Conclusions: Thirty-four studies were identified and divided into four thematic groups: home medical support, exercise, self-management and mental health. The number of studies that focused on mental health preservation in severe COPD was very limited; i.e., none refer directly to those treated with respiratory failure. Improving patients’ self-efficacy gave promising effects to the acceptance of palliative care, pulmonary rehabilitation completion and mental health. Physical activity might be recommended to be included in interventions for mental health enhancement, although little is known about the role of the particular forms of exercise. An increasing beneficial use of new technologies for psychosocial interventions was noted. Psychosocial interventions applied in advanced COPD underline the roles of self-efficacy, telehealth and physical activity in physical and mental health preservation. However, all of the above elements need to be independently tested on more homogenous groups of patients and have the possible modes of their treatment analysed.

Whole-body vibration improves the functional parameters of individuals with metabolic syndrome: an exploratory study

BACKGROUND

Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that increases the cardiovascular risk. Regular physical exercise can promote benefits, but the MetS individuals are demotivated to perform it. Thus, new possibilities are important as an alternative intervention. The whole-body vibration can be considered an exercise modality and would be a safe and low-cost strategy to improve functional parameters of individuals in different clinical conditions. The aim of this exploratory study was to assess effects of whole-body vibration on functional parameters of MetS individuals. The hypothesis of this work was that the whole-body vibration could improve the functionality of MetS individuals.

METHODS

Twenty-two individuals performed the intervention. The vibration frequency varied from 5 to 14 Hz and the peak-to-peak displacements, from 2.5 to 7.5 mm. Each session consisted of one minute-bout of working time followed by a one minute-bout of passive rest in each peak-to-peak displacement for three-times. The whole-body vibration protocol was applied twice per week for 5 weeks. Data from the trunk flexion, gait speed, sit-to-stand test and handgrip strength were collected. Physiological parameters (blood pressure and heart rate) were also evaluated. The Wilcoxon Rank test and Student t-test were used.

RESULTS

No significant changes (p > 0.05) were observed in physiological parameters (arterial blood pressure and heart rate). Significant improvements were found in trunk flexion (p = 0.01), gait speed (p = 0.02), sit-to-stand test (p = 0.005) and handgrip strength (p = 0.04) after the whole-body vibration.

CONCLUSIONS

In conclusion, whole-body vibration may induce biological responses that improve functional parameters in participants with MetS without interfering in physiological parameters, comparing before and after a 5-week whole-body vibration protocol.

TRIAL REGISTRATION

Register in the Registro Brasileiro de Ensaios Clínicos (ReBEC) with the number RBR 2bghmh (June 6th, 2016) and UTN: U1111-1181-1177. (virgula).

Cardiorespiratory responses in different types of squats and frequencies of whole body vibration in patients with chronic obstructive pulmonary disease

This study aims to investigate the cardiorespiratory responses to different vibration frequencies to characterize the intensity of exercise, as well as to compare the effect of two types of squatting exercises (static and dynamic) on the whole body vibration (WBV) exercise in individuals with chronic obstructive pulmonary disease (COPD). Twenty-six subjects were divided and paired into healthy and COPD groups that performed static squatting associated with WBV (frequencies: 30, 35, and 40 Hz; amplitude: 2 mm) and dynamic squatting associated with WBV (frequency: 35 Hz; amplitude 2 mm) on a vertical vibration platform. Oxygen consumption (V̇o₂), heart rate (HR), minute ventilation (V̇e), ratio of minute ventilation to oxygen production (V̇e/V̇o₂), ratio of minute ventilation to carbon dioxide production (V̇e/V̇co₂), oxygen saturation (SpO₂), and rating of perceived exertion were measured. For both groups, there was a decrease in V̇e/V̇o₂ and V̇e/V̇co₂ ratios during static and dynamic squats, as well as an increase in other cardiorespiratory parameters, and no significant difference existed between them. There was an effect of the type of squat on the HR variation; the values in the static squat were higher than those of the dynamic squat in both groups. There was a significant difference with a reduction in SpO₂ at 40 Hz frequency when compared with 30 Hz in the COPD group. The other variables behaved similarly between the frequencies. The WBV exercise, regardless of the frequencies used, represented a mild effort that promoted cardiorespiratory response in COPD, with greater responses in the static squat and no adverse effect. NEW & NOTEWORTHY This study showed that an acute session of light exercise of whole body vibration (WBV) can increase the cardiorespiratory responses in patients with chronic obstructive pulmonary disease (COPD), reaching values similar to that of the control group. The results might contribute, therefore, to the elaboration of exercise protocols with WBV for the treatment of patients with COPD during rehabilitation. Thus, future studies referring to training on the vibratory platform could use these exercise parameters and demonstrate possible long-term benefits.

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

To investigate whether whole body vibration (WBV) training increases the explosive force of the knee extensors in chronic kidney disease (CKD) patients. Fourteen CKD patients undergoing hemodialysis were randomly allocated in WBV training or Sham group. Explosive force parameters (contractile impulse [CImp] and relative rate of force development [RFDr]) obtained in early (30 and 50 msec) and late phases (100 and 200 msec) of the knee extensors force/time curve. CImp and RFDr obtained at the early phase of force/time curve reduced after the intervention period, with a smaller decline for WBV (CImp at 50 msec [~-15% and -51%, P=0.038], RFDr at 30 msec [~-22% and -52%, P=0.044] and RFDr at 50 msec [~-11% and -54%; P=0.008]). In the late phase there was a lower decline for WBV group compared to Sham group, respectively: CImp: 100 msec (~-8% and -55%, P=0.025), 200 msec (~-3% and -46%, P= 0.025); RFDr 100 msec (~0.01% and -56%, P=0.033), 200 msec (~-5% and -36%, P=0.004). Three months of WBV training may attenuate the explosive force reduction in CKD patients.

Whole-body vibration training - better care for COPD patients: a systematic review and meta-analysis

Purpose

Whole-body vibrating training (WBVT) is a modality aiming to improve neuromuscular performance of patients with COPD. However, a consensus on the effects of WBVT has not been reached. We aimed to clarify the effects of WBVT on functional exercise capacity, pulmonary function, and quality of life in COPD patients.

Patients and methods

PubMed, Web of Science, and EMBASE were searched through April 5, 2018. We calculated the pooled weight mean difference (WMD) using a random-effects model. Quality assessment and publication bias analyses were also performed.

Results

We included eight randomized control trials involving 365 patients. Compared with control group, WBVT increased 6-minute walking distance (6-MWD) (WMD: 62.14 m; 95% CI: 48.12–76.16; P<0.001), the change of 6-MWD (Δ6-MWD) (WMD: 42.33 m; 95% CI: 15.21–69.45; P=0.002), the change of the time to finish five repeated sit-to-stand tests (WMD: −2.07 seconds; 95% CI: −4.00 to −0.05; P=0.04), and decreased the change of St George’s Respiratory Questionnaire score (WMD: −6.65 points; 95% CI: −10.52 to −2.78; P<0.001). However, no significant difference was found between the two groups regarding forced expired volume in 1 second (FEV₁) (% predicated), change of FEV₁ (% predicated), sit-to-stand test, 6-MWD (% predicated), change of 6-MWD (% predicated), St George’s Respiratory Questionnaire score, COPD Assessment Test score, and change of COPD Assessment Test score.

Conclusion

WBVT has beneficial effects on functional exercise capacity for COPD patients.

Acute Effects of Whole-Body Vibration on the Pain Level, Flexibility, and Cardiovascular Responses in Individuals With Metabolic Syndrome

The aim of the study was to assess the acute effect of whole-body vibration (WBV) exercise, with low frequency (5 Hz), on the pain level (PL), trunk flexibility, and cardiovascular responses (blood pressure [BP] and heart rate [HR]) in individuals with metabolic syndrome (MetS). Forty-four individuals were included in the study (control: 15) or in (WBV exercise: 29) groups. They were submitted to 3 bouts (1 minute each) of WBV exercise (5 Hz and peak-to-peak displacements of 2.5, 5.0, and 7.5 mm, corresponding to peak accelerations of 0.12, 0.25, and 0.35 g, respectively, sitting in a chair with the feet on the platform with knees flexed, followed by 1 minute of interset rest. The Control Group performed the same protocol, but the platform was turned off. The PL was measured through the visual analog pain scale, and the flexibility was measured through the anterior trunk flexion test. Significant improvements on PL (P = .031) and flexibility (P = .004) were found only in the WBV exercise group. The BP and HR remained at physiological levels. In conclusion, the WBV exercise would lead to physiological response decreasing PL and increasing flexibility as well as maintaining the cardiovascular responses in individuals with MetS.

QUALITY OF LIFE OF PATIENTS WITH METABOLIC SYNDROME IS IMPROVED AFTER WHOLE BODY VIBRATION EXERCISES

Background:

Whole body vibration exercises (WBVE) improve the quality of life (QoL) of different populations. Metabolic syndrome patients (MetS) may be favored by physical activity. Questionnaires are used to assess the QoL. The aim was to evaluate the QoL of patients with MetS that have undergone WBVE with a brief WHOQOL (WHOQOL-BREF).

Material and Methods:

MetS patients were randomly divided into three groups: (i) control group (CG), (ii) treated with WBVE once per week (WBVE1) and (iii) treated with WBVE twice per week (WBVE2). In the first session, the patient was sat in a chair in front of the platform with the feet on its base in 3 peak to peak displacements (2.5, 5.0 and 7.5 mm) and frequency of 5 Hz was used. From the second to the last session, patients were subjected to the same protocol, however they were standing on the base of the platform and the frequency was increased up to 14 Hz. The patients fulfilled the WHOQOL-BREF before the first and after the last sessions. Cronbach coefficients were determined to each domain of the WHOQOL-BREF and test Wilcoxon (p<0.05) was used.

Results:

The patients of the WBVE1 group had improvements in the physical, psychological and environment domains while in the WBVE2, the improvements were in the physical and social relationships domain of the WHOQOL-BREF.

Conclusion:

It was observed that the WBVE in a protocol (one or two times per week) with a progressive and increased frequency improves the QoL of patients with MetS in different domains of the WHOQOL-BREF.

Whole-Body Vibration Training During a Low Frequency Outpatient Exercise Training Program in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Trial

BACKGROUND

The aim of the study was to investigate whether whole-body vibration training (WBVT) can be applied beneficially within an outpatient low frequency exercise program.

METHODS

In a prospective, controlled, randomized study, WBVT effectiveness and safety were investigated in COPD stage II-IV patients undergoing a 3-month training program. Participants took part in a 90-min circuit training once a week. On top patients were randomized to either perform squats with WBVT, or without (conventional training group (CTG)). Before and after the intervention, a sit-to-stand test (STST), a 6-min walk test (6-MWT), the COPD assessment test (CAT), and the chronic respiratory disease questionnaire (CRQ) were evaluated.

RESULTS

Twenty-eight out of 55 patients completed the study (n = 12 WBTV, n = 16 CTG). The STST time remained nearly constant for the CTG (Δ -0.8 ± 3.1 s) and the WBVT (Δ 1.4 ± 3.2 s; P = 0.227), respectively. Similarly, for both WBVT and CTG, the 6-min walk distance remained unchanged (Δ 7 ± 55 m vs. 9 ± 45 m, P = 0.961). In three out of four categories, the CRQ scores showed a significant improvement within WBVT, and in one category when comparing across groups. The CAT score dropped by -0.8 ± 2.9 points within CTG and by 2.4 ± 2.7 points within WBVT (P = 0.105). There were no adverse events related to WBVT.

CONCLUSION

The implementation of WBVT in the context of an outpatient low frequency exercise program did not significantly improve the patients' exercise capacity. An improvement in CAT and partially in CRQ was shown within WBVT. However, regarding the high dropout rate (49%), these results must be interpreted with caution.

Cardiopulmonary response during whole-body vibration training in patients with severe COPD

Several studies in patients with chronic obstructive pulmonary disease (COPD) have shown that whole-body vibration training (WBVT) has beneficial effects on exercise capacity. However, the acute cardiopulmonary demand during WBVT remains unknown and was therefore investigated in this study. Ten patients with severe COPD (forced expiratory volume in 1 s: 38±8% predicted) were examined on two consecutive days. On day one, symptom-limited cardiopulmonary exercise testing was performed on a cycle ergometer. The next day, six bouts of repeated squat exercises were performed in random order for one, two or three minutes either with or without WBVT while metabolic demands were simultaneously measured. Squat exercises with or without WBVT induced comparable ventilatory efficiency (minute ventilation (VE)/carbon dioxide production (V'_CO2 ): 38.0±4.4 with WBVT versus 37.4±4.1 without, p=0.236). Oxygen uptake after 3 min of squat exercises increased from 339±40 mL·min^-1 to 1060±160 mL·min^-1 with WBVT and 988±124 mL min^-1 without WBV (p=0.093). However, there were no significant differences between squat exercises with and without WBVT in oxygen saturation (90±4% versus 90±4%, p=0.068), heart rate (109±13 bpm versus 110±15 bpm, p=0.513) or dyspnoea (Borg scale 5±2 versus 5±2, p=0.279). Combining squat exercises with WBVT induced a similar cardiopulmonary response in patients with severe COPD compared to squat exercises without WBVT. Bearing in mind the small sample size, WBVT might be a feasible and safe exercise modality even in patients with severe COPD.

Benefits of Whole-Body Vibration, as a Component of the Pulmonary Rehabilitation, in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review with a Suitable Approach

Background. Appropriate management, including pulmonary rehabilitation, associated with correct diagnosis of chronic obstructive pulmonary disease (COPD) in patients can contribute to improving clinical conditions of these patients. Physical activity is recommended for COPD patients. Whole-body vibration (WBV) is a modality of physical activity. Putting together the biological effects and safe use of WBV, it may be a potentially feasible intervention to add to pulmonary rehabilitation. The purpose of this investigation was to systematically review studies regarding the effects of WBV, as a component of the pulmonary rehabilitation, in patients with COPD. Results. A total of six publications met inclusion for review. There was evidence to support the beneficial use of WBV to improve functional performance of the lower limbs and quality of life. However, the appropriateness of and descriptors of WBV methods were poorly described. Conclusions. The results of this review support the use of WBV as a component of pulmonary rehabilitation to assist management of patients with COPD. However, future research should examine the dose-response curve and optimal dosing regimen of WBV according to standard reporting recommendations for people with COPD. Such an approach will allow comparison among studies and the potential of meta-analysis of randomized controlled trials.