Whole-body vibration training versus conventional balance training in patients with severe COPD-a randomized, controlled trial

Rainer Gloeckl, Tessa Schneeberger, Daniela Leitl, Tobias Reinold, Christoph Nell, Inga Jarosch, Klaus Kenn, Andreas R Koczulla, Rainer Gloeckl, Tessa Schneeberger, Daniela Leitl, Tobias Reinold, Christoph Nell, Inga Jarosch, Klaus Kenn, Andreas R Koczulla

Abstract

Background: Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training.

Methods: 48 patients with severe COPD (FEV1: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5-26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses.

Results: Static balance performance improved significantly more (p = 0.032) in favor of WBV (path length during semi-tandem stand: - 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more (p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. - 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s2, p = 0.018 vs. 0.01 ± 0.11 m/s2, p = 0.71).

Conclusions: WBV can improve balance performance and muscular power significantly more compared to conventional balance training.

Trial registration: Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://ichgcp.net/clinical-trials-registry/NCT03157986&cntry=&state=&city=&dist = .

Keywords: Chronic obstructive pulmonary disease; Exercise; Force measurement platform; Neuromuscular power; Pulmonary rehabilitation; Vibration platform.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Exercises performed during whole-body vibration balance training. Whole body vibration training and conventional balance training performed for 2 sets of 1 min per exercise and training session: a dynamic squats, b dynamic heel raises, c static one-leg stance, and d dynamic lunge step. (patients provided written informed consent for the use of these figures)
Fig. 2
Fig. 2
COPD Patient performing a semi-tandem stance balance test on a force measurement platform. Patient provided written informed consent for the use of this picture
Fig. 3
Fig. 3
Consort flow diagram
Fig. 4
Fig. 4
Changes in balance performance during Romberg stance, semi-tandem stance, and 1-leg stance following a whole-body vibration (WBV) balance training or conventional balance training (BAL)

References

    1. Armstrong WJ, Nestle HN, Grinnell DC, Cole LD, Van Gilder EL, Warren GS, et al. The acute effect of whole-body vibration on the hoffmann reflex. J Strength Cond Res. 2008;22:471–476. doi: 10.1519/JSC.0b013e3181660605.
    1. Abercromby AF, Amonette WE, Layne CS, McFarlin BK, Hinman MR, Paloski WH. Variation in neuromuscular responses during acute whole-body vibration exercise. Med Sci Sports Exerc. 2007;39(1642):1650.
    1. Ritzmann R, Kramer A, Gruber M, Gollhofer A, Taube W. EMG activity during whole body vibration: motion artifacts or stretch reflexes? Eur J Appl Physiol. 2010;110(143):151.
    1. Wang W, Wang S, Lin W, Li X, Andersen LL, Wang Y. Efficacy of whole body vibration therapy on pain and functional ability in people with non-specific low back pain: a systematic review. BMC Complement Med Ther. 2020;20:158. doi: 10.1186/s12906-020-02948-x.
    1. Marin-Cascales E, Alcaraz PE, Ramos-Campo DJ, Martinez-Rodriguez A, Chung LH, Rubio-Arias JA. Whole-body vibration training and bone health in postmenopausal women: a systematic review and meta-analysis. Medicine. 2018;97:e11918. doi: 10.1097/MD.0000000000011918.
    1. Alashram AR, Padua E, Annino G. Effects of whole-body vibration on motor impairments in patients with neurological disorders: a systematic review. Am J Phys Med Rehabil. 2019;98(1084):1098.
    1. Rogan S, de Bruin ED, Radlinger L, Joehr C, Wyss C, Stuck NJ, et al. Effects of whole-body vibration on proxies of muscle strength in old adults: a systematic review and meta-analysis on the role of physical capacity level. Eur Rev Aging Phys Act. 2015;12:12. doi: 10.1186/s11556-015-0158-3.
    1. Zhou J, Pang L, Chen N, Wang Z, Wang C, Hai Y, et al. Whole-body vibration training—better care for COPD patients: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis. 2018;13:3243–3254. doi: 10.2147/COPD.S176229.
    1. Gloeckl R, Jarosch I, Bengsch U, Claus M, Schneeberger T, Andrianopoulos V, et al. What's the secret behind the benefits of whole-body vibration training in patients with COPD? A randomized, controlled trial. Respir Med. 2017;126:17–24. doi: 10.1016/j.rmed.2017.03.014.
    1. Porto EF, Castro AA, Schmidt VG, Rabelo HM, Kumpel C, Nascimento OA, et al. Postural control in chronic obstructive pulmonary disease: a systematic review. Int J Chron Obstruct Pulmon Dis. 2015;10:1233–1239.
    1. Loughran KJ, Atkinson G, Beauchamp MK, Dixon J, Martin D, Rahim S, et al. Balance impairment in individuals with COPD: a systematic review with meta-analysis. Thorax. 2020;75:539–546. doi: 10.1136/thoraxjnl-2019-213608.
    1. Beauchamp MK, Hill K, Goldstein RS, Janaudis-Ferreira T, Brooks D. Impairments in balance discriminate fallers from non-fallers in COPD. Respir Med. 2009;103(1885):1891.
    1. Hakamy A, Bolton CE, Gibson JE, McKeever TM. Risk of fall in patients with COPD. Thorax. 2018;73(1079):1080.
    1. Yohannes AM, Raue PJ, Kanellopoulos D, McGovern A, Sirey JA, Kiosses DN, et al. Predictors of all-cause mortality in patients with severe COPD and major depression admitted to a rehabilitation hospital. Chest. 2016;149:467–473. doi: 10.1378/chest.15-0529.
    1. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013;188:e13–64. doi: 10.1164/rccm.201309-1634ST.
    1. GOLD-Report Global Strategy of the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2020; . Accessed 15 Sep 2020.
    1. Troosters T, Gosselink R, Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999;14(270):274.
    1. Veilleux LN, Rauch F. Reproducibility of jumping mechanography in healthy children and adults. J Musculoskelet Neuronal Interact. 2010;10(256):266.
    1. Siglinsky E, Krueger D, Ward RE, Caserotti P, Strotmeyer ES, Harris TB, et al. Effect of age and sex on jumping mechanography and other measures of muscle mass and function. J Musculoskelet Neuronal Interact. 2015;15:301–308.
    1. Slinde F, Suber C, Suber L, Edwen CE, Svantesson U. Test-retest reliability of three different countermovement jumping tests. J Strength Cond Res. 2008;22(640):644.
    1. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J. 2014;44:1428–1446. doi: 10.1183/09031936.00150314.
    1. Kon SS, Patel MS, Canavan JL, Clark AL, Jones SE, Nolan CM, et al. Reliability and validity of 4-metre gait speed in COPD. Eur Respir J. 2013;42:333–340. doi: 10.1183/09031936.00162712.
    1. Kon SS, Canavan JL, Jones SE, Nolan CM, Clark AL, Dickson MJ, et al. Minimum clinically important difference for the COPD assessment test: a prospective analysis. Lancet Respir Med. 2014;2:195–203. doi: 10.1016/S2213-2600(14)70001-3.
    1. Jones SE, Kon SS, Canavan JL, Patel MS, Clark AL, Nolan CM, et al. The five-repetition sit-to-stand test as a functional outcome measure in COPD. Thorax. 2013;68:1015–1020. doi: 10.1136/thoraxjnl-2013-203576.
    1. Puhan MA, Siebeling L, Zoller M, Muggensturm P, ter Riet G. Simple functional performance tests and mortality in COPD. Eur Respir J. 2013;42(956):963.
    1. Cooper BG, Stocks J, Hall GL, Culver B, Steenbruggen I, Carter KW, et al. The Global Lung Function Initiative (GLI) Network: bringing the world's respiratory reference values together. Breathe. 2017;13:e56–e64. doi: 10.1183/20734735.012717.
    1. Jirange P, Vaishali K, Sinha MK, Bairapareddy KC, Alaparthi GK. A cross-sectional study on balance deficits and gait deviations in COPD patients. Can Respir J. 2021;2021:6675088. doi: 10.1155/2021/6675088.
    1. Stolzenberg N, Belavy DL, Rawer R, Felsenberg D. Whole-body vibration versus proprioceptive training on postural control in post-menopausal osteopenic women. Gait Posture. 2013;38(416):420.
    1. Oliveira CC, Annoni R, Lee AL, McGinley J, Irving LB, Denehy L. Falls prevalence and risk factors in people with chronic obstructive pulmonary disease: a systematic review. Respir Med. 2020;176:106284. doi: 10.1016/j.rmed.2020.106284.
    1. Chuatrakoon B, Ngai SPC, Sungkarat S, Uthaikhup S. Balance impairment and effectiveness of exercise intervention in chronic obstructive pulmonary disease-a systematic review. Arch Phys Med Rehabil. 2020 doi: 10.1016/j.apmr.2020.01.016.
    1. Delbressine JM, Vaes AW, Goertz YM, Sillen MJ, Kawagoshi A, Meijer K, et al. Effects of exercise-based interventions on fall risk and balance in patients with chronic obstructive pulmonary disease: a systematic review. J Cardiopulm Rehabil Prev. 2020;40:152–163. doi: 10.1097/HCR.0000000000000513.
    1. Beauchamp MK, Janaudis-Ferreira T, Parreira V, Romano JM, Woon L, Goldstein RS, et al. A randomized controlled trial of balance training during pulmonary rehabilitation for individuals with COPD. Chest. 2013;144:1803–1810. doi: 10.1378/chest.13-1093.
    1. Sherrington C, Tiedemann A, Fairhall N, Close JC, Lord SR. Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. NSW Public Health Bull. 2011;22(78):83.
    1. Camillo CA, Osadnik CR, van Remoortel H, Burtin C, Janssens W, Troosters T. Effect of "add-on" interventions on exercise training in individuals with COPD: a systematic review. ERJ Open Res. 2016 doi: 10.1183/23120541.00078-2015.
    1. Ko MC, Wu LS, Lee S, Wang CC, Lee PF, Tseng CY, et al. Whole-body vibration training improves balance control and sit-to-stand performance among middle-aged and older adults: a pilot randomized controlled trial. Eur Rev Aging Phys Act. 2017;14:11. doi: 10.1186/s11556-017-0180-8.
    1. Lam FM, Chan PF, Liao LR, Woo J, Hui E, Lai CW, et al. Effects of whole-body vibration on balance and mobility in institutionalized older adults: a randomized controlled trial. Clin Rehabil. 2018;32:462–472. doi: 10.1177/0269215517733525.
    1. Alvarez-Barbosa F, Del Pozo-Cruz J, Del Pozo-Cruz B, Garcia-Hermoso A, Alfonso-Rosa RM. Effects of whole-body vibration on functional mobility, balance, gait strength, and quality of life in institutionalized older people: a systematic review and meta-analysis of randomized controlled trials. J Aging Phys Act. 2020;28(219):230.
    1. Alam MM, Khan AA, Farooq M. Effect of whole-body vibration on neuromuscular performance: a literature review. Work. 2018;59(571):583.
    1. Bosco C, Colli R, Introini E, Cardinale M, Tsarpela O, Madella A, et al. Adaptive responses of human skeletal muscle to vibration exposure. Clin Physiol. 1999;19:183–187. doi: 10.1046/j.1365-2281.1999.00155.x.
    1. Cardinale M, Lim J. Electromyography activity of vastus lateralis muscle during whole-body vibrations of different frequencies. J Strength Cond Res. 2003;17(621):624.
    1. Cardinale M, Rittweger J. Vibration exercise makes your muscles and bones stronger: fact or fiction? J Br Menopause Soc. 2006;12:12–18. doi: 10.1258/136218006775997261.
    1. Burke JR, Schutten MC, Koceja DM. Kamen G Age-dependent effects of muscle vibration and the Jendrassik maneuver on the patellar tendon reflex response. Arch Phys Med Rehabil. 1996;77:600–604. doi: 10.1016/S0003-9993(96)90302-0.
    1. Marin PJ, Bunker D, Rhea MR, Ayllon FN. Neuromuscular activity during whole-body vibration of different amplitudes and footwear conditions: implications for prescription of vibratory stimulation. J Strength Cond Res. 2009;23:2311–2316. doi: 10.1519/JSC.0b013e3181b8d637.
    1. Pepin V, Brodeur J, Lacasse Y, Milot J, Leblanc P, Whittom F, et al. Six-minute walking versus shuttle walking: responsiveness to bronchodilation in chronic obstructive pulmonary disease. Thorax. 2007;62:291–298. doi: 10.1136/thx.2006.065540.
    1. Studenski S. Bradypedia: is gait speed ready for clinical use? J Nutr Health Aging. 2009;13:878–880. doi: 10.1007/s12603-009-0245-0.
    1. Gloeckl R, Heinzelmann I, Seeberg S, Damisch T, Hitzl W, Kenn K. Effects of complementary whole-body vibration training in patients after lung transplantation: a randomized, controlled trial. J Heart Lung Transplant. 2015;34:1455–1461. doi: 10.1016/j.healun.2015.07.002.
    1. Delecluse C, Roelants M, Diels R, Koninckx E, Verschueren S. Effects of whole body vibration training on muscle strength and sprint performance in sprint-trained athletes. Int J Sports Med. 2005;26:662–668. doi: 10.1055/s-2004-830381.
    1. Iwamoto J, Takeda T, Sato Y, Uzawa M. Effect of whole-body vibration exercise on lumbar bone mineral density, bone turnover, and chronic back pain in post-menopausal osteoporotic women treated with alendronate. Aging Clin Exp Res. 2005;17:157–163. doi: 10.1007/BF03324589.
    1. Beck BR, Norling TL. The effect of 8 mos of twice-weekly low- or higher intensity whole body vibration on risk factors for postmenopausal hip fracture. Am J Phys Med Rehabil. 2010;89:997–1009. doi: 10.1097/PHM.0b013e3181f71063.

Source: PubMed

Patrocinadores y Colaboradores

Condiciones médicas

Intervenciones de drogas

3
Suscribir