Effect of Multi-Frequency Whole-Body Vibration on Muscle Activation, Metabolic Cost and Regional Tissue Oxygenation

Himanshu Saxena, Kevin R Ward, Chandramouli Krishnan, Bogdan I Epureanu, Himanshu Saxena, Kevin R Ward, Chandramouli Krishnan, Bogdan I Epureanu

Abstract

Prolonged immobilization from a critical illness can result in significant muscle atrophy. Whole-body vibration (WBV) could potentially attenuate the issue of muscle atrophy; however, there exists no device that could potentially provide WBV in supine position that is suitable for critically ill patients. Hence, the purpose of this study was to develop a new wearable suit, called therapeutic vibration device (TVD), that can provide WBV in supine position and test its effects on physiologic markers of physical activity including muscle activation, oxygen consumption (VO2), and regional hemoglobin oxygen saturation (rSO2). The prototype TVD delivered multi-frequency WBV axially to 19 healthy participants in supine position for 10 minutes simultaneously at 25 Hz/4.2 grms on the feet and 15 Hz/0.7 grms on the shoulders. Muscle activation was recorded by electromyography (EMG), VO2 was measured by indirect calorimetry and rSO2 was recorded by near-infrared spectroscopy. Recordings were collected from each participant from multiple body locations, on three separate days, at baseline and during the intervention. Acceleration was also recorded to gain insight into transmissibility and coherence. Repeated-measures ANOVA using Bonferroni correction revealed that the muscle activity significantly increased by 4% - 62% (p < 0.05), VO2 improved by 22.3% (p < 0.05) and rSO2 increased by 1.4% - 4.5% (p < 0.05) compared to baseline. WBV provided by the TVD is capable of producing physiologic responses consistent with mild physical activity. Such effects could potentially be valuable as an adjunct to physical therapy for early mobilization to prevent atrophy occurring from prolonged immobilization.

Keywords: Early mobilization; exoskeleton; muscle atrophy; post intensive care syndrome; rehabilitation; tonic vibration reflex.

Figures

FIGURE 1.
FIGURE 1.
(a) A picture showing the therapeutic vibration device delivering whole-body vibration using inertial actuators to a participant in a supine position. The actuators are preloaded using a restraint mechanism while the participant remains passive. (b) Triaxial accelerometer mounting and coordinate axes orientation with respect to the direction of vibration – i.e., in y-axis on feet and z-axis on shoulders, respectively. They are mounted on foot shaker, tibialis anterior, rectus femoris, brachialis and shoulder shaker.
FIGURE 2.
FIGURE 2.
A schematic of the study design.
FIGURE 3.
FIGURE 3.
(a) Mean ± SEM of the low pass filtered acceleration on foot shaker (FTSH), tibialis anterior (TA), rectus femoris (RF), brachialis (BC) and shoulder shaker (SHSH). (b) Transmissibility, and (c) Coherence computed using the cross spectral density method from the mean acceleration of all participants in the direction of vibration (refer Fig. 1(b) for the coordinate axes of the accelerometers) at simultaneous excitation frequencies of 15 Hz on shoulders and 25 Hz on feet.
FIGURE 4.
FIGURE 4.
(a) A sample EMG frequency spectrum of the soleus (SO) muscle from a single participant in a single session at multi-frequency synchronous excitation of 15 Hz on shoulders and 25 Hz on feet. The gray dotted line depicts the raw EMG signal and the black solid line depicts the band-pass (8th order Butterworth filter 10-400 Hz), linear interpolated filtered EMG signal. The motion artifacts (sharp spikes) at excitation frequencies and corresponding harmonics up to 400 Hz have been removed using the linear interpolation method. (b) Mean ± SEM of the filtered EMG RMS at baseline and during vibration normalized to the maximum voluntary isometric contraction (MVIC) at excitation frequencies of 15 Hz and 25 Hz. EMG measured from the muscle bellies of soleus (SO), tibialis anterior (TA), gastrocnemius lateralis (GL), vastus medialis (VM), vastus lateralis (VL), rectus femoris (RF), semitendinosus (ST) and deltoideus medius (DM). Asterisks indicate statistical significance at p < 0.05 and n.s. indicates not significant.
FIGURE 5.
FIGURE 5.
(a) Mean ± SEM of each metabolic data point in time series at baseline and during vibration. (b) Mean ± SEM of oxygen uptake (VO2), carbon dioxide production (VCO2), energy expenditure (EE), minute ventilation (VE), and tidal volume (VT) recorded at rest and during vibration. Asterisks indicate statistical significance at p < 0.05 and n.s. indicates not significant.
FIGURE 6.
FIGURE 6.
(a) Mean ± SEM of each regional hemoglobin oxygen saturation (rSO2%) data point in time series at baseline and during vibration. (b) Comparison of rSO2% (mean ± SEM) at rest and during vibration. Asterisks indicate statistical significance at p < 0.05.

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