COPD Rehabilitation Improves With Whole-Body Vibration on Galileo (Vibraflex)

COPD Rehabilitation Improves With Whole-Body Vibration on Galileo (Vibraflex)

From Medscape Medical News:
Nancy A. Melville, author

December 8, 2011 — Patients with chronic obstructive pulmonary disease (COPD) show improvements in rehabilitative exercise efforts when the activities are complemented with whole-body vibration sessions, according to a study published online November 21 and in the January 2012 print issue of Respiratory Medicine.
When using whole-body vibration, patients exercise on a vibrating platform that produces sinusoidal oscillations. The method has been associated with improved neuromuscular and hormonal responses in healthy participants compared with resistance training alone, and it has also been shown to offer benefits for patients with other diseases, according to Rainer Gloeckl, from the Department of Respiratory Medicine, Schoen Klinik Hospital, Schoenau am Koenigssee, Germany, and colleagues.

“So far, [whole-body vibration] has also been established in rehabilitation programs for patients with neurological diseases to improve postural control or for patients with osteoporosis to enhance bone mineral density,” they write.

Endurance and strength training are considered essential components for rehabilitation of patients with COPD, who suffer from limitations in exercise capacity that are associated with poor quality of life and an increased mortality risk.

“Whilst the use of endurance and strength training are established and evidence-based exercise modalities in patients with COPD, the validation of further complementary exercise methods is considered a remaining challenge,” the authors note.

In an effort to determine the benefits of incorporating whole-body vibration into endurance and strength training for COPD rehabilitation, the researchers randomly assigned 82 patients with stage 3 or 4 COPD enrolled in a 3-week inpatient rehabilitation program to either a group that performed 3 × 3 minutes of bilateral dynamic squat exercises on a side-alternating vibration platform at 24 to 26 Hz 3 times per week (n = 42), or a control group to receive the same amount of exercise time without whole-body vibration (n = 40).
All patients also received endurance training, including 15 minutes of cycling at 60% peak Watts, and strength training involving 4 to 6 exercises with 3 sets at a 20-repetition maximum for major muscle groups.

At the end of the study, patients in the whole-body vibration group showed significantly higher improvements in 6-minute walking distance compared with patients in the control group (whole-body vibration group, 64 ± 59 m; control group, 37 ± 52 m, with a between-group difference of 27 m; 95% confidence interval, 1 - 53; P = .046).
In addition, patients in the whole-body vibration group also showed decreases in the time required for a sit-to-stand test compared with patients in the control group (whole-body vibration group, −4.0 ± 4.8 seconds; control group, −2.0 ± 3.1 seconds, with a between-group difference of −1.9 seconds; 95% confidence interval, −4.0 to 0.1 seconds; P = .067).
Both groups demonstrated similar improvements in health-related quality of life.

Five patients in the whole-body vibration group discontinued the intervention because of acute exacerbation, and 1 discontinued for acute gonarthrosis (arthrosis of the knee), whereas 3 patients in the control group discontinued for acute COPD exacerbation, and 1 for an acute abdominal issue.
Study limitations include lack of follow up, blinding, and record keeping of the number of repetitions for each patient.

“In consideration of the short total exposure time to [whole-body vibration] (81 min in 3 weeks), the additionally attained effects are quite striking,” the authors write.
The whole-body vibration concept originated in the 1970s as a means for Russian cosmonauts to train in space and prevent the loss of bone mineral and muscle mass during space flights, and the method was revived in the 1990s for use by professional athletes in exercise training.

Since then, whole-body vibration has gained favor in therapeutic settings. The technology used in the study (Galileo, Novotec Medical GmbH) was used at 24 to 26 Hz and 6 mm peak-to-peak amplitude and provided a side-alternating movement said to induce “muscle contractions on the entire flexor and extensor chain of muscles in the legs and all the way up to the trunk,” according to the authors.

Muscle contractions that occur during the vibration training are caused by stretch reflexes instead of the voluntary muscle control that occurs with common resistance training, the authors explained. “The user has no direct influence on muscle activity itself and can only control body posture, movement and exercise objective.”

The authors note that the whole-body vibration method should not be used to replace conventional exercise training for reasons including that “[s]pecific exercises for arms, accessory respiratory muscles or the upper trunk cannot be easily performed on a vibration plate and it is not possible to undertake endurance training on a vibration platform.”

The authors have disclosed no relevant financial relationships.