Effect of vibrotherapy on pro-inflammatory cytokines and the severity of depression in adolescents

Recently, the level of pro-inflammatory cytokines (PIC) has attracted the attention of researchers and doctors in the pathophysiology of depressive disorders. It is through immunomodulatory pathways that the therapeutic effect of physical activity seems to work in depression. Therefore, German scientists decided to analyze the effect of exercise on the severity of depression and PIC levels, focusing on the less studied age group of adolescents. Physical activity was obtained through whole-body vibration (WBV) or exercises on an ergometer, comparing these methods with each other and with conventional therapy as usual (TAU).

• The severity of depression decreased both after WBV or ergometer to a much greater extent than after TAU alone.
• The treatments tested affected PIC levels in a variety of ways.

Prepared on the basis of:

Immunological Effects of an Add-On Physical Exercise Therapy in Depressed Adolescents and Its Interplay with Depression Severity. Wunram HL, Oberste M, Hamacher S et al. Int J Environ Res Public Health. 2021 Jun 17;18(12):6527.

Study population

Adolescent patients with depression (n = 64; 28.1% of men).

Test procedure

Patients were divided into groups receiving:

• TAU + WBV (n = 21)
• TAU + ergometer exercises (n = 20)
• only TAU (n = 23).

The split was not completely random.

Each patient underwent a total of 18 treatment sessions, in one of the above regimes, over a period of 6 weeks.

The analyzed PICs were interleukin-6 (IL-6) and tumor necrosis factor (TNF-α). Their level was analyzed before the start of the therapy (t0), after the end of the 6-week therapy (t1) and 8 weeks after t1 (t2).

The influence of the studied therapies on the severity of depression was assessed on the basis of self-assessment using the “Depression Inventory for Children and Adolescents”.

Use of vibration in the study

Vibrations in the form of WBV were delivered using a Galileo vibration platform (Advanced Plus, Novotec Medical GmbH, Germany) where activity similar to human gait was simulated. The vibration frequency was 20 Hz, the amplitude 2 mm. During the first 12 days, single sessions of vibrotherapy lasted 2 minutes, on the following days – 3 minutes. This corresponded to the muscle contractions occurring when walking 15,840 steps in the first 12 days and 23,760 steps in subsequent sessions.

Results

The severity of depression decreased both after WBV or exercise on the ergometer to a much greater extent than after TAU alone.

The level of IL-6 decreased in all groups from t0 to t1, but increased again in the WBV or TAU alone group at t2.

TNF-α also decreased at t1 relative to t0, but only in the ergometer or TAU alone group.

Comment

Intensive exercise therapy in the form of WBV or exercise on an ergometer positively influenced the reduction of adolescent depression, most likely, at least in part, as a result of immunomodulation. When interpreting these results, the small size of the study groups and the non-random allocation of control patients should be taken into account.

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