Vibrotherapy as a method of physical activity in COPD that does not cause dyspnea

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in humans. An important element of pulmonary rehabilitation is the training of peripheral muscles that stimulates the cardiovascular and musculoskeletal systems. Unfortunately, standard resistance exercises or training on a treadmill carry a risk of acute dyspnea or hypoxemia. Research shows that whole-body vibration (WBV), the type of passive physical activity, may not cause dyspnea in people with COPD, but the potential of this method in normal environmental (residential) conditions is unknown. The effects of short-term WBV administration on people with COPD have also not been thoroughly studied. Therefore, the goal of Australian researchers was to describe the acute effects of WBV or simulated vibrations (SWBV) on the dyspnea and heart rate of people with COPD in their normal housing conditions.

• Changes in perceived dyspnea remained constant from “very slight” to “slight” in both WBV and SWBV groups, with no differences between the two.
• Heart rate increased in both groups, remaining at a similar level after both WBV and SWBV.
• The presented study showed that a WBV session can be performed in patients with COPD without causing dyspnea, as is in the case of other forms of exercise.

Prepared on the basis of:

Whole-body vibration as a mode of dyspnoea free physical activity: a community-based proof-of-concept trial. Furness, T., Joseph, C., Welsh, L. et al. BMC Res Notes 6, 452 (2013).

Study population

17 elderly people with COPD living in Metropolitan Melbourne and the Mornington Peninsula in Victoria (Australia) participated in the study. The results were obtained at the home of each participant.

Test procedure

Two experimental sessions were conducted: 1) WBV, followed by at least 7 days later, 2) simulated vibrations, i.e. SWBV. Subjectively perceived dyspnea was determined using the Borg CR-10 index of the visual analog scale. Heart rate and oxygen saturation (SpO₂) were objectively measured using the CARESCOPE™ V100 Vital Signs Monitor (GE Health Care, USA). Data were collected before the intervention, i.e. after 5 minutes of relaxation in a chair and within 30 seconds after the end of WBV or SWBV session.

Use of vibration in the study

A side alternating vibration platform (Amazing Super Health, AUS) was used. In the case of the WBV session, the platform frequency was ~25 Hz, amplitude ~2.0 mm, peak acceleration ~24.7 m/s², gravitational force ~2.5 g. During the SWBV session, the platform frequency was ~25 Hz and the amplitude ~0.0 mm. Participants stood with their knees flexed ~20 ° during each session. Each session consisted of five one-minute doses of vibration (WBV) or sham vibration (SWBV), interspersed with one-minute periods of passive rest.

Results

Changes in perceived dyspnea remained constant from “very slight” to “slight” in both groups. An increase in heart rate was also observed regardless of the administration of WBV or SWBV (p = 0.01). This increase was greater after WBV (11 beats/min) than after SWBV (8 beats/min), although the difference was not statistically significant (p = 0.67). Oxygen saturation decreased by 1% during WBV (p = 0.08), but did not change during SWBV (p = 0.61).

Comment

The results of this community study showed no significant differences in the level of dyspnea or other variables tested in COPD patients in their natural living conditions after WBV administration compared to a placebo. Thus WBV does not induce physical exertion comparable to other forms of training in people with COPD. People with COPD (2nd degree) experienced dyspnea during WBV less often than during the following exercises described by others: resistance training, walking on a treadmill or during the 6-minute walk test. During the presented study, oxygen saturation in the WBV group decreased by 1%, from 97 to 96%. The clinical significance of this effect was negligible due to the lack of hypoxemia and not reaching the critical level for exercise – SpO₂ ≤ 85%.

The presented environmental study showed that a WBV session can be performed in patients with COPD without inducing dyspnea, as during other forms of exercise. There were also no significant differences between WBV and SWBV in terms of heart rate or oxygen saturation. Taking into account the known beneficial effects of WBV on peripheral muscle function and functional independence, the presented results open the field for long-term studies on WBV in COPD, which can be conducted in patients’ homes.

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