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Whole-Body Vibration Therapy in Patients with Pulmonary Hypertension and Right Heart Failure: Lessons from a Pilot Study

  • Felix GerhardtEmail author
  • Stephan Rosenkranz
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Abstract

In patients with pulmonary arterial hypertension (PAH) in addition to targeted medication, supportive training programs may be beneficial. In this pilot study, we evaluated the feasibility, effectiveness, and safety of oscillatory whole-body vibration (WBV) in patients on stable targeted therapy. We randomized 22 patients with PAH (PAP ≥ 25 mmHg and pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg) in WHO functional class II or III to receive training (16 sessions of 1 h within 4 weeks) or to a control group that subsequently received WBV. Follow-up measures included 6-minute walking, cardiopulmonary exercise test, echocardiography, N-terminal prohormone of brain natriuretic peptide (NTproBNP), and functional analytic parameters (“chair-rising” and “two-leg jump” test) as well as health-related quality of life (HRQoL; SF-36, LH-PH questionnaires). Patients who underwent WBV showed a significant improvement of 39.7 ± 7.8 m in 6-min walking distance (6MWD) (p < 0.05; WBV +35.4 ± 10.9 m, control group −4.4 ± 7.6 m). Taken together, all patients (n = 22) showed significant net improvements versus baseline in the 6MWD (+38.6 m), peakVO2 (+65.7 mL/min), anaerobic threshold (+40.9 mL VO2/min), muscle power (+4.4%), and HRQoL (SF-36 + 9.7, LPH −11.5 points) (all p < 0.05). WBV was well tolerated in all patients. With this concept of “passive” training, WBV can improve exercise capacity and quality of life even in physically very limited patients substantially.

Keywords

Pulmonary hypertension Right heart failure Training Whole-body vibration 

References

  1. 1.
    Hoeper MM, Humbert M, Souza R, et al. A global view of pulmonary hypertension. Lancet Respir Med. 2016;4:306–22.CrossRefGoogle Scholar
  2. 2.
    Humbert M, Guignabert C, Bonnet S, et al. Pathology and pathobiology of pulmonary hypertension: state of the art and research perspectives. Eur Respir J. 2019;53(1). pii: 1801887.CrossRefGoogle Scholar
  3. 3.
    Olschewski A, Berghausen EM, Eichstaedt CA, et al. Pathobiology, pathology and genetics of pulmonary hypertension: update from the Cologne Consensus Conference 2018. Int J Cardiol. 2018;272S:4–10.CrossRefGoogle Scholar
  4. 4.
    Rosenkranz S. Pulmonary hypertension 2015: current definitions, terminology, and novel treatment options. Clin Res Cardiol. 2015;104:197–207.CrossRefGoogle Scholar
  5. 5.
    Rosenkranz S, Howard LS, Gomberg-Maitland M, Hoeper MM. Systemic consequences of pulmonary hypertension and right-sided heart failure. Circulation. 2020 [Epub ahead of press].Google Scholar
  6. 6.
    Loewe B, Graefe K, Ufer C, et al. Anxiety and depression in patients with pulmonary hypertension. Psychosom Med. 2004;66:831–6.CrossRefGoogle Scholar
  7. 7.
    Mereles D, Ehlken N, Kreuscher S, et al. Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation. 2006;114:1482–9.CrossRefGoogle Scholar
  8. 8.
    Gruenig E, Ehlken N, Ghofrani A, et al. Effect of exercise and respiratory training on clinical progression and survival in patients with severe chronic pulmonary hypertension. Respiration. 2011;81:394–401.CrossRefGoogle Scholar
  9. 9.
    Galiè N, Humbert M, Vachiery JL, et al. 2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: the Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). Endorsed by: association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT). Eur Heart J. 2016;37:67–119.CrossRefGoogle Scholar
  10. 10.
    Cochrane DJ, Loram ID, Stannard SR, Rittweger J. Changes in joint angle, muscle-tendon complex length, muscle contractile tissue displacement and modulation of EMG activity during acute whole-body vibration. Muscle Nerv. 2009;40(3):420–9.CrossRefGoogle Scholar
  11. 11.
    Ritzmann R, Kramer A, Gollhofer A, Taube W. The effect of whole body vibration on the H-reflex, the stretch reflex, and the short-latency response during hopping. Scand J Med Sci Sports. 2013;23(3):331–9.CrossRefGoogle Scholar
  12. 12.
    Rittweger J, Schiessl H, Felsenberg D. Oxygen uptake during whole-body vibration exercise: comparison with squatting as a slow voluntary movement. Eur J Appl Physiol. 2001;86(2):169–73.CrossRefGoogle Scholar
  13. 13.
    Otsuki T, Takanami Y, Aoi W, et al. Arterial stiffness acutely decreases after whole-body vibration in humans. Acta Physiol. 2008;194:189–94.CrossRefGoogle Scholar
  14. 14.
    Pérez-Turpin JA, Zmijewski P, Jimenez-Olmedo JM, et al. Effects of whole body vibration on strength and jumping performance in volleyball and beach volleyball players. Biol Sport. 2014;31:239–45.CrossRefGoogle Scholar
  15. 15.
    Bruyere O, Wuidart MA, Di Palma E, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Arch Phys Med Rehabil. 2005;86:303–7.CrossRefGoogle Scholar
  16. 16.
    Álvarez-Barbosa F, del Pozo-Cruz J, del Pozo-Cruz B, et al. Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+. Maturitas. 2014;79:456–63.CrossRefGoogle Scholar
  17. 17.
    O’Keefe K, Orr R, Huang P, et al. The effect of whole body vibration exposure on muscle function in children with cystic fibrosis: a pilot efficacy trial. J Clin Med Res. 2013;5:205–16.PubMedPubMedCentralGoogle Scholar
  18. 18.
    Kantele S, Karinkanta S, Sievänen H. Effects of long-term whole-body vibration training on mobility in patients with multiple sclerosis: a meta-analysis of randomized controlled trials. J Neurol Sci. 2015;358:31–7.CrossRefGoogle Scholar
  19. 19.
    Greulich T, Nell C, Koepke J, et al. Benefits of whole body vibration training in patients hospitalised for COPD exacerbations—a randomized clinical trial. BMC Pulm Med. 2014;14:60.CrossRefGoogle Scholar
  20. 20.
    Furness T, Joseph C, Naughton G, et al. Benefits of whole-body vibration to people with COPD: a community-based efficacy trial. BMC Pulm Med. 2014;14:80.CrossRefGoogle Scholar
  21. 21.
    Gerhardt F, Dumitrescu D, Beccard R, et al. Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension: a randomized clinical trial. Heart. 2017;103:592–8.CrossRefGoogle Scholar
  22. 22.
    The Criteria Committee of the New York Heart Association. Nomenclature and criteria for diagnosis of diseases of the heart and great vessels. 9th ed. Boston, MA: Little, Brown & Co; 1994. p. 253–6.Google Scholar
  23. 23.
    Ulrich S, Fischler M, Speich R, et al. Wrist actigraphy predicts outcome in patients with pulmonary hypertension. Respiration. 2013;86:45–51.CrossRefGoogle Scholar
  24. 24.
    Wilkens H, Grimminger F, Hoeper M, et al. Burden of pulmonary arterial hypertension in Germany. Respir Med. 2010;104:902–10.CrossRefGoogle Scholar
  25. 25.
    Grünig E, et al. ERS statement on exercise training and rehabilitation in patients with severe chronic pulmonary hypertension. Eur Respir J. 2019;53:1800332.CrossRefGoogle Scholar
  26. 26.
    Ehlken N. Economic evaluation of exercise training in patients with pulmonary hypertension. Lung. 2014;192:359–36.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Klinik III für Innere Medizin (Kardiologie, Pneumologie und Internistische Intensivmedizin)Herzzentrum der Universität zu KölnKölnGermany

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