Is There a Role For Whole Body Vibration in Protecting Cardiovascular Disease?

Keywords
Cardiovascular Diseases; Mortality; Exercise/prevention and control; Vibration; Exercise Movement Techniques; Mobility; Stroke/rehabilitation

Cardiovascular disease is the leading cause of death worldwide. In this context, it is well accepted that physical activity plays a critical role as a powerful therapeutic strategy for prevention and progression of cardiovascular disease, both in experimental models and in different clinical situations.^1,2

Whole body vibration training (WBV) is a new intriguing training program. Importantly, if vibration-induced protection is an effective method of exercise, it could be an alternative to exercise training especially for those who are unable to perform the traditional exercise. Therefore, the effects of WVB on different systems, including the cardiovascular system, has been investigated in recent years.

Considering clinical studies, the results suggesting benefits with this strategy have been conflicting. For example, the effects of WBV on neuromuscular performance, mobility, spasticity, and cardiovascular responses have been studied after stroke. Although some positive results were reported, recent systematic review concluded that there is no solid evidence confirming the beneficial effects of WBV among people with stroke.³ On the other hand, in pediatric cancer patients, WBV improved lower extremity muscle mass and strength, balance control, gait, and walking ability.⁴ Likewise, in patients with moderate COPD, WBV increased physical performance and quality of life. However, there were no effects on inflammatory and oxidative biomarkers.⁵

In experimental models, WBV therapy after ischemia reduced brain damage in senescent rats.⁶ In another model, WBV attenuates oxidative stress to ameliorate liver steatosis and improves insulin resistance in db/db mice.⁷ Likewise, whole-body vibration reversed ageing-induced increases in hepatic lipid storage in mice.⁸

In this issue of the Arquivos Brasileiros de Cardiologia, Autor et al studied the safety and efficacy of vibration on myocardial ischemia-reperfusion injury.⁹ Twenty four male Wistar rats were divided into control and vibration groups and all the rats were subjected to myocardial IR injury. Vibration training consisted of vertical sinusoidal whole body vibration for 30 min per day, 6 days per week. The data showed that vibration training increased the cardiac tolerance to IR injury in rats, as evidenced by the reduction of infarct size and cardiac arrhythmias, and by facilitation of spontaneous defibrillation.

Although promising, these results should be interpreted with caution, because not infrequently, the success of the experimental treatments studied does not replicate when applied to clinical studies. Additionally, cardioprotection strategies in situations of ischemia reperfusion is the main model used to exemplify the difficulties of translational medicine, since positive results from experimental studies are obfuscated by the fact that to date, cardioprotection strategies in clinical studies have shown negative results.¹⁰

For the above, although the data are not consistent, there is evidence of the benefit of WBV in different models. However, the vast majority of the evidence comes from experimental research and clinical studies with small numbers of patients, single-centre, non-randomized, and not having cardiovascular events as the main outcomes. Therefore, more studies are needed to clarify the exact role of this new modality of physical activity in the management of cardiovascular disease.

References

• ¹
  Lavie CJ, Milani RV. Cardiac rehabilitation and exercise training in secondary coronary heart disease prevention. Prog Cardiovasc Dis. 2011;53(6):397-403.
• ²
  Ghorbanzadeh V, Mohammadi M, Dariushnejad H, Abhari A, Chodari L, Mohaddes G. Cardioprotective effect of crocin combined with voluntary exercise in rat: role of mir-126 and mir-210 in heart angiogenesis. Arq Bras Cardiol .2017;109(1):54-62.
• ³
  Leite HR, Camargos ACR, Mendonça VA, Lacerda ACR, Soares BA, Oliveira VC. Current evidence does not support whole body vibration in clinical practice in children and adolescents with disabilities: a systematic review of randomized controlled trial. Braz J Phys Ther. 2018 Sep 19.pii:S1413-3555(18)30023-6.
• ⁴
  Rustler V, Däggelmann J, Streckmann F, Bloch W, Baumann FT. Whole-body vibration in children with disabilities demonstrates therapeutic potentials for pediatric cancer populations: a systematic review. Support Care Cancer. Oct 27 [Epub ahead print]
• ⁵
  Neves CDC, Lacerda ACR, Lage VKS, Soares AA, Chaves MGA, Lima LP,et al. Whole body vibration training increases physical measures and quality of life without altering inflammatory-oxidative biomarkers in patients with moderate COPD. J Appl Physiol. 2018;125(2):520-8.
• ⁶
  Raval AP, Schatz M, Bhattacharya P, d'Adesky N, Rundek T, Dietrich WD, et al. Whole body vibration therapy after ischemia reduces brain damage in reproductively senescent female rats. Int J Mol Sci. 2018;19(9):2749.
• ⁷
  Liu Y, Zhai M, Guo F, Shi T, Liu J, Wang X, et al. whole body vibration improves insulin resistance in db/db mice: amelioration of lipid accumulation and oxidative stress. Appl Biochem Biotechnol. 2016; 179(5):819-29.
• ⁸
  Reijne AC, Ciapaite J, van Dijk TH, Havinga R, van der Zee EA, Groen AK, et al. Whole-body vibration partially reverses aging-induced increases in visceral adiposity and hepatic lipid storage in mice. PLoS One 2016; 11(2):e0149419.
• ⁹
  Shekarforoush S, Naghii MR. Whole-body vibration training increases myocardial salvage against acute ischemia in adult male rats. Arq Bras Cardiol. 2019; 112(1):32-37.
• ¹⁰
  Garcia LR, Polegato BF, Zornoff LAM. Challenges of translational science. Arq Bras Cardiol 2017;108(5):388-9.

Publication Dates

• Publication in this collection
  Jan 2019