Safety of Whole-Body Vibration Exercise for Heart Transplant Recipients

Zusammenfassung

Fragestellung: Die positiven Wirkungen des Ganzkörpervibrationstrainings (WBV) werden bis dato in der Rehabilitation nach Herztransplantation nicht eingesetzt, obwohl gerade diese Patienten oft eine ausgeprägte Muskelschwäche und Osteoporose zeigen. Ziel dieser Studie war es, die Sicherheit eines WBV sowie die kardiovaskulären und metabolischen Reaktionen bei herztransplantierten Patienten zu untersuchen. Material und Methode: 14 männliche, klinisch stabile, herztransplantierte Patienten wurden in diese Studie eingeschlossen. Als Intervention führten die Patienten eine Einheit Ganzkörpervibrationstraining am Galileo 2000 durch. Die Herzfrequenz, systolischer und diastolischer Blutdruck, die Plasmalaktatkonzentration sowie die BORG-Skala wurden zur Bestimmung der objektiven und subjektiven Belastung während WBV herangezogen. Ergebnisse: Abbruchgrund bei WBV war bei jedem Patienten die lokalisierte Muskelschwäche der Beinmuskulatur. Die durchschnittliche Versuchsdauer betrug 248 Sekunden (Range 51 - 607). Herzfrequenz, systolischer und diastolischer Blutdruck sowie die Plasmalaktatkonzentrationen erreichten während des WBV Werte wie bei aerobem Ausdauertraining. Es kam bei keinem Patienten zu unerwarteten Zwischenfällen. Schlussfolgerung: Die Ergebnisse dieser Pilotstudie weisen darauf hin, dass WBV bei herztransplantierten Patienten sicher durchführbar ist. Bei einer Einheit WBV entspricht die kardiovaskuläre und metabolische Antwort von Herztransplantierten jener bei aerobem Ausdauertraining.

Abstract

Purpose: The benefits of whole-body vibration exercise (WBV) have not yet been recognized in heart transplant recipients although these patients often show a severe loss in skeletal muscle strength and bone mineral density over time. At present, WBV is not generally recommended for rehabilitation of transplant patients. The purpose of this study was to document the safety, cardiovascular responses and metabolic changes to WBV in heart transplant patients. Material and Methods: 14 male clinically stable heart transplant recipients were included in this study. The subjects were exposed to one set of whole-body vibration using the Galileo 2000 device. Heart rate, systolic and diastolic blood pressure, blood lactate concentration and the Borg scale were used to determine objective and subjective exertion during WBV. Results: In every patient WBV was terminated due to muscular fatigue. The mean duration of exercise was 248 seconds (range, 51 - 607 seconds). Heart rate, systolic and diastolic blood pressure, lactate concentrations and the Borg score increased during WBV to levels achieved during aerobic exercise. No patient experienced adverse events. Conclusion: The results of this pilot study indicate that WBV is feasible and safe in heart transplant recipients. The cardiovascular and metabolic response of an acute bout of WBV is similar to that of standard aerobic exercise.

Schlüsselwörter

Sicherheit - Ganzkörpervibrationstraining - Herztransplantation - Muskelschwäche - Osteoporose

Key words

Safety - whole-body vibration exercise - heart transplantation - muscle weakness - osteoporosis

References

• 1 Oliver D, Pflugfelder P W, McCartney N, McKelvie R S, Suskin N, Kostuk W J. Acute cardiovascular responses to leg-press resistance exercise in heart transplant recipients.  Int J Cardiol. 2001;  81 61-74
• 2 Hosenpud J D, Novick R J, Breen T J, Daily O P. The registry of the international society for heart and lung transplantation: eleventh official report.  J Heart Lung Transplant. 1994;  13 561-570
• 3 Braith R W, Limacher M C, Leggett S H, Pollock M L. Skeletal muscle strength in heart transplant recipients.  J Heart Lung Transplant. 1993;  12 1018-1023
• 4 Pisani B, Mullen G M. Prevention of osteoporosis in cardiac transplant recipients.  Curr Opin Cardiol. 2002;  17 160-164
• 5 Torvinen S, Kannus P, Sievanen H, Jarvinen T A, Pasanen M, Kontulainen S, Jarvinen T L, Jarvinen M, Oja P, Vuori I. Effect of four-month vertical whole body vibration on performance and balance.  Med Sci Sports Exerc. 2002;  34 1523-1528
• 6 Torvinen S, Kannu P, Sievanen H, Jarvinen T A, Pasanen M, Kontulainen S, Jarvinen T L, Jarvinen M, Oja P, Vuori I. Effect of a vibration exposure on muscular performance and body balance. Randomized cross-over study.  Clin Physiol Funct Imaging. 2002;  22 145-152
• 7 Torvinen S, Sievanen H, Jarvinen T A, Pasanen M, Kontulainen S, Kannus P. Effect of 4-min vertical whole body vibration on muscle performance and body balance: a randomized cross-over study.  Int J Sports Med. 2002;  23 374-379
• 8 Torvinen S, Kannus P, Sievanen H, Jarvinen T A, Pasanen M, Kontulainen S, Nenonen A, Jarvinen T L, Paakkala T, Jarvinen M, Vuori I. Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study.  J Bone Miner Res. 2003 May;  18 876-884
• 9 Rittweger J, Beller G, Felsenberg D. Acute physiological effects of exhaustive whole-body vibration exercise in man.  Clin Physiol. 2000;  20 134-142
• 10 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;  86 169-173
• 11 Rittweger J, Just K, Kautzsch K, Reeg P, Felsenberg D. Treatment of chronic lower back pain with lumbar extension and whole-body vibration exercise: a randomized controlled trial.  Spine. 2002;  27 1829-1834
• 12 Rittweger J, Mutschelknauss M, Felsenberg D. Acute changes in neuromuscular excitability after exhaustive whole body vibration exercise as compared to exhaustion by squatting exercise.  Clin Physiol Funct Imaging. 2003 Mar;  23 81-86
• 13 Cardinale M, Bosco C. The use of vibration as an exercise intervention.  Exerc Sport Sci Rev. 2003;  31 3-7
• 14 Bosco C, Colli R, Introini E, Cardinale M, Tsarpela O, Madella A, Tihanyi J, Viru A. Adaptive responses of human skeletal muscle to vibration exposure.  Clin Physiol. 1999;  19 183-187
• 15 Rubin C, Xu G, Judex S. The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli.  FASEB J. 2001;  15 2225-2229
• 16 Rubin C, Turner S, Bain S, Mallinckrodt C, McLeod K. Low mechanical signals strengthen long bones.  Nature. 2001;  412 603-604
• 17 Borg G. Simple rating methods for estimation of perceived exertion. In: Borg G (ed) Physical Work and Effort. Oxford; Pergamon Press 1976: 39-47
• 18 Niset G, Hermans L, Depelchin P. Exercise and heart transplantation: a review.  Sports Med. 1992;  12 359-379
• 19 Badenhop D T. The therapeutic role of exercise in patients with orthotopic heart transplant.  Med Sci Sports Exerc. 1995;  27 975-985
• 20 Braith R W, Edwards D G. Exercise following heart transplantation.  Sports Med. 2000;  30 171-192
• 21 Schmidt A, Pleiner J, Bayerle-Eder M, Wiesinger G F, Rodler S, Quittan M, Mayer G, Wolzt M. Regular physical exercise improves endothelial function in heart transplant recipients.  Clin Transplant. 2002 Apr;  16 137-143
• 22 Rittweger J, Ehrig J, Just K, Mutschelknauss M, Kirsch K A, Felsenberg D. Oxygen uptake in whole-body vibration exercise: influence of vibration frequency, amplitude, and external load.  Int J Sports Med. 2002;  23 428-432
• 23 Marconi C. Pathophysiology of cardiac transplantation and the challenge of exercise.  Int J Sports Med. 2000;  21, Suppl 2 S106-108
• 24 Marconi C, Marzorati M, Fiocchi R, Mamprin F, Ferrazzi P, Ferretti G, Cerretelli P. Age-related heart rate response to exercise in heart transplant recipients. Functional significance.  Pflugers Arch. 2002;  443 698-706
• 25 Squires R W, Leung T C, Cyr N S, Allison T G, Johnson B D, Ballman K V, Wagner J A, Olson L J, Frantz R P, Edwards B S, Kushwaha S S, Dearani J A, Daly R C, McGregor C G, Rodeheffer R J. Partial normalization of the heart rate response to exercise after cardiac transplantation: frequency and relationship to exercise capacity.  Mayo Clin Proc. 2002;  7 1295-1300
• 26 Gullestad L, Haywood G, Ross H, Bjornerheim R, Geiran O, Kjekshus J, Simonsen S, Fowler M. Exercise capacity of heart transplant recipients: the importance of chronotropic incompetence.  J Heart Lung Transplant. 1996;  15 1075-1083
• 27 Ewert T, Cieza A, Stucki G. ICF in rehabilitation.  Phys Med Rehab Kuror. 2002;  12 157-162
• 28 Gutenbrunner C. Prevention, physical medicine and implications of the International Classification of Functioning, Disability and Health (ICF).  Phys Med Rehab Kuror. 2002;  12 187-189