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1.
J Heart Lung Transplant ; 34(11): 1455-61, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26279196

RESUMO

BACKGROUND: In recent years, some studies have shown that whole-body vibration training (WBVT) may be a beneficial training mode in patients with chronic obstructive pulmonary disease (COPD). However, the effects of WBVT in patients after lung transplantation (LTx) have not yet been investigated. METHODS: Eighty-three LTx patients (56 ± 7 years of age, 51% male, 10 ± 12 weeks post-LTx, forced expiratory volume in 1 second [FEV1] 68 ± 20 percent predicted [% pred], baseline 6-minute walk distance [6MWD] 350 ± 120 meters) admitted to a 4-week inpatient multidisciplinary program of pulmonary rehabilitation (PR) performed supervised endurance and strength training on 5 days per week. In addition, patients were randomly assigned to 1 of 2 supervised intervention groups on 3 days/week: (1) 4 × 2 minutes of bilateral dynamic squat exercises on a side-alternating vibration platform at 24 to 26 Hz (WBVT); and (2) a control group (CON) with the same amount of exercise time on the floor. RESULTS: Seventy patients completed the study (WBVT: n = 34; CON: n = 36). Improvement in 6MWD was significantly (p = 0.029) higher in the WBVT group (83.5 meters [95% CI 65.4 to 101.7]) compared with the CON group (55.2 m [95% CI 37.5 to 72.8]). Also, peak work rate increased significantly (p = 0.042) more in the WBVT group (16.8 W [95% CI 13.5 to 20.5]) than in the CON group (12.6 W [95% CI 9.0 to 16.1]). No adverse events related to the intervention occurred during the study. CONCLUSIONS: A complementary WBVT on top of conventional endurance and strength training seems to be a feasible and safe exercise modality in patients after LTx. Furthermore, it may even enhance the benefits of a comprehensive PR on exercise capacity.


Assuntos
Terapia por Exercício/métodos , Tolerância ao Exercício/fisiologia , Transplante de Pulmão/reabilitação , Educação de Pacientes como Assunto/métodos , Cuidados Pós-Operatórios/métodos , Doença Pulmonar Obstrutiva Crônica/reabilitação , Vibração/uso terapêutico , Feminino , Seguimentos , Volume Expiratório Forçado , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/cirurgia , Testes de Função Respiratória , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
2.
Chron Respir Dis ; 12(3): 212-21, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25904085

RESUMO

In recent years, several studies have shown that whole body vibration training (WBVT) may be a beneficial training mode in a variety of chronic diseases and conditions such as osteoporosis, fibromyalgia, multiple sclerosis, or chronic low back pain. However, a systematic review on the effects of WBVT in patients with chronic obstructive pulmonary disease (COPD) has not been performed yet. An extensive literature search was performed using various electronic databases (PubMed, Embase, LILACS, and PEDro). They were searched from inception until September 20, 2014, using key words like "COPD" and "whole body vibration training." A total of 91 studies could be identified and were screened for relevance by two independent reviewers. Six studies were included in a qualitative analysis. Trials studied either the effects of WBVT versus an inactive control group, versus sham WBVT, during an acute COPD exacerbation or as a modality on top of conventional endurance and strength training. All randomized trials reported a significantly superior benefit on exercise capacity (6-minute walking distance) in favor of the WBVT group. Although there are only few studies available, there is some preliminary evidence that WBVT may be an effective exercise modality to improve functional exercise capacity in patients with COPD.


Assuntos
Tolerância ao Exercício , Doença Pulmonar Obstrutiva Crônica/terapia , Vibração/uso terapêutico , Teste de Esforço , Humanos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Respiration ; 88(5): 399-405, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25323335

RESUMO

BACKGROUND: The Oxymizer® is a special nasal cannula that provides a higher luminal diameter in combination with an incorporated oxygen (O2) reservoir. It is assumed that a higher O2 concentration can be delivered breath by breath in order to increase oxygenation. OBJECTIVE: We aimed to investigate the effects of the Oxymizer on endurance time in comparison to a conventional nasal cannula (CNC). METHODS: Forty-three patients with severe chronic obstructive pulmonary disease (COPD, age 60 ± 9 years, FEV1 37 ± 16% pred.) and indications for LTOT were recruited during pulmonary rehabilitation for this cross-over study. After an initial maximal incremental cycle test, all patients performed 4 cycling endurance time tests at 70% of their peak work rate (twice with the Oxymizer and twice with a CNC, in reverse order). RESULTS: The endurance time was significantly higher when patients cycled while using the Oxymizer in comparison to while using the CNC [858 ± 754 vs. 766 ± 652 s; between-group difference 92 s (95% confidence interval 32-152), p < 0.001]. In addition to a longer cycling duration, O2 saturation at isotime was significantly higher with the Oxymizer (93.5 ± 5.4 vs. 90.4 ± 5.3%; p = 0.027). Furthermore, there was a positive correlation (r = 0.427, p = 0.002) between the O2 flow rate and improvements in the constant work rate test, showing greater improvements in favor of the Oxymizer in patients with a higher demand for O2 (≥ 4 liters/min). CONCLUSION: We show that O2 delivery via the Oxymizer is superior to a CNC with regard to endurance capacity and oxygenation during exercise in patients with severe COPD. It seems that patients with a higher demand for O2 (≥ 4 liters/min), in particular, may benefit more from the use of the Oxymizer.


Assuntos
Catéteres , Exercício Físico , Hipóxia/terapia , Oxigenoterapia/instrumentação , Doença Pulmonar Obstrutiva Crônica/terapia , Idoso , Estudos Cross-Over , Desenho de Equipamento , Tolerância ao Exercício/fisiologia , Feminino , Humanos , Hipóxia/etiologia , Hipóxia/fisiopatologia , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia
4.
Respir Med ; 106(1): 75-83, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22104540

RESUMO

INTRODUCTION: To date endurance and strength training are established and evidence-based exercise methods in patients with chronic obstructive pulmonary disease (COPD). There is an unmet need for further research in new and complementary exercise modalities. Additional whole body vibration training during pulmonary rehabilitation may be such a new approach that has not yet been investigated in patients with COPD. METHODS: Eighty-two patients (65 ± 9 yrs, FEV(1) pred. 38 ± 11%, female 51%) with COPD in GOLD stage III to IV assessed for a 3-week inpatient multidisciplinary rehabilitation program were on top randomly assigned to one of two intervention groups: (1) 3 × 3 min of bilateral dynamic squat exercises on a side-alternating vibration platform at 24-26 Hz three times per week (WBV) and (2) a control group (CON) with the same amount of exercise time without WBV. RESULTS: Thirty-six patients completed the study in each group. The improvement in 6-min walking distance was significantly higher in the WBV-group when compared to the CON-group (WBV: 64 ± 59 m, CON: 37 ± 52 m with a between-group difference of 27 m [95% CI, 1-53], p = 0.046). The time required for a sit-to-stand test also decreased more markedly in the WBV-group than in the CON-group (WBV: -4.0 ± 4.8 s, CON: -2.0 ± 3.1 s with a between-group difference of -1.9 s [95% CI, -4.0 to 0.1], p = 0.067). Improvements in health-related quality of life were similar in both groups. CONCLUSIONS: WBV training seems to be a promising new exercise modality for patients with COPD and may enhance the effects of a multidisciplinary rehabilitation program.


Assuntos
Terapia por Exercício/métodos , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/reabilitação , Testes de Função Respiratória/métodos , Vibração/uso terapêutico , Idoso , Tolerância ao Exercício , Feminino , Humanos , Masculino , Modalidades de Fisioterapia , Estudos Prospectivos , Músculos Respiratórios/fisiopatologia , Fatores de Tempo , Resultado do Tratamento , Caminhada
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