Seefried L, Genest F, Luksche N, Schneider M, Fazeli G, Brandl M, Bahner U, A Heidland A
Orthopedic Center of Musculoskeletal Research, Orthopedic Department, University of Würzburg, Germany.
J Musculoskelet Neuronal Interact. 2017 Dec 1;17(4):268-274.
The aim of this study was to assess safety and effectiveness of Whole Body Vibration exercise (WBV) to improve physical performance and parameters of inflammation in patients on maintenance hemodialysis (MHD).
Prospective, open-label trial in n=14 patients on maintenance hemodialysis. Participants performed WBV twice weekly for 12 weeks before (n=8) or after (n=6) hemodialysis sessions. The primary endpoint was physical performance assessed by the Short-Physical-Performance-Battery (SPPB). Secondary endpoints included established parameters of musculoskeletal assessment and blood chemistry.
As compared to baseline, physical performance (SPPB) improved significantly (p=0.035). Moderate advances were also seen for 6-Minute-Walking test, Timed-up-and-go test, jumping height and handgrip strength. Improvements were particularly pronounced in subjects with seriously impaired baseline performance. Skeletal muscle index showed a tendency to better values. Laboratory data exhibited a significant reduction of white blood cell count and a trend to lower levels of hsCRP. WBV was generally well tolerated. Two events of clinically significant blood pressure decline occurred in patients exercising after dialysis sessions.
Results of this pilot study suggest effectiveness and safety of WBV in hemodialysis patients. Beneficial effects may affect both, parameters of physical performance and systemic inflammatory activity, which should be verified in larger scale clinical trials.
本研究旨在评估全身振动训练（WBV）对改善维持性血液透析（MHD）患者身体机能及炎症参数的安全性和有效性。
对14例维持性血液透析患者进行前瞻性开放标签试验。参与者在血液透析治疗前（n = 8）或后（n = 6）每周进行两次WBV训练，共12周。主要终点是通过简短体能状况量表（SPPB）评估身体机能。次要终点包括既定的肌肉骨骼评估参数和血液生化指标。
与基线相比，身体机能（SPPB）显著改善（p = 0.035）。6分钟步行试验、计时起立行走试验、跳跃高度和握力也有适度改善。在基线表现严重受损的受试者中，改善尤为明显。骨骼肌指数有向好的趋势。实验室数据显示白细胞计数显著降低，高敏C反应蛋白水平有降低趋势。WBV总体耐受性良好。透析后锻炼的患者发生了两起具有临床意义的血压下降事件。
这项初步研究的结果表明WBV对血液透析患者有效且安全。有益效果可能同时影响身体机能参数和全身炎症活动，这一点应在更大规模的临床试验中得到验证。
