Whole body vibration training during allogeneic hematopoietic cell transplantation—the effects on patients’ physical capacity

Abstract

Patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) experience a considerable decline in physical and psycho-social capacity. Since whole body vibration (WBV) is known to efficiently stimulate the neuromuscular system and enhance cardiorespiratory fitness and muscle strength in frail individuals, we hypothesized that WBV would maintain various physical and psychological capacities in patients during alloHCT. Seventy-one patients were randomly allocated to either an intervention group (IG) doing WBV or an active control group (CG) doing mobilization exercises five times per week. We determined peak oxygen consumption (VO 2peak) and maximum power, maximum strength, functional performance, body composition, quality of life (QoL), and fatigue. Tests were carried out before conditioning therapy, at hospital discharge and at day ± 180 (follow-up). As 18 patients did not participate in post-intervention assessment and follow-up data from 9 patients was not collectible, per-protocol (PP) analysis of 44 patients is presented. During hospitalization, WBV maintained maximum strength, height, and power output during jumping, as well as reported QoL, physical functioning, and fatigue level compared with mobilization. At follow-up, relative VO 2peak (p = 0.035) and maximum power (p = 0.011), time and power performing chairrising test (p = 0.022; p = 0.009), and reported physical functioning (p = 0.035) significantly increased in the IG, while fatigue decreased (p = 0.005). CG's body cell mass and phase angle had significantly decreased at follow-up (p = 0.002; p = 0.004). Thus, WBV might maintain maximum strength, functional performance, QoL, and fatigue during alloHCT, while cardiorespiratory fitness might benefit from accelerated recovery afterwards.

Impact of whole-body vibration exercise on physical performance and bone turnover in patients with monoclonal gammopathy of undetermined significance

“…WBV as intervention was selected for this type of patients because i) available data confirms this type of exercise to be safe [33] , ii) WBV is time efficient, iii) WBV allows employing established principles of exercise intervention in untrained elderly patients [27] and iv) evidence reveals that WBV vibration is a potent stimulus to induce favorable changes in bone metabolism and architecture [43] . There is clear evidence that exercise intervention and specifically WBV elicit improvements in neuro-muscular performance [35] , [41] . Accordingly, the comprehensive assessment of physical performance in the present investigation was an integral part of the outcome measures [60] .…”

“…Many findings confirm safety and feasibility as well as efficacy of low-magnitude high-frequency WBV for improving physical performance in healthy subjects as well as in adult patients with chronic diseases, chemotherapy-induced peripheral neuropathy as well as pediatric cancer patients [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] . More recently, favorable effects of WBV on quality of life, physical functioning, and fatigue were evidenced in patients with hematological malignancies [41] , [42] . Beyond the well-established neuromuscular adaption, further evidence implies positive responses of WBV on bone metabolism and bone mineral density in patients with osteoporosis [43] , [44] .…”

Cardiopulmonary performance in allogeneic hematopoietic cell transplantation recipients—evaluation of pre-transplant risk assessments

“…We enrolled a sample of 71 patients in this study [25]. Data on 59 patients were used for survival analysis: four patients had to be excluded due to a nonmalignant disease, two died before alloHCT, medical data were missing on one patient, and five patients were unable to perform CPET (four patients due to inappropriate blood values, one due to a respiratory infection).…”

“…This survival analysis relied on the baseline data from a randomized controlled trial [25]. This study was designed to investigate the effects of whole body vibration training on patient's physical performance during alloHCT.…”

“…Included patients underwent study assessments prior to their first administration of conditioning therapy including CPET and body composition analysis in the course of baseline procedure. More information about the study design and inclusion and exclusion criteria can be found elsewhere [25]. For OS-and NRM-analysis, patients were followed for 2 years after alloHCT.…”