The effectiveness of combined lower limb strengthening and whole-body vibration, compared to strengthening alone, for improving patient-centred outcomes in adults with COPD: A systematic review.
Karina Berner, Susanna C S Albertyn, Sujatha Dawnarain and 4 others
PMID 32671277WHAT IT FOUND
Adding whole-body vibration to lower limb strength training improved walking distance more than strength training alone in three of five trials.
It did not improve lung function. Isolated leg strength showed no consistent benefit over standard training.
Key findings
01Functional exercise capacity, measured by the six-minute walk test, improved significantly more in the vibration group than the control group in three studies, while two studies found no significant between-group difference.
02Pulmonary function, measured by FEV1, showed no significant differences between groups in any of the three studies that assessed it.
03Lower limb muscle strength results were inconsistent; one study showed significant improvement in leg press force for the vibration group, but another found no between-group difference in knee extension torque.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The review included only five randomised controlled trials with a small total sample size of 263 participants. There was substantial heterogeneity in the intervention protocols, including different frequencies, amplitudes, squatting positions, and durations of training across the studies. Meta-analysis was not performed due to this heterogeneity, so results are reported narratively. Blinding of participants and therapists was not possible in any of the included studies, which may introduce bias. Follow-up periods were short, ranging from 3 to 12 weeks, so long-term effects are unknown. All included studies were conducted in high-income countries, limiting generalisability to other settings. The methodological quality of the included trials was moderate, with PEDro scores ranging from 5 to 7 out of 10.
Declared interests
No specific funding sources or conflicts of interest were declared in the provided text.
The easy way to misread this
Do not assume that whole-body vibration is a necessary component for improving walking distance in COPD patients. The studies varied widely in their protocols, and the control groups in several studies also showed significant improvements. The benefit of adding vibration specifically, rather than the strength training itself, is not consistently proven across all outcomes, particularly for muscle strength and lung function.