Review Article

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, Lauren J. Hendricks, Jodie Johnson, Almorette Landman, Marlette Burger
South African Journal of Physiotherapy | Vol 76, No 1 | a1412 | DOI: https://doi.org/10.4102/sajp.v76i1.1412 | © 2020 Karina Berner, Susanna C.S. Albertyn, Sujatha Dawnarain, Lauren J. Hendricks, Jodie Johnson, Almorette Landman, Marlette Burger | This work is licensed under CC Attribution 4.0
Submitted: 29 October 2019 | Published: 11 June 2020

About the author(s)

Karina Berner, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Susanna C.S. Albertyn, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Sujatha Dawnarain, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Lauren J. Hendricks, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Jodie Johnson, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Almorette Landman, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Marlette Burger, Division of Physiotherapy, Department of Health and Rehabilitation Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa


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Abstract

Background: People with chronic obstructive pulmonary disease (COPD) experience various impairments, reducing quality of life (QoL). Rehabilitation that does not elicit dyspnoea, such as strength training, is recommended to improve patient outcomes.

Objectives: To systematically review evidence for the effectiveness of lower limb strengthening combined with whole-body vibration training (WBVT), versus lower limb strengthening alone, in adults with COPD for improving lower limb muscle strength, functional exercise capacity (FEC), pulmonary function and QoL.

Method: Eight databases were searched (inception–May 2019). Only randomised controlled trials (RCTs) with PEDro scores ≥ 5/10 were included. Heterogeneity rendered meta-analyses inappropriate; thus data were synthesised narratively.

Results: Five RCTs (mean PEDro score: 5.8/10) were included. Only one RCT showed a significant difference for leg press peak force (kg) at 12 weeks (p = 0.001), favouring WBVT. FEC improved significantly (p < 0.05) in favour of WBVT at 3 and 12 weeks. Combined training was not more effective for short-term (≤ 12 weeks) improvements in pulmonary function or QoL.

Conclusion: Level II evidence suggests that combining strengthening with WBVT has significant beneficial short-term effects on FEC in adults with COPD. Results are limited by the small number of studies and small sample sizes. Combined WBVT and strengthening was not more effective than strengthening alone for improving lower limb muscle strength, pulmonary function and QoL.

Clinical implications: Combining low (6–10 Hz) to moderate (24–26 Hz) frequency WBVT with strengthening may be a more effective modality to improve FEC than strengthening alone, should resources allow.


Keywords

chronic obstructive pulmonary disease; whole-body vibration training; strength training; pulmonary rehabilitation; lower limb muscle strength; quality of life; functional exercise capacity; pulmonary function

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