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      Whole-body vibration training versus conventional balance training in patients with severe COPD—a randomized, controlled trial

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          Abstract

          Background

          Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training.

          Methods

          48 patients with severe COPD (FEV 1: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5–26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses.

          Results

          Static balance performance improved significantly more ( p = 0.032) in favor of WBV (path length during semi-tandem stand: − 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more ( p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. − 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s 2, p = 0.018 vs. 0.01 ± 0.11 m/s 2, p = 0.71).

          Conclusions

          WBV can improve balance performance and muscular power significantly more compared to conventional balance training.

          Trial registration: Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03157986&cntry=&state=&city=&dist = 

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12931-021-01688-x.

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          Most cited references48

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          An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation.

          Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our knowledge of its efficacy and scope. The purpose of this Statement is to update the 2006 document, including a new definition of pulmonary rehabilitation and highlighting key concepts and major advances in the field. A multidisciplinary committee of experts representing the ATS Pulmonary Rehabilitation Assembly and the ERS Scientific Group 01.02, "Rehabilitation and Chronic Care," determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant clinical and scientific expertise. The final content of this Statement was agreed on by all members. An updated definition of pulmonary rehabilitation is proposed. New data are presented on the science and application of pulmonary rehabilitation, including its effectiveness in acutely ill individuals with chronic obstructive pulmonary disease, and in individuals with other chronic respiratory diseases. The important role of pulmonary rehabilitation in chronic disease management is highlighted. In addition, the role of health behavior change in optimizing and maintaining benefits is discussed. The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.
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            An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.

            Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers. The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease. Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT. This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results.
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              Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations.

              This systematic review update includes 54 randomised controlled trials and confirms that exercise as a single intervention can prevent falls (pooled rate ratio 0.84, 95% CI 0.77-0.91). Meta-regression revealed programs that included balance training, contained a higher dose of exercise and did not include walking training to have the greatest effect on reducing falls. We therefore recommend that exercise for falls prevention should provide a moderate or high challenge to balance and be undertaken for at least 2 hours per week on an ongoing basis. Additionally, we recommend that: falls prevention exercise should target both the general community and those at high risk for falls; exercise may be undertaken in a group or home-based setting; strength and walking training may be included in addition to balance training but high risk individuals should not be prescribed brisk walking programs; and other health-related risk factors should also be addressed.
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                Author and article information

                Contributors
                rainer.gloeckl@gmx.de
                Journal
                Respir Res
                Respir Res
                Respiratory Research
                BioMed Central (London )
                1465-9921
                1465-993X
                4 May 2021
                4 May 2021
                2021
                : 22
                : 138
                Affiliations
                [1 ]GRID grid.10253.35, ISNI 0000 0004 1936 9756, Department of Pulmonary Rehabilitation, , Philipps-University of Marburg, German Center for Lung Research, ; Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany
                [2 ]GRID grid.490689.a, Institute for Pulmonary Rehabilitation Research, , Schoen Klinik Berchtesgadener Land – Schoenau am Koenigssee, ; Königsee, Germany
                [3 ]GRID grid.6936.a, ISNI 0000000123222966, Department of Prevention, Rehabilitation and Sports Medicine, , Technical University of Munich, ; Munich, Germany
                [4 ]GRID grid.10253.35, ISNI 0000 0004 1936 9756, Department of Internal Medicine, Division of Pulmonary Diseases, , Philipps University of Marburg, ; Marburg, Germany
                [5 ]GRID grid.21604.31, ISNI 0000 0004 0523 5263, Teaching Hospital, , Paracelsus Medical University, ; Salzburg, Austria
                Author information
                http://orcid.org/0000-0002-2741-2748
                Article
                1688
                10.1186/s12931-021-01688-x
                8097810
                33947416
                b786e0b8-24b4-4b35-b72e-25e2a33de1f7
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 30 October 2020
                : 18 March 2021
                Categories
                Research
                Custom metadata
                © The Author(s) 2021

                Respiratory medicine
                chronic obstructive pulmonary disease,pulmonary rehabilitation,exercise,neuromuscular power,force measurement platform,vibration platform

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