Long-term effects of WBV vibrotherapy in patients with RA

In rheumatoid arthritis (RA), functional capacity is often impaired and patients are forced to lead sedentary lifestyles; in addition, they often take medication with negative effects on bone mass. Researchers at the South African public university in Johannesburg therefore investigated the effects of whole body vibration (WBV) therapy, considered a passive substitute for physical activity, on RA symptoms.

• WBV training significantly improved the functional performance of the RA women in the study – impairment as measured by the mHAQ fell from 1.22 ± 0.19 before the intervention to 0.92 ± 0.19 after the intervention, with the control group remaining at around 1.13 – 1.17 throughout.
• Hip bone mineral density was unchanged in the WBV group (1.01 ± 0.05 before vs 0.94 ± 0.05 g/cm2 after the intervention), whereas it decreased significantly in the control group (0.97 ± 0.05 before vs 0.84 ± 0.05 g/cm2 after the intervention).

• The severity of RA disease did not change during the study and fatigue levels remained unchanged in the control group, while they improved (decreased) in the WBV group (from 4.4 ± 0.63 before to 1.1 ± 0.65 after the intervention).
  

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Study population

Thirty-nine adult female patients diagnosed with RA according to the American College of Rheumatology 1987 and meeting the relevant criteria were included in the study.

Study procedure

The women were randomly assigned to a control group (CON, n = 15) that did not undergo WBV vibrotherapy or to a WBV group (n = 16) that received three months of WBV vibrotherapy, consisting of 2 short sessions per week. Patients were assessed at baseline, immediately after 3 months of intervention and after a further 3 months. Functional performance was analysed using the modified Health Assessment Questionnaire (mHAQ); RA disease activity using the Clinical Disease Activity Index; quality of life using self-assessment of fatigue and pain; physical activity using accelerometry; and bone mineral density (BMD) and body composition using DXA.

Use of vibration in the study

Two 15-minute sessions per week were used (24 sessions/ 12 weeks). Subjects were subjected to WBV (amplitude 3 mm, frequency 30 Hz) in a standing position on a DKN XG 5.0 vertical synchronous vibration platform (DKN Technology, USA), where ten 60-second vibration applications interrupted by 30-second rest periods were applied.

Results

WBV training significantly improved the functional performance of the female RA subjects observed 3 months after the intervention – impairment as measured by the mHAQ decreased from 1.22 ± 0.19 to 0.92 ± 0.19, with CON remaining around 1.13 – 1.17 ± 0.19 (p = 0.02).

The hip BMD was unchanged in the WBV group (1.01 ± 0.05 before vs 0.94 ± 0.05 g/cm2 after the intervention, p = 0.50), while it decreased significantly in the CON group (0.97 ± 0.05 before vs 0.84 ± 0.05 g/cm2 after the intervention, p = 0.01).

RA disease severity did not change during the study and fatigue levels remained unchanged in the CON group, while they improved (decreased) in the WBV group (from 4.4 ± 0.63 before to 1.1 ± 0.65 after the intervention, p = 0.01). Furthermore, in the CON group, women presented less frequent 10-minute periods of light to moderate physical activity at the end of the study (2.8 ± 0.61 instances per day before the intervention vs. 1.8 ± 0.64 after the intervention, p = 0.01), whereas in the WBV group such instances of activity remained the same (3.1 ± 0.59 before vs. 3.0 ± 0.61 after the intervention, p = 0.70).

Comment

WBV therapy offers hope for sustained improvement in functional capacity, mitigation of bone mass loss at the hip, as well as reduction of fatigue in RA.

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