Original article
Functional Performance and Inflammatory Cytokines After Squat Exercises and Whole-Body Vibration in Elderly Individuals With Knee Osteoarthritis

https://doi.org/10.1016/j.apmr.2012.04.017Get rights and content

Abstract

Simão AP, Avelar NC, Tossige-Gomes R, Neves CD, Mendonça VA, Miranda AS, Teixeira MM, Teixeira AL, Andrade AP, Coimbra CC, Lacerda AC. Functional performance and inflammatory cytokines after squat exercises and whole-body vibration in elderly individuals with knee osteoarthritis.

Objective

To investigate the effects of squat exercises combined with whole-body vibration on the plasma concentration of inflammatory markers and the functional performance of elderly individuals with knee osteoarthritis (OA).

Design

Clinical, prospective, randomized, single-blinded study.

Setting

Exercise physiology laboratory.

Participants

Elderly subjects with knee OA (N=32) were divided into 3 groups: (1) squat exercises on a vibratory platform (platform group, n=11); (2) squat exercises without vibration (squat group, n=10); and (3) the control group (n=11).

Interventions

The structured program of squat exercises in the platform and squat groups was conducted 3 times per week, on alternate days, for 12 weeks.

Main Outcome Measures

Plasma soluble tumor necrosis factor-α receptors 1 (sTNFR1) and 2 (sTNFR2) were measured using immunoassays (the enzyme-linked immunosorbent assay method). The Western Ontario and McMaster Universities Osteoarthritis Index questionnaire was used to evaluate self-reported physical function, pain, and stiffness. The 6-minute walk test, the Berg Balance Scale, and gait speed were used to evaluate physical function.

Results

In the platform group, there were significant reductions in the plasma concentrations of the inflammatory markers sTNFR1 and sTNFR2 (P<.001 and P<.05, respectively) and self-reported pain (P<.05) compared with the control group, and there was an increase in balance (P<.05) and speed and distance walked (P<.05 and P<.001, respectively). In addition, the platform group walked faster than the squat group (P<.01).

Conclusions

The results suggest that whole-body vibration training improves self-perception of pain, balance, gait quality, and inflammatory markers in elderly subjects with knee OA.

Section snippets

Methods

This prospective, randomized, single-blinded study assessed variables immediately before and after a 12-week training program. For the allocation of participants, a 1:1 ratio randomization was performed using opaque envelopes for the concealment of allocation. To minimize the chance of bias, opaque, sealed, and serial-numbered envelopes were used that were opened sequentially (only after the participant's name and further details were written on the envelope) and kept in a locked, secure place.

Results

The characteristics of the sample population are shown in table 2. There were no significant differences in age, sex distribution, body height or weight, body mass index (BMI), or the OA grade among the 3 groups (P>.05), which confirmed the baseline homogeneity of the groups. The average age of the participants was 72 years, and the mean BMI was 28.7kg/m2. Most of the sample (87.5%) were women.

All participants in both intervention groups complied with the full intervention program. The overall

Discussion

The results of this study showed that the addition of vibration to squat exercise training improved gait performance and static and dynamic balance and decreased biomarkers and self-perception of pain in elderly patients with knee OA.

The addition of whole-body vibration to squat exercise training generates vertical sinusoidal vibrations that stimulate the primary endings of the muscle spindles, activating α-motor neurons that result in muscle contractions that are comparable to the tonic

Conclusions

The addition of vibration training to squat exercise training improves static and dynamic balance and gait performance. Also, the addition of vibration training reduces the self-perception of pain and inflammatory markers in elderly patients with knee OA.

Suppliers

  • a

    FitVibe; GymnaUniphy NV, Pasweg 6a, 3740 Bilzen, Belgium.

  • b

    Mega Accelerometer, ZPP1-3D-BC The Acceleration Measuring Kit; Mega Electronics Ltd, PO Box 1199 (Microkatu 1) FI-70211, Kuopio, Finland.

  • c

    Stone Fitness Equipment, PO Box 494,

Acknowledgments

We thank the Santa Casa of Diamantina, Minas Gerais, Brazil.

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  • Cited by (0)

    Supported by FAPEMIG, CNPq, and CAPES.

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

    Clinical Trial Registration No.: ACTRN12610000475044.

    In-press corrected proof published online on Jun 15, 2012, at www.archives-pmr.org.

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