Advertisement

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

  • Adriano P. Simão
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil

    Multicenter Post Graduation Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo, Brazil
    Search for articles by this author
  • Núbia C. Avelar
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil

    Multicenter Post Graduation Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo, Brazil
    Search for articles by this author
  • Rosalina Tossige-Gomes
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
    Search for articles by this author
  • Camila D. Neves
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
    Search for articles by this author
  • Vanessa A. Mendonça
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil

    Multicenter Post Graduation Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo, Brazil
    Search for articles by this author
  • Aline S. Miranda
    Affiliations
    Immunopharmacology Laboratory, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
    Search for articles by this author
  • Mauro M. Teixeira
    Affiliations
    Immunopharmacology Laboratory, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
    Search for articles by this author
  • Antônio L. Teixeira
    Affiliations
    Immunopharmacology Laboratory, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
    Search for articles by this author
  • André P. Andrade
    Affiliations
    Physical Education School, Occupational Therapy and Physiotherapy, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
    Search for articles by this author
  • Cândido C. Coimbra
    Affiliations
    Endocrinology Laboratory, Biological Sciences Institute, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
    Search for articles by this author
  • Ana Cristina Lacerda
    Correspondence
    Reprint requests to Ana Cristina R. Lacerda, PhD, School of Health and Biological Sciences, Exercise Physiology Laboratory, Federal University of the Jequitinhonha and Mucuri Valleys, Gloria's St #187, DownTown, 39100-000 Diamantina, Minas Gerais, Brazil
    Affiliations
    Exercise Physiology Laboratory, School of Health and Biological Sciences, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil

    Multicenter Post Graduation Program in Physiological Sciences, Brazilian Society of Physiology, São Paulo, Brazil
    Search for articles by this author
Published:April 30, 2012DOI:https://doi.org/10.1016/j.apmr.2012.04.017

      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.

      Key Words

      List of Abbreviations:

      BMI (body mass index), g (gravity), IL (interleukin), OA (osteoarthritis), sTNFR1 (soluble tumor necrosis factor-α receptor-1), sTNFR2 (soluble tumor necrosis factor-α receptor-2), sTNFRs (soluble receptors of tumor necrosis factor-α), TNF-α (tumor necrosis factor-α), TNFR1 (cell surface tumor necrosis factor-α receptor-1), TNFR2 (cell surface tumor necrosis factor-α receptor-2), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Kuettner K.E.
        • Cole A.A.
        Cartilage degeneration in different human joints.
        Osteoarthritis Cartilage. 2005; 13: 93-103
        • Miller G.D.
        • Nicklas B.J.
        • Loeser R.F.
        Inflammatory biomarkers and physical function in older, obese adults with knee pain and self-reported osteoarthritis after intensive weight-loss therapy.
        J Am Geriatr Soc. 2008; 56: 644-651
        • Penninx B.W.
        • Abbas H.
        • Ambrosius W.
        • et al.
        Inflammatory markers and physical function among older adults with knee osteoarthritis.
        J Rheumatol. 2004; 31: 2027-2031
        • Englund M.
        The role of biomechanics in the initiation and progression of OA of the knee.
        Best Pract Res Clin Rheumatol. 2010; 24: 39-46
        • Fernandes J.C.
        • Martel-Pelletier J.
        • Pelletier J.P.
        The role of cytokines in osteoarthritis pathophysiology.
        Biorheology. 2002; 39: 237-246
        • Jan M.H.
        • Lin C.H.
        • Lin Y.F.
        • Lin J.J.
        • Lin D.H.
        Effects of weight-bearing versus nonweight-bearing exercise on function, walking speed, and position sense in participants with knee osteoarthritis: a randomized controlled trial.
        Arch Phys Med Rehabil. 2009; 90: 897-904
        • Dunlop D.D.
        • Semanik P.
        • Song J.
        • et al.
        Moving to maintain function in knee osteoarthritis: evidence from the osteoarthritis initiative.
        Arch Phys Med Rehabil. 2010; 91: 714-721
        • Verschueren S.M.
        • Roelants M.
        • Delecluse C.
        • Swinnen S.
        • Vanderschueren D.
        • Boonen S.
        Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study.
        J Bone Miner Res. 2004; 19: 352-359
        • Roelants M.
        • Delecluse C.
        • Verschueren S.M.
        Whole-body-vibration training increases knee-extension strength and speed of movement in older women.
        J Am Geriatr Soc. 2004; 52: 901-908
        • Trans T.
        • Aaboe J.
        • Henriksen M.
        • Christensen R.
        • Bliddal H.
        • Lund H.
        Effect of whole body vibration exercise on muscle strength and proprioception in females with knee osteoarthritis.
        Knee. 2009; 16: 256-261
        • Bogaerts A.
        • Verschueren S.
        • Delecluse C.
        • Claessens A.L.
        • Boonen S.
        Effects of whole body vibration training on postural control in older individuals: a 1 year randomized controlled trial.
        Gait Posture. 2007; 26: 309-316
        • Delecluse C.
        • Roelants M.
        • Verschueren S.
        Strength increase after whole-body vibration compared with resistance training.
        Med Sci Sports Exerc. 2003; 35: 1033-1041
        • Hinton R.
        • Moody R.L.
        • Davis A.W.
        • Thomas S.F.
        Osteoarthritis: diagnosis and therapeutic considerations.
        Am Fam Physician. 2002; 65: 841-848
        • Kellgren J.H.
        • Lawrence J.S.
        Radiological assessment of osteo-arthrosis.
        Ann Rheum Dis. 1957; 16: 494-502
        • Schiphof D.
        • de Klerk B.M.
        • Koes B.W.
        • Bierma-Zeinstra S.
        Good reliability, questionable validity of 25 different classification criteria of knee osteoarthritis: a systematic appraisal.
        J Clin Epidemiol. 2008; 61: 1205-1215
        • Bertolucci P.H.
        • Brucki S.M.
        • Campacci S.R.
        • Juliano Y.
        [The Mini-Mental State Examination in a general population: impact of educational status] [Portuguese].
        Arq Neuropsiquiatr. 1994; 52: 1-7
        • Rees S.S.
        • Murphy A.J.
        • Watsford M.L.
        Effects of whole body vibration on postural steadiness in an older population.
        J Sci Med Sport. 2009; 12: 440-444
        • Avelar N.C.
        • Simao A.P.
        • Tossige-Gomes R.
        • et al.
        The effect of adding whole-body vibration to squat training on the functional performance and self-report of disease status in elderly patients with knee osteoarthritis: a randomized, controlled clinical study.
        J Altern Complement Med. 2011; 17: 1149-1155
        • Griffin M.J.
        Minimum health and safety requirements for workers exposed to hand-transmitted vibration and whole-body vibration in the European Union; a review.
        Occup Environ Med. 2004; 61: 387-397
        • Kawanabe K.
        • Kawashima A.
        • Sashimoto I.
        • Takeda T.
        • Sato Y.
        • Iwamoto J.
        Effect of whole-body vibration exercise and muscle strengthening, balance, and walking exercises on walking ability in the elderly.
        Keio J Med. 2007; 56: 28-33
        • Harada N.
        • Chiu V.
        • Damronrodriguez J.
        • Fowler E.
        • Siu A.
        • Reuben D.B.
        Screening for balance and mobility impairment in elderly individuals living in residential care facilities.
        Phys Ther. 1995; 75: 462-469
        • Fernandes M.I.
        Tradução e validação do questionário de qualidade de vida específico para a osteoartrose WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) para a língua portuguesa [dissertação].
        Universidade Federal de São Paulo, São Paulo2002
        • Bellamy N.
        • Buchanan W.W.
        • Goldsmith C.H.
        • Campbell J.
        • Stitt L.W.
        Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee.
        J Rheumatol. 1988; 15: 1833-1840
        • Miyamoto S.T.
        • Lombardi Junior I.
        • Berg K.O.
        • Ramos L.R.
        • Natour J.
        Brazilian version of the Berg Balance Scale.
        Braz J Med Biol Res. 2004; 37: 1411-1421
        • Berg K.O.
        • Maki B.E.
        • Williams J.I.
        • Holliday P.J.
        • Wood-Dauphinee S.L.
        Clinical and laboratory measures of postural balance in an elderly population.
        Arch Phys Med Rehabil. 1992; 73: 1073-1080
        • Abreu S.S.E.
        • Caldas C.P.
        Gait speed, balance and age: a correlational study among elderly women with and without participation in a therapeutic exercise program.
        Rev Bras Fisioter. 2008; 12: 324-330
        • ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories
        ATS statement: guidelines for the six-minute walk test.
        Am J Respir Crit Care Med. 2002; 166: 111-117
        • Steffen T.M.
        • Hacker T.A.
        • Mollinger L.
        Age- and gender-related test performance in community-dwelling elderly people: Six-Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds.
        Phys Ther. 2002; 82: 128-137
        • Cohen J.
        A power primer.
        Psychol Bull. 1992; 112: 155-159
        • Cohen J.
        The earth is round (p < .05).
        Am Psychol. 1994; 49: 997-1003
        • Portney L.G.
        • Watkins M.P.
        Foundations of clinical research: applications to practice.
        3rd ed. Prentice Hall, Upper Saddle River2008
        • Montero-Odasso M.
        • Schapira M.
        • Soriano E.R.
        • et al.
        Gait velocity as a single predictor of adverse events in healthy seniors aged 75 years and older.
        J Gerontol A Biol Sci Med Sci. 2005; 60: 1304-1309
        • Avdic D.
        • Pecar D.
        Significance of specificity of Tinetti B-POMA test and fall risk factor in third age of life.
        Bosn J Basic Med Sci. 2006; 6: 50-57
        • Madureira M.M.
        • Takayama L.
        • Gallinaro A.L.
        • Caparbo V.F.
        • Costa R.A.
        • Pereira R.M.
        Balance training program is highly effective in improving functional status and reducing the risk of falls in elderly women with osteoporosis: a randomized controlled trial.
        Osteoporos Int. 2007; 18: 419-425
        • Mbourou G.A.
        • Lajoie Y.
        • Teasdale N.
        Step length variability at gait initiation in elderly fallers and non-fallers, and young adults.
        Gerontology. 2003; 49: 21-26
        • Bautmans I.
        • Van Hees E.
        • Lemper J.C.
        • Mets T.
        The feasibility of Whole Body Vibration in institutionalised elderly persons and its influence on muscle performance, balance and mobility: a randomised controlled trial [ISRCTN62535013].
        BMC Geriatr. 2005; 5: 17
        • van Baar M.E.
        • Dekker J.
        • Oostendorp R.A.
        • Bijl D.
        • Voorn T.B.
        • Bijlsma J.W.
        Effectiveness of exercise in patients with osteoarthritis of hip or knee: nine months' follow up.
        Ann Rheum Dis. 2001; 60: 1123-1130
        • Murphy S.L.
        • Strasburg D.M.
        • Lyden A.K.
        • et al.
        Effects of activity strategy training on pain and physical activity in older adults with knee or hip osteoarthritis: a pilot study.
        Arthritis Rheum. 2008; 59: 1480-1487
        • Liu C.J.
        • Latham N.K.
        Progressive resistance strength training for improving physical function in older adults.
        Cochrane Database Syst Rev. 2009; (CD002759)
        • Aderka D.
        • Engelmann H.
        • Maor Y.
        • Brakebusch C.
        • Wallach D.
        Stabilization of the bioactivity of tumor necrosis factor by its soluble receptors.
        J Exp Med. 1992; 175: 323-329
        • Goekoop R.J.
        • Kloppenburg M.
        • Kroon H.M.
        • et al.
        Low innate production of interleukin-1beta and interleukin-6 is associated with the absence of osteoarthritis in old age.
        Osteoarthritis Cartilage. 2010; 18: 942-947
        • Goldring S.R.
        • Goldring M.B.
        The role of cytokines in cartilage matrix degeneration in osteoarthritis.
        Clin Orthop Relat Res. 2004; : S27-S36
        • Waetzig G.H.
        • Rosenstiel P.
        • Arlt A.
        • et al.
        Soluble tumor necrosis factor (TNF) receptor-1 induces apoptosis via reverse TNF signaling and autocrine transforming growth factor-beta1.
        FASEB J. 2005; 19: 91-93
        • Gokhale R.
        • Chandrashekara S.
        • Vasanthakumar K.C.
        Cytokine response to strenuous exercise in athletes and non-athletes—an adaptive response.
        Cytokine. 2007; 40: 123-127
        • Kaneyama K.
        • Segami N.
        • Yoshimura H.
        • Honjo M.
        • Demura N.
        Increased levels of soluble cytokine receptors in the synovial fluid of temporomandibular joint disorders in relation to joint effusion on magnetic resonance images.
        J Oral Maxillofac Surg. 2010; 68: 1088-1093
        • Cope A.P.
        • Aderka D.
        • Doherty M.
        • et al.
        Increased levels of soluble tumor necrosis factor receptors in the sera and synovial fluid of patients with rheumatic diseases.
        Arthritis Rheum. 1992; 35: 1160-1169