Effect of Whole Body Vibration on Skin Blood Flow and Nitric Oxide Production

Abstract

Neurological and Microvascular FunctionNeuropathies are among the most common complications of diabetes mellitus 1 and are the cause of more than 60% of all nontraumatic amputations in the United States.2 Neuropathy is a set of syndromes, each with a wide range of clinical and subclinical manifestations, the most common of which is distal symmetric polyneuropathy (DSPN).1,3 Distal symmetric polyneuropathy occurs in both type I and type II diabetes, and the symptoms range considerably. Some patients experience no symptoms but show deficits during neurological examinations, while others experience negative symptoms such as loss of thermal and tactile sensations, especially in the lower limbs.1,3 Still others may experience dysesthesia, a painful prickling or electric shock-like sensation in the legs and/or feet, especially at night. 4 The etiology of diabetic neuropathy is multifactorial, 3 making it difficult to identify the treatment. However, a common factor in each of the proposed underlying mechanisms of the pathogenesis is reactive oxygen species, which are the products of metabolic dysfunctions that result from hyperglycemia. [5][6][7] Herein lies some insight into addressing the problem of DSPN. Oxidative stress from these free radicals is implicated in vascular dysfunction, 7 including a change in the expression of endothelial nitric oxide (NO) synthase, 8 resulting in reduced bioavailability of NO. Reduced bioavailability of NO is a factor in nerve ischemia 9 ; therefore, therapies to increase NO may result in increased blood flow and a decrease in symptoms of DSPN.Nitric oxide production is induced by laminar shear stress, resulting from the frictional forces between the vascular endothelium and moving blood. 10 An example of this type of shear stress can be found when blood flows in the vessels during moderate exercise.11,12 Externally applied, low-frequency vibration also results in endothelial shear stress sufficient to produce NO and improve blood flow. [13][14][15][16][17][18] AbstractBackground: Vascular dysfunction due to hyperglycemia in individuals with diabetes is a factor contributing to distal symmetric polyneuropathy (DSPN). Reactive oxygen species reduce the bioavailability of nitric oxide (NO), a powerful vasodilator, resulting in reduced circulation and nerve ischemia. Increases in blood NO concentrations and circulation have been attributed to whole body vibration (WBV). The purpose of this study was to the determine the effects of low-frequency, low-amplitude WBV on whole blood NO concentrations and skin blood flow (SBF) in individuals with symptoms of DSPN. Methods:Ten patients with diabetes and impaired sensory perception in the lower limbs participated in this crossover study. Each submitted to 2 treatment conditions, WBV and sham, with a 1-week washout period between. Blood draws for NO analysis and laser Doppler imager scans of SBF were performed before, immediately after, and following a 5-minute recovery of each of the treatments. Conclusions: These findings demonstrate that pa...

Effects of Whole Body Vibration on Glycemic Indices and Peripheral Blood Flow in Type II Diabetic Patients

“…However, using high frequency, Button et al (13) and Hazell et al (14) reported no significant difference in local blood flow in healthy participants between vibration and control groups. In diabetic patients, and in contrast to Lythgo et al (12) findings on healthy subjects, Johnson et al (15) showed low frequency (26 Hz) and low amplitude (2 mm) vibration increased blood flow (to the skin area in the feet). Similarly, Sañudo et al (16) revealed significant improvement of femoral artery blood flow after 12 weeks of WBV training in diabetic patients (12)(13)(14)(15)(16) Hz, 4 mm, 3 days a week).…”

“…Baum et al (2) revealed FBS and HbA1c levels in type II diabetics were reduced by approximately 6.3% and 0.3% respectively after 12 weeks of WBV using a horizontal swinging platform (30-35 Hz, 2 mm amplitude, 8 bouts of 30 seconds, 3 days a week). More recently, del Pozo-Cruz et al (9) reported 12 weeks of WBV training (12)(13)(14)(15)(16) Hz, 4 mm, 3 days a week) significantly improved levels of FBS and HbA1c. However, in contrast to the beneficial effects reported by Baum et al (2) and del Pozo-Cruz et al (9), Behboudi et al (8) found that FBS and HbA1c levels were not significantly improved after 8 weeks of WBV training (30 Hz, 2 mm, 3 days a week).…”

Potential Effects of Whole-Body Vibration Exercises on Blood Flow Kinetics of Different Populations: A Systematic Review With a Suitable Approach

“…Johnson et al (2014) with a single session, also observed a significant increase in the skin blood flow. These findings are of clinical importance due to endothelial dysfunction with capillary alterations and impairment of the blood flow in this population group (Rajendran et al, 2013;Coelho et al, 2011;Widmer and Lerman 2014;Murray et al, 2004).…”

“…In patients with diabetes, increments in the blood flow speed and maximum diastolic velocity after WBV were observed (Sañudo et al, 2013;Johnson et al, 2014). Johnson et al (2014) with a single session, also observed a significant increase in the skin blood flow.…”

“…In addition, vibration might reduce the viscosity of blood and thereby increase the mean speed of blood flow in the popliteal artery (Kerschan-Schindl et al, 2001) which may be of importance in many populations. The results of the review indicated that in six of the seven studies analyzed, the WBVE has improved the blood flow both in healthy people and in some clinical populations (Sañudo et al, 2013;Herrero et al, 2011a;Herrero et al, 2011b;Johnson et al, 2014), although differences between studies deserve to be analyzed.…”