[Effects of whole body vibration on bone strength and physical fitness in elderly COPD patients complicated with osteoporosis].

Objective: To investigate the effects of adding whole body vibration (WBV) to routine exercise regimen of pulmonary rehabilitation (PR) on bone strength, lung function and exercise ability of elderly patients with stable chronic obstructive pulmonary disease (COPD) complicated with osteoporosis (OP). Methods: Thirty seven elderly patients with stable COPD were randomly divided into control group (group C, n=12, age: 64.6±3.8 years), conventional PR group (PR group, n=12, age: 66.1±4.9 years), and whole body vibration combined PR group (WP group, n=13, age: 65.5±3.3 years). Before intervention, X-ray and computerized tomography bone scan, bone metabolic markers, pulmonary function, cardiopulmonary exercise, 6-minute walking and isokinetic muscle strength were performed, and then intervened for 36 weeks, three times/week, among which group C subjects were given routine treatment, PR group added aerobic running and static weight resistance on the basis of routine treatment, and WP group added WBV on the basis of PR group intervention. After the intervention, the same indicators were detected. Results: Compared with before the intervention, the pulmonary function indexes of each group were significantly improved after the intervention (P＜0.05), and the bone mineral density and bone microstructure indexes of the patients in the WP group were also significantly improved (P＜0.05). Compared with group C and group PR, the bone mineral density, bone microstructure, parathyroid hormone (PTH), insulin-like growth factor-1 (IGF-1), interleukin-6 (IL-6), osteocalcin (OCN) and other bone metabolism indexes, knee flexion, peak extension torque, fatigue index and muscle strength of patients in WP group were significantly improved (P＜0.05). Conclusion: Adding WBV to the conventional PR regimen can improve the bone strength, lung function and exercise capacity of elderly patients with COPD complicated with OP, and may be able to make up for the deficiency of the current conventional PR regimen for insufficient muscle and bone stimulation.目的: 探讨在肺康复(PR)常规运动方案中加入全身振动(WBV)对稳定期慢性阻塞性肺疾病(COPD)合并骨质疏松(OP)老年患者的骨强度、肺功能、运动能力的干预效果。方法: 将37例稳定期COPD老年患者随机分为对照组(C组,n=12,年龄:64.6±3.8岁)、常规PR组(PR组,n=12,年龄:66.1±4.9岁)、全身振动联合PR组(WP组,n=13,年龄:65.5±3.3岁),干预前进行X射线和电子计算机断层骨扫、骨代谢标志物、肺功能、心肺运动、6 min步行和等速肌力的测试,然后进行36周、3次/周的干预,其中C组受试者给予常规治疗,PR组在常规治疗的基础上加入有氧跑和静态自重抗阻动作,WP组在PR组干预的基础上加入WBV。干预完成后,检测干预前相同的指标。结果: 与干预前比较,干预后各组肺功能指标均显著提升(P＜0.05),WP组患者骨密度、骨微结构指标也显著提升(P＜0.05);与C组和PR组比较,WP组患者骨密度、骨微结构指标和甲状旁腺激素(PTH)、胰岛素样生长因子-1(IGF-1)、白介素-6(IL-6)、骨钙素(OCN)等骨代谢指标以及膝屈曲、伸展峰值力矩、疲劳指数肌力指标改善效果明显(P＜0.05)。结论: 将WBV加入常规PR常规运动方案中可改善COPD并发OP老年患者的骨强度、肺功能和运动能力,可弥补现行常规运动方案对肌肉和骨骼刺激不足的缺陷。.