Exercício de vibração de corpo inteiro como intervenção não farmacológica para melhorar a resposta funcional e reduzir a pressão arterial em indivíduos hipertensos com osteoartrite do joelho e promover respostas relacionadas com biomarcadores inflamatórios em diferentes condições clínicas

Abstract

Knee Osteoarthritis (KOA) is a degenerative joint disease that presents a low-grade chronic inflammation linked to aging (inflamm-aging) and may be associated with other clinical conditions such as arterial hypertension. The functional disability is an important characteristic of the KOA and can affect about 20% of people who have symptomatic KOA, mainly due to the weakness of the quadriceps. Pharmacological treatment is usually used both to reduce the signs and symptoms of KOA and to control blood pressure (BP), however, a more sustainable form of treatment has been suggested. The whole-body vibration exercise (WBVE) has been proposed as a non-pharmacological intervention for these clinical conditions. The objective of this study was to investigate whether WBVE could be used as a non-pharmacological tool to improve the functional response in KOA individuals, to present an antihypertensive effect in hypertensive KOA individuals and to synthesize the effects of WBVE on the inflammatory biomarkers response (IBR) in different clinical status. An experimental crossover study of two periods (8 weeks washout) was carried out. Nineteen KOA individuals and with hypertension were allocated into 2 groups: (i) group submitted to WBVE, with peak to peak displacement from 2.5 to 7.5 mm, frequency from 5 to 14 Hz and acceleration peak from 0.12 to 2.95g; (ii) group control (0 Hz). Participants were positioned seated in a chair in front of the vibrating platform with their feet resting on its base (2 x/week, for 5 weeks). The measurement of BP, 5-repetition chair stand test (5CST) and surface electromyography of the vastus lateralis muscles were taken before and after the protocol. A systematic review was carried out following the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) and was recorded in the International Prospective Registry of systematic reviews (PROSPERO). The searches were realized using 7 databases. The results of the crossover study showed that no differences were found between groups in the baseline (anthropometry, functional capacity, BP parameters and medications). The WBVE reduced systolic BP (p=0.02), mean BP (p=0.02) and 5CST execution time (p=0.018), while no differences were found in diastolic BP (p=0.11) and the electromyographic profile. A systematic review included 4 randomized controlled trials involving IBR after WBVE with different groups, protocols and outcomes. Based on the findings on the effects of WBVE on individuals with KOA, it is possible to conclude that only 5 weeks of intervention with a comfortable posture showed an antihypertensive effect and improved the functional response in this population without alteration of muscle excitation. In addition, the investigation through systematic review showed that WBVE can be benefit in management of inflammatory conditions through changes in IBR. Therefore, WBVE could be considered a sustainable tool, contributing to reduce the pharmacological need in several clinical conditions, improving functional response, reducing BP in hypertensive individuals with KOA and promoting responses related to inflammatory biomarkers.