Chronic obstructive pulmonary disease (COPD) is an irreversible disorder characterized by persistent airflow limitation and increased lung compliance. It leads to dyspnea, skeletal muscle dysfunction, impaired functional capacity, and reduced quality of life. Physical inactivity is considered a major contributor to symptom deterioration, the development of a vicious cycle, and ultimately increased mortality.
According to the American College of Sports Medicine (ACSM), the American Thoracic Society (ATS), and the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), pulmonary rehabilitation should include aerobic and resistance exercise for at least 20 minutes per session, performed three to five times per week for a minimum of 12 weeks. Exercise intensity should be progressively increased to exceed 60% of peak oxygen uptake (VO₂peak), and patients are encouraged to maintain long-term exercise habits. However, there is still no consensus regarding the optimal initial intensity, progression strategy, and exercise duration.
Previous studies have demonstrated that whole-body vibration (WBV) can improve lower extremity muscle strength, functional capacity, and quality of life in patients with COPD. However, its effects on lung function and the optimal training dose remain unclear. In addition, COPD also affects respiratory muscles, upper extremity strength and flexibility, as well as cardiac autonomic function.
Therefore, the aim of this study is to investigate the effects of different WBV frequencies on lung function, respiratory muscle function, upper extremity strength and flexibility, and cardiac autonomic function, in order to determine the optimal training dose.
No prior experience with whole-body vibration therapy or exposure to vibration-related occupations or sports.
Aged between 18 and 65 years.
Pregnancy.
Acute thrombosis.
Severe cardiovascular disease.
Presence of a cardiac pacemaker.
Parallel
Whole body vibration
BehavioralAll participants will receive three different frequencies of WBV (15, 25, and 35 Hz) in a block-randomized order, with a washout period of at least 7 days between conditions. Subsequently, participants will undergo three additional sessions at the final randomized frequency over one week to evaluate the cumulative effects.
Pulmonary function test
Pulmonary function test is examined by spirometry, which measures the ability to inhale and exhale air over time. The results include forced vital capacity (FVC in L), forced exploratory volume in the first second (FEV1 in L), and the FVC/FEV1 ratio.
Diaphragm excursion and thickness
Diaphragm excursion (unit: mm) and thickness (unit: mm) are examined by diaphragmatic ultrasound when a participant performs maximal inspiration and expiration.
Respiratory muscle strength
Respiratory muscle strength is measured using a manometer, which records both maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in cmH₂O
cardiopulmonary response
A cardiopulmonary exercise test collects gases (including measures of oxygen consumption, carbon dioxide production in ml/kg/min) and records heart rate (beat/min), which can be used to estimate cardiopulmonary response.
Upper limb muscle strength
Maximal voluntary contraction of upper limbs muscles. (unit: N)
Handgrip strength
Maximal voluntary handgrip strength. (unit: N)
Upper limb flexibility
Flexibility is examined by scratch test (unit: cm)
Heart rate variability (Standard Deviation of Normal-to Normal intervals, SDNN)
Heart rate variability (HRV) is examined to assess the automatic nervous system. Standard deviation of normal-to-normal (SDNN in ms) reflects overall heart rate variability and automatic function
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