Periodic whole body acceleration: a novel therapy for cardiovascular disease.
BACKGROUND
Periodic whole body acceleration in the spinal axis (pGz) applied by a motion platform is a novel treatment modality that induced endothelial nitric oxide release into the circulation of animals, healthy subjects and patients with inflammatory diseases during single treatment sessions in previous studies. We hypothesized that patients with advanced arteriosclerotic diseases who are not candidates for a surgical intervention would clinically benefit from repeated pGz treatments over several weeks through improvement of endothelial function.


METHODS
11 patients, 5 men (37 to 71 y) with stable ischemic heart disease, LVEF < 35%, NYHA stage > II, and 6 patients (51 to 83 y, 1 woman) with intermittent leg claudication, Fontaine stage II, were enrolled after optimization of pharmacological therapy. PGz was applied for 40 min, 5 days/week during 5 weeks. Quality of life (SF-36 questionnaire), exercise performance, and endothelial function were assessed at baseline, during the treatment period, and 4 weeks after discontinuation of pGz.


RESULTS
PGz was well tolerated. In heart failure paitents, pGz therapy improved quality of life, increased 6 min walking distance by a mean +/- SE of 105 +/- 24 m, and improved postischemic skin hyperemia (p < .05 in all instances). In 4 of 6 patients with intermittent claudication, quality of life, treadmill walking distance and post-ischemic skin hyperemia improved with pGz therapy (p < .05). Four weeks after discontinuation of pGz, most therapeutic effects had vanished in both patient groups.


CONCLUSIONS
In patients with severe heart failure and with leg claudication who remain symptomatic despite maximal medical therapy and who were not candidates for surgery, periodic acceleration applied over several weeks improved quality of life and exercise capacity. The clinical benefits appear to be mediated through improved endothelial function.
Kohler
M
M
Pulmonary Divison, Dept. of Internal Medicine, University Hospital of Zurich, Switzerland.
Amann-Vesti
B R
BR
Clarenbach
C F
CF
Brack
T
T
Noll
G
G
Russi
E W
EW
Bloch
K E
KE
D000054:Acceleration; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000534:rehabilitation*; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000534:rehabilitation*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005080:Exercise Test; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007383:Intermittent Claudication / Q000503:physiopathology / Q000628:therapy; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood; D026741:Physical Therapy Modalities / Q000295:instrumentation*; D011788:Quality of Life; D016896:Treatment Outcome
D009569:Nitric Oxide