Angina and Whole Body Vibration     

Angina pectoris occurs when there is damage, blockage or narrowing of one or more of the coronary arteries in the heart. This leads to pain due to lack of blood and oxygen to the area affected. Angina pain can occur during physical activity, stress, extreme temperatures, after heavy meals, with smoking or drinking alcohol. It is a warning sign that the heart is working too hard and that an individual is at greater risk for a heart attack, cardiac arrest or sudden cardiac death. The pain is often described as burning, suffocating and squeezing. It usually goes away with rest or medication. Angina can be caused by coronary artery disease (CAD), coronary artery spasm, uncontrolled high blood pressure, and other cardiac conditions. Symptoms can include pain that starts in the chest and may radiate into the arm, neck, shoulder, upper back, and jaw. The pain may be achy, burning, squeezing or sharp. An individual may also experience a feeling of indigestion or numbness into the arms and hands. Because these symptoms are similar to a heart attack it is important that an individual experiencing these types of symptoms seek medical attention immediately. There are five types of angina which are; stable, unstable, variant, microvascular, and atypical. Treatment for angina includes lifestyle modifications and medication. Surgery may also be indicated in some individuals. Surgical interventions include percutaneous coronary intervention and coronary artery bypass surgery.  

Although exercise may bring on angina pain in some individuals, under the guidance of a doctor it is an important tool to assist with lifestyle modifications. Physical activity should be encouraged to help improve exercise tolerance and reduce symptoms of angina ¹. There are also beneficial effects on weight, blood lipids, blood pressure, glucose tolerance and insulin sensitivity. These are all factors that need to be modified to improve CAD. Exercise should be done within the individual’s limitations ¹. In general, other recommendations for cardiovascular diseases include expending about 1000 kcal of energy on physical activity per week ². This is the amount used to walk one hour five days a week. The authors report that this amount was associated with significant health benefits and that it could be achieved through various means, even accumulated through short bout s of activity throughout the day².

In humans, Whole Body Vibration (WBV) has been found to increase heart rate and improve peak oxygen uptake as effectively as a traditional exercise program ³. Another study found that WBV acutely decreased arterial stiffness directly following each bout ⁴. Arterial stiffness is considered a cardiovascular risk factor ⁴. Furthermore, using WBV has demonstrated a reduction in plaque buildup and a thinner aortic wall at 60 Hz compared to 30 Hz in rabbits ⁵. It was also concluded that WBV may play an important role in lipid metabolism. Because these results were found in animal studies, the exact benefits for humans are limited. Although this research shows potential benefits for using WBV in individuals with angina, due to the nature of angina and association with potential underlying medical issues, it is essential that an individual speaks with a physician prior to adding WBV to his/her exercise routine.  It is important that the physician understands WBV so they can help determine whether the benefits will outweigh any risks or possible contraindications. An acute Deep Vein Thrombosis (DVT) and other circulatory issues as well as various cardiac conditions are considered contraindications to using WBV. Once a physician has cleared an individual to use WBV, they should begin at a lower intensity and duration. Also symptoms should be continuously monitored. WBV should be discontinued if any symptoms related to an individual’s angina become worse, and any changes should be discussed with a physician. An individual should follow any guidelines or restrictions recommended by his/her physician regarding exercise. Once an individual has become comfortable with the machine, and no changes in symptoms occur, the intensity of exercises can be increased and exercises at the appropriate level may be added.  In general, if an individual experiences shortness of breath, pain or dizziness when using WBV it should be discontinued immediately.

References

1.       Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F, Daly C, De Backer G, Hjemdahl P, Lopez-Sendon J, Marco J, Morais J, Pepper J, Sechtem U, Simoons M, Thygesen K, Priori SG, Blanc JJ, Budaj A, Camm J, Dean V, Deckers J, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Tamargo J, Zamorano JL. 2006. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology, European Heart Journal, 27(11), 1341-81.

2.       Ignarro LJ, Balestrieri ML, Napoli C. 2007. Nutrition, physical activity, and cardiovascular disease: an update, Cardiovascular Research, 73(2), 326-40.

3.       Bogaerts AC, Delecluse C, Claessens AL, Troosters T, Boonen S, Verschueren SM. 2009. Effects of whole body vibration training on cardiorespiratory fitness and muscle strength in older individuals (a 1-year randomised controlled trial), 38(4), 448-54.

4.       Otsuki T, Takanami Y, Aoi W, Kawai Y, Ichikawa H, Yoshikawa T. 2008. Arterial stiffness acutely decreases after whole-body vibration in humans, Acta Physiology, 194(3), 189-94.

5.       Oki M, Ishitake T, Ohkubo A, Matoba T. 1989. Frequency dependence of the suppressive effects of vibration on atherosclerosis in the rabbit, The Kurume Medical Journal 36(4), 161-6.

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