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Congestive Heart Failure and Whole Body Vibration Congestive Heart Failure (CHF) is a chronic condition that causes the heart to be unable to adequately pump oxygenated blood to the rest of the body. The inability to deliver oxygen rich blood to the body is most evident during active periods and with exercise. Systolic heart failure is when the heart muscle pumps blood poorly from the heart. Diastolic heart failure occurs when the stiffness of the heart muscle prevents the heart chambers from filling adequately. The lack of pumping action by the heart leads to a buildup of fluid in the body. The reduced oxygen and nutrition to the organs results in damage to the tissues and they are unable to function as they should. Coronary artery disease is the most common cause of CHF. Cardiomyopathy, congenital heart disease, heart attacks, heart valve disease, and arrhythmias are also conditions of the heart that can lead to CHF. Other diseases that may cause or contribute to CHF include emphysema, severe anemia, and hypo/hyperthyroidism. There are several possible symptoms of CHF, which include shortness of breath, cough, swelling in the extremities and abdomen, weight gain, irregular pulse, palpitations, disturbance with sleep, fatigue, feelings of weakness and fainting, loss of appetite, and indigestion. Less common symptoms include an inability to concentrate, drowsiness, decreased urine output, need to urinate at night, and nausea and vomiting. All of these symptoms may occur gradually and occur initially during bouts of activity and exercise. As the disease progresses, many of these symptoms may begin to occur at rest. Sometimes symptoms occur suddenly following a specific heart issue, such as a heart attack. Because it is a long-term condition, physician monitoring and self-monitoring are important aspects of treatment. Self-monitoring includes taking prescribed medication, limiting salt intake, staying active but balancing activity with adequate rest, losing weight (if needed), and not smoking. Daily consistent monitoring of weight is important, as increasing weight may be a sign of fluid retention. Medications include ACE inhibitors, diuretics, digitalis glycosides, angiotensin receptor blockers, and beta-blockers. Surgeries for CHF include heart valve surgery, coronary bypass surgery, and angioplasty. Devices that may be used include pacemakers and implantable cardioverter-defibrillator. With severe CHF, circulatory support maybe required while an individual awaits a heart transplant. Physical activity is valuable for individuals with stable CHF. It may improve CHF symptoms and quality of life as well as decreasing hospital visits1. Low to moderate levels of activity, 30-45 minutes most days of the week, is recommended1. New exercise routines should be discussed with a physician and it is important to rest between bouts of activity1. Research has found that regular exercise in individuals with CHF reduces symptoms, increases functional capacity, and improves quality of life similar to pharmacological interventions2. Exercising at 40-70% maximal capacity, for 20-45 minutes, 3 to 5 days a week has been recommended2. THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OR PRESCRIBE. PLEASE CONSULT YOUR HEALTH PROVIDER. 25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2 416-285-6055 fax 416-285-8918 [email protected] www.t-zonevibration.com -2In humans, Whole Body Vibration (WBV) has been found to increase heart rate and improve peak oxygen uptake as effectively as a traditional exercise program3. Another study found that WBV acutely decreased arterial stiffness directly following each bout4. Arterial stiffness is considered a cardiovascular risk factor4. Furthermore, using WBV has demonstrated a reduction in plaque buildup and a thinner aortic wall at 60 Hz compared to 30 Hz in rabbits5. It was also concluded that WBV might play an important role in lipid metabolism. Because these results were found in animal studies, the exact benefits for humans are limited. Studies have also shown that WBV increases blood flow in the legs6,7. Since each study was performed with a specific population, it is unknown if the benefits will translate to other populations. Although this research shows potential benefits for using WBV to improve cardiovascular health, due to the nature of CHF, it is essential that an individual speak with a physician prior to adding WBV to his/her exercise routine. It is important that the physician understand WBV so he/she can help determine whether the benefits will outweigh any risks or possible contraindications. Heart failure is considered a relative contraindication to using WBV. Contraindications are recommended due to the lack of research in a particular area or when there is a known consequence. Without the research, it cannot be determined if the benefits to using WBV outweigh any potential risks. One manufacturer lists serious degrees of decompensated chronic heart failure as a contraindication due to the concern of acute decompression from using WBV. After clearance from a physician, an individual should begin WBV at a lower intensity and duration. In addition, symptoms should be continuously monitored. WBV should be discontinued, if any symptoms related to an individual’s CHF 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. http://www.chfn.ca/living-with-heart-failure/physical-activity, retrieved May 11, 2011. 2. Wexler R, Elton T, Pleister A, Feldman D. 2009. 2009. You can do more to slow the progression of heart failure, The Journal of Family Practice, 58(3), 122-8. 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. THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OR PRESCRIBE. PLEASE CONSULT YOUR HEALTH PROVIDER. 25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2 416-285-6055 fax 416-285-8918 [email protected] www.t-zonevibration.com -34. 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. 6. Lythgo N, Eser P, de Groot P, Galea M. 2009. Whole-body vibration dosage alters leg blood flow, Clinical Physiology and Functional Imaging, 29(1), 53-9. 7. Lohman EB 3rd, Petrofsky JS, Maloney-Hinds C, Betts-Schwab H, Thorpe D. 2007. The effect of whole body vibration on lower extremity skin blood flow in normal subjects, Medical Science Monitor, 13(2), CR71-6. THIS IS FOR EDUCATIONAL PURPOSES ONLY. WE DO NOT DIAGNOSE OR PRESCRIBE. PLEASE CONSULT YOUR HEALTH PROVIDER. 25 Curity Avenue, Unit 2A, Toronto, ON M4B 3M2 416-285-6055 fax 416-285-8918 [email protected] www.t-zonevibration.com