Efficacy of whole-body vibration training in the management of patients with COPD: a systematic review and meta-analysis.

Abstract

Background Chronic obstructive pulmonary disease (COPD) often presents with skeletal muscle dysfunction, which worsens prognosis. Whole-body vibration training (WBVT) has been proposed as an adjunct to pulmonary rehabilitation, but evidence of its clinical efficacy remains inconsistent. Objective To evaluate the effects of WBVT on functional capacity, muscle strength, pulmonary function, and quality of life in individuals with COPD. Methods A systematic review and meta-analysis were conducted following PRISMA guidelines and registered in PROSPERO. Only randomized controlled trials were included. Outcomes assessed included 6-minute walk distance (6MWD), five-repetition sit-to-stand test (5STS), pulmonary function, and quality of life. Results Fifteen RCTs met the inclusion criteria. WBVT significantly improved functional capacity measured by the 6MWD (MD = 34.35 m; 95% CI: 13.67,55.04; GRADE: very low). Subgroup analysis revealed a clinically meaningful improvement compared with usual care (MD = 75.97 m; 95% CI: 58.65,93.30), but not when compared with active exercise interventions. For the 5STS, a clinically relevant gain was observed versus usual care (MD = -5.95 seconds; 95% CI: -10.76, -1.14), with no significant difference compared to conventional exercise. No statistically significant effects were found for FEV₁ or quality of life. Most trials presented high risk of bias, and evidence certainty ranged from low to very low. Conclusion WBVT may offer benefits in walking distance and sit-to-stand performance only when compared with no rehabilitation exposure, a scenario that is unrealistic in contemporary clinical practice given the strong evidence supporting structured exercise-based pulmonary rehabilitation for COPD management.