Whole body vibration, an alternative for exercise to improve recovery from surgery?

Abstract

Although exercise is usually associated with beneficial effects on physical and mental health, patients recovering from surgery may be hampered to perform active exercise. Whole body vibration (WBV) is suggested a passive alternative for physical training. Aim of the present study was to explore the therapeutic potential of WBV compared to physical exercise during early post-surgery recovery. Male three months old Wistar rats underwent major abdominal surgery. Starting the day after surgery, rats were subjected to either daily WBV or exercise (treadmill running) for 15 consecutive days. Control rats underwent pseudo treatment. During the first week after surgery, effects of interventions were obtained from continuous recording of hemodynamic parameters, body temperature and activity (via an implanted transducer). Behavioral tests were performed during the second post-surgical week to evaluate anxiety-like behavior, short and long-term memory functions, cognitive flexibility and motor performance. Animals were sacrificed 15 days after surgery and brain tissue was collected for analysis of hippocampal neuroinflammation and neurogenesis. Surgery significantly impacted all parameters measured during the first post-surgery week, irrespective of the type of surgery. Effect on cognitive performance was limited to cognitive flexibility; both WBV and exercise prevented the surgery-induced decline. Exercise, but not WBV increased anxiety-like behavior and grip strength. WBV as well as exercise prevented the surgery-induced declined neurogenesis, but surgery-associated hippocampal neuroinflammation was not affected. Our results indicated that active exercise and WBV share similar therapeutic potentials in the prevention of surgery induced decline in cognitive flexibility and hippocampal neurogenesis. In contrast to exercise, WBV did not increase anxiety-like behavior. Since neither intervention affected hippocampal neuroinflammation, other mechanisms and/or brain areas may be involved in the behavioral effects. Taken together, we conclude that WBV may provide a relevant alternative to active exercise during the early stage of post-operative recovery.

Keywords: Exercise; Hemodynamics; Neurogenesis; Neuroinflammation; Postoperative cognitive dysfunction; Whole body vibration.

Fig. 1

General Experimental Design: (A) Animals underwent a standard abdominal surgery or telemetry probe surgery to obtain measurements of baseline physiological parameters (day 0). (B) From day 1 to day 14, active exercise (treadmill running (running exercise – surgery)) or passive exercise (WBV – (WBV – surgery)) or pseudo intervention (pseudo exercise – surgery) was performed. (C) From day 7 to day 13 behavioral tests were conducted including open field, novel object and novel location recognition, Morris water maze (MWM), grip hanging and balance beam tests. (D) Animals were terminated and brain tissue was collected at day 15.

Fig. 2

Effects of standard abdominal surgery and telemetry surgery on maximum weight loss within the first 5 days (panel A). Panel B: Body weight over the time course of the study in experimental groups pooled according to intervention. Data are depicted as mean ± SEM. (Non-Surgery n: 16 (7 home cage and 7 pseudo exercise); Pseudo exercise – surgery n: 16 (8 abdominal – 8 telemetry); WBV – surgery n: 16 (8 abdominal – 8 telemetry); Running exercise – surgery n: 15 (8 abdominal – 7 telemetry).

Fig. 3

Early effects of telemetry surgery (pseudo exercise), and WBV and running exercise – telemetry surgery interventions on baseline physiological parameters including heart rate (panel A), core temperature (panel B), mean blood pressure (panel C) and on locomotor activity (panel D). Data are depicted as values during the dark phase (from day 1 to day 6) and during the light phase (from day 0 to day 6). Statistical outcome represents 24 h mean (dark and light phase) and circadian rhythmicity. Mean values as well as circadian rhythms of all parameters showed significant time course alterations during the experiment, without significant effects of interventions or interaction of time course and interventions. Data are depicted as mean ± SEM. (Heart Rate: pseudo exercise – surgery n = 6, WBV – surgery n = 7, running exercise – surgery n = 6; Temperature: pseudo exercise – surgery n = 7, WBV – surgery n = 8, running exercise – surgery n = 7; Blood Pressure: pseudo exercise – surgery n = 5, WBV – surgery n = 7, running exercise – surgery n = 5; Activity: pseudo exercise – surgery n = 7, WBV – surgery n = 8, running exercise – surgery n = 7).

Fig. 4

Effects of surgery (pseudo exercise), and WBV and running exercise interventions after surgery on exploratory and anxiety-related behavior in open field test. The total walking distance (panel A), in the number of rearings (panel B) and time spent in the corner (panel C) and the number of center entries (panel D). Data are depicted as mean ± SEM. *: P < .05. **P < .01. ***P < .001 (non – surgery n = 14, pseudo exercise – surgery n = 16, WBV – surgery n = 16, running exercise – surgery n = 15).

Fig. 5

Effects of surgery (pseudo exercise), and WBV and running exercise interventions after surgery on long-term learning and memory in Morris water maze (MWM) test; learning curves of the 6 training sessions (day 1 and day 2) (Panel A); learning curves of 3 reversal trials (day 3) (Panel B). Platform crossing in the MWM second probe trial (day 3) (Panel C). Memory consolidation (last training sessions – first reversal) (Panel D). Data are depicted as mean ± SEM. Asterisks indicate: *P < .05. **P < .01. ***P < .001. (non – surgery n = 14, pseudo exercise – surgery n = 16, WBV – surgery n = 16, running exercise – surgery n = 15).

Fig. 6

Effects of surgery (pseudo exercise), and WBV and running exercise interventions after surgery on muscle strength in grip hanging test (Panel A) and motor coordination in balance beam test (Panel B). Data are depicted as mean ± SEM. (Grip hanging/balance beam: non – surgery n = 13–13, pseudo exercise – surgery n = 16–16, WBV – surgery n = 16–16, running exercise – surgery n = 14–10).

Fig. 7

Effects of surgery (pseudo exercise), and WBV and running exercise interventions after surgery on microglia activity in subregions of dorsal hippocampus including CA1 (panel A) and Hilus regions (panel B). Data are depicted as mean ± SEM. * indicates: P < .05. (Non – surgery n = 10, pseudo exercise – surgery n = 13, WBV – surgery n = 14, running exercise – surgery n = 11).

Fig. 8

Effects of surgery (pseudo), and WBV and running exercise interventions after surgery on neurogenesis (DCX positive cells) in the dentate gyrus. Data are depicted as mean ± SEM. (non – surgery n = 14, pseudo exercise – surgery n = 15, WBV – surgery n = 16, running exercise – surgery n = 15).