Whole body vibration versus magnetic therapy on bone mineral density in elderly osteoporotic individuals

Whole-Body Vibration Therapy as a Modality for Treatment of Senile and Postmenopausal Osteoporosis: A Review Article

Whole-body vibration therapy is an intentional biomechanical stimulation of the body using various frequencies of vibrations with the motive of health improvement. Ever since its discovery, this therapy has been extensively used in physiotherapeutic measures and the sports industry. For its property of increasing bone mass and density, space agencies use this therapy on astronauts who return to Earth after long-term space missions to regain lost bone and muscle mass. The potential of this therapy to restore bone mass encouraged researchers to look for its scope in the treatment of age-related bone degenerative diseases such as osteoporosis and sarcopenia, as well as in the correction of posture control and gait in geriatrics and post-menopausal women. Osteoporosis and osteopenia account for roughly half of all fractures worldwide. These degenerative diseases also cause gait and posture changes. Bisphosphonates, monoclonal antibodies, parathyroid hormone fragments, hormone replacement therapies, and calcium and vitamin D supplementation are among the medical treatments available. Lifestyle changes and physical exercise are advised. However, vibration therapy's scope as a treatment option is yet to be explored. The safe range of frequency, amplitude, duration, and intensity of the therapy is still to be determined. This article is a review of the results of various clinical trials done in the last 10 years that target the effect of vibration therapy in both osteoporotic women and the elderly for the treatment of such ailments and deformities. We collected data from PubMed using advanced search and applied the exclusion criteria. In total, we analyzed nine clinical trials.

Effect of 50-Hertz Sinusoidal Vibration on the Uterus in Ovariectomy-Induced Osteoporotic Rats

Objective

To evaluate the influence of sinusoidal vibration (50-Hertz) stimulation on the uterus of osteoporotic rats.

Methods

We constructed an osteoporosis rat model by ovariectomy (OVX). 36 3-month-old Sprague Dawley rats were randomly divided into the control group, vibrating group, sham operation group, sham operation vibrating group, OVX group, and OVX vibrating group (n = 6 per group). Rats started to vibrate one week after the operation: one 10 minutes 50-Hertz sinusoidal vibration per day, except for Saturday and Sunday. In the second, 8, and 12 week after vibration stimulation, rats were sacrificed in batches. And then, the uteruses were taken out to measure the wet weight and calculate uterus relative wet weight.

Results

Compared with the control group, OVA induced a significant increase in wet weight and relative wet weight in rat uterus. The vibration was to the uterus wet weight and the uterus relative wet weight in ovariectomized rats and at the same time had no significant effect, but the 12-week prolonged vibration can significantly reduce the uterus wet weight and the uterus relative wet weight in ovariectomized rats than 2 weeks.

Conclusions

The uterus wet weight and the uterus relative wet weight were increased in the OVA-induced osteoporosis rats. The 50-Hertz sinusoidal vibration had no significant effect on the uterus wet weight and the uterus relative wet weight in the ovariectomized rats at the same time, but 12 weeks of vibration can significantly reduce the uterine wet weight and uterine relative wet weight of ovariectomized rats. And the uterus relative wet weight can be used as a new indicator of stimulating the uterus.

Pulsed electromagnetic fields may be effective for the management of primary osteoporosis: a systematic review and meta-analysis

Little is known about the effect of pulsed electromagnetic fields (PEMFs) as an option for preventing osteoporosis. This study sought to investigate the effectiveness of PEMFs for the management of primary osteoporosis in older adults. We searched databases from the inception to date to target trials examining the effects of PEMFs compared to placebo or sham or other agents for the management of primary osteoporosis for a meta-analysis using random effects model. Eight trials including 411 participants were included. PEMFs was non-inferior to conventional pharmacological agents and exercise respectively in preventing the decline of Bone Mineral Density (BMD) at the lumbar (MD 8.76; CI -9.64 to 27.16 and MD 1.33; CI -2.73 to 5.39) and femur neck (MD 0.04; CI -1.09 to 1.16 and MD 1.50; CI -0.26 to 3.26), and significantly improving balance function measured by Berg Balance Scale (BBS) (MD 0.91; CI 0.32 to 1.49) and Timed Up and Go test (MD -3.61; CI -6.37 to -0.85), directly after intervention. The similar trends were observed in BMD and BBS at 12- and 24-weeks follow-up from baseline. PEMFs had positive effects non-inferior to first-line treatment on BMD and better over placebo on balance function in older adults with primary osteoporosis, but with moderate to very low certainty evidence and short-term follow-ups. There is a need for high-quality randomised controlled trials evaluating PEMFs for the management of primary osteoporosis.

The effect of whole-body vibration training with different amplitudes on bone mineral density in elderly women

BACKGROUND: The effects of whole-body vibration training (WBVT) with same frequency and different amplitudes on bone mineral density (BMD) in the elderly is not reported. OBJECTIVE: To compare the effect of 45-Hz WBVT with different amplitudes on the BMD in elderly women. METHODS: Age-, height-, and weight-matched patients were assigned to a low-amplitude group (n= 19, amplitude of 2 mm), medium-amplitude group (n= 18, amplitude of 3 mm), high-amplitude group (n= 19, amplitude 4 mm), and control group (n= 20). The WBVT was conducted for 24 weeks in the three amplitude groups. The BMD at lumbar vertebrae L2-4 and the proximal femur was measured at 0 and 24 weeks. RESULTS: The BMD at lumbar vertebrae L2-4 was higher in the high-amplitude group than in the low-amplitude and middle-amplitude groups, and the BMD of the greater trochanter was significantly higher than that in the low-amplitude group (p< 0.05). The BMD of the greater trochanter was significantly higher in the middle- than low-amplitude group (p< 0.05). CONCLUSION: A higher amplitude should be considered when WBVT is performed in elderly patients to increase bone density and prevent osteoporosis.

Effects of whole-body vibration training with the same amplitude and different frequencies on the proximal femoral bone density in elderly women

BACKGROUND

This study investigated the whole-body vibration training with the same amplitude and different vibration frequencies was used to compare the difference in bone mineral density (BMD) of the proximal femurs in elderly women.

METHODS

This study included three age-, height-, and weight-matched groups; the medium-frequency group (N.=19) received 24 weeks of whole-body vibration training with a vibration frequency of 20 Hz; the high-frequency group (N.=18) received 24 weeks of whole-body vibration training with a vibration frequency of 40 Hz; and the control group (N.=19) received no intervention. Changes in the BMD of the proximal femur on the dominant side in the three groups were measured using dual-energy X-ray absorptiometry.

RESULTS

According to the between-group comparison, the BMD of the greater trochanter and Ward's triangle in the middle-frequency group increased by 7.6% and 13.3%, respectively (P<0.05), while the BMD of the greater trochanter and Ward's triangle in the high-frequency group increased by 10.6% and 16.9%, respectively (P<0.05). There was no significant difference in BMD between the medium-frequency group and the high-frequency group at 24 weeks (P>0.05).

CONCLUSIONS

Whole-body vibration training with a frequency of 20 Hz and 40 Hz improved the BMD of the proximal femurs in elderly women to varying degrees but had no significant effect on femoral neck BMD. Under the same amplitude conditions, an increase in vibration frequency did not cause further changes in BMD.

[Neuromuscular stimulation in conditions of vibrational physical activity for the prevention of osteoporosis]

The review discusses the modern possibilities of non-drug rehabilitation of patients with osteoporosis. Osteopenia (osteoporosis) and osteoporosis-associated bone fractures are a global public health problem, and an intensive search is undergoing for new methods of treatment, prevention, diagnosis and screening of this disease. Innovative technologies for influencing bone remodeling using vibration training seem to be an effective method that allows you to simultaneously positively affect maintaining bone density, increasing muscle strength and improving coordination, especially in elderly patients. The evolution of study of the effects of intense neuromuscular stimulation under accelerated physical exertion, which began with fundamental work on experimental animals, now includes numerous clinical studies. Vibrational physical activity is one of the methods of biomechanical stimulation, which is considered as an innovative method in the field of rehabilitation and physiotherapy. The physiological basis of this effect is intensive neuromuscular stimulation, which causes a reflex reaction of skeletal muscles. This scientific review describes the results of both monotherapy and combined methods of exposure to vibrational stimulation using modern pharmacotherapy. Attention is focused on the positions of importance in the design of the study and the planning of rehabilitation programs of uniformly accelerated training.

Therapeutic effects of whole-body vibration on fracture healing in ovariectomized rats: a systematic review and meta-analysis

OBJECTIVE

Whole-body vibration (WBV), providing cyclic mechanical stimulation, has been used to accelerate fracture healing in preclinical studies. This study aimed to summarize and evaluate the effects of WBV on bone healing in ovariectomized rat models and then analyze its potential effects on fractures in human postmenopausal osteoporosis.

METHODS

PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure, VIP, SinoMed, and WanFang databases were searched from their inception date to September 2017, and an updated search was conducted in January 2018. Studies that evaluated the effects of WBV on bone healing compared with control groups in ovariectomized rats were included. Two authors selected studies, extracted data, and assessed the methodological quality. Meta-analyses were performed when the same outcomes were reported in two or more studies.

RESULTS

Nine eligible studies were selected. In treatment groups, callus areas were significantly improved in the first 3 weeks, normalized total bone volume and total tissue volume values increased dramatically at 8 weeks, and the mechanical tests showed a significant difference at the end point of the study.

CONCLUSIONS

This study suggested that WBV could accelerate callus formation in the early phase of bone healing, promote callus mineralization and maturity in the later phase, and restore mechanical properties of bones.

Whole-body vibration in the reduction of the cellulite

OBJECTIVE

Evaluate the effects of the whole body vibration in improving of cellulite in the women's gluteal region.

METHODS

Controlled clinical trial performed with 42 women, with cellulite in the gluteal region, detected by means of clinical examination. After evaluation, the women were divided into two groups: Whole-Body Vibration (WBV_G) and control (C_G). The evaluations were performed at the beginning and the end of 10 sessions and superficial skin temperature, perimetry in the gluteal region, analysis of body contouring, analysis of improvement by blind reviewers and instrument of satisfaction, by numeric scale were investigated.

RESULTS

In the thermographic analysis, the WBV_G obtained significant increase of superficial skin temperature on the right (p = 0.02) and left (p = 0.02) gluteal region. There was no difference in intra- and intergroups in perimetry and the analysis of body contour. The WBV_G obtained a higher percentage of improvement by assessment of the blind reviewers (p = 0.003) and greater aesthetics satisfaction (p = 0.006), when compared to C_G.

CONCLUSION

WBV provided an improvement in the aspect of the cellulite when assessed by blind reviewers and greater participants' satisfaction, providing a significant increase in the superficial skin temperature in the gluteal region.

Effects of Single or Multiple Sessions of Whole Body Vibration in Stroke: Is There Any Evidence to Support the Clinical Use in Rehabilitation?

Background and Purpose

Recently new technologies and new techniques, such as Whole Body Vibration (WBV), have been introduced by the health and fitness industry to pursue therapeutic or physical performance goals. The aim of this systematic review is to investigate the effectiveness of single or multiple WBV sessions alone or in association with traditional rehabilitation, compared to traditional rehabilitation therapy or with sham therapy in poststroke patients.

Methods

Randomized Control Trials and controlled clinical trials written in English between January 1st, 2003, and December 31st, 2017, were selected from PubMed, Cochrane-Central-Register-of-Controlled-Trials, and Physiotherapy-Evidence-Database (PEDro). The single WBV session and multiple sessions' effects were assessed. Study characteristics, study population, intervention protocols, effects of WBV sessions, and adverse events were investigated with a descriptive analysis.

Results

The search reported 365 articles and after screening and removal of duplicates, 11 manuscripts with PEDro score≥6/10 were selected (391 poststroke patients). Study characteristics, study population, intervention protocols (frequencies, amplitude of vibration, and peak acceleration), effects of a single or multiple WBV sessions, and adverse events were analyzed. They have been investigated with particular attention to bone turnover, structure and muscle functions, spasticity, postural control and risk of falls, functional mobility, somatosensory threshold, and activity and participation. Comparing WBV group with control group no significant benefits emerged.

Discussion

This systematic review included studies involving participants with non homogeneous characteristics, just considering the incorporation of studies on individuals with chronic and postacute stroke. Despite these limits, WBV treatment has no significant risks for patients and shows interesting effects of WBV treatment in Structure and muscle functions, Spasticity and Postural control.

Conclusions

Even though treatment with WBV appears safe and feasible, there is insufficient evidence to support its clinical use in poststroke rehabilitation at this point. More studies assessing other functional tests and with more specific treatment protocols are needed.