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Rajnish RK, Elhence A, Jha SS, Dhanasekararaja P. Pain Management in Osteoporosis. Indian J Orthop 2023; 57:230-236. [PMID: 38107816 PMCID: PMC10721585 DOI: 10.1007/s43465-023-01047-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/07/2023] [Indexed: 12/19/2023]
Abstract
The most prevalent metabolic bone disease, osteoporosis, is characterized by a decrease in bone mineral density and alterations to the bone's microstructure, both of which can result in fragility fractures. It affects a significant section of the population. Acute or chronic pain from these fractures is typical in elderly adults with other coexisting conditions. Since the antiresorptive medication only partially reduces pain, other analgesics are required for effective pain management. NSAIDs or selective COX-2 inhibitors can reduce acute pain, but persistent neuropathic pain is difficult to manage with these drugs. Opioids have their adverse effects and safety concerns, although they can be used to address acute or chronic pain. Hence, a multifaceted approach is to be implemented, including pharmacological and nonpharmacological therapy and surgical treatment in a selected number of cases. This chapter briefly describes the etiology of pain, its mechanism, and pain management in osteoporotic patients.
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Affiliation(s)
- Rajesh Kumar Rajnish
- Department of Orthopaedics, All India Institute of Medical Sciences, India Jodhpur
| | - Abhay Elhence
- Department of Orthopaedics, All India Institute of Medical Sciences, India Jodhpur
| | - S. S. Jha
- Harishchandra Institute of Orthopedics & Research, Patna, India
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de Oliveira RDJ, de Oliveira RG, de Oliveira LC, Santos-Filho SD, Sá-Caputo DC, Bernardo-Filho M. Effectiveness of whole-body vibration on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 2023; 34:29-52. [PMID: 36282343 DOI: 10.1007/s00198-022-06556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 09/16/2022] [Indexed: 01/07/2023]
Abstract
The present study observed significant effects of whole-body vibration (WBV) on bone mineral density (BMD) in postmenopausal women, with high-quality evidence for high-frequency, low-magnitude, and high-cumulative-dose use. The aim was to update a previous systematic review with meta-analysis to observe the effects of WBV on BMD in postmenopausal women. For the meta-analysis, the weighted mean difference between WBV and control groups, or WBV and conventional exercise, was used for the area of bone mineral density (aBMD) of the lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and Ward's area, or volumetric trabecular bone mineral density (vBMDt) of the radius and tibia. Methodological quality was assessed using the PEDro scale and the quality of evidence using the GRADE system. In total, 23 studies were included in the systematic review and 20 in the meta-analysis. Thirteen studies showed high methodological quality. WBV compared with control groups showed significant effects on aBMD in the primary analysis (lumbar spine and trochanter), sensitivity (lumbar spine), side-alternating vibration (lumbar spine and trochanter), synchronous vibration (lumbar spine), low frequency and high magnitude (lumbar spine and trochanter), high frequency and low magnitude (lumbar spine), high frequency and high magnitude (lumbar spine, trochanter, and Ward's area), high cumulative dose and low magnitude (lumbar spine), low cumulative dose and high magnitude (lumbar spine and trochanter), and positioning with semi-flexed knees (trochanter). Of these results, only high frequency associated with low magnitude and high cumulative dose with low magnitude showed high-quality evidence. At this time, considering the high quality of evidence, it is possible to recommend WBV using high frequency (≈ 30 Hz), low magnitude (≈ 0.3 g), and high cumulative dose (≈ 7000 min) to improve lumbar spine aBMD in postmenopausal women. Other parameters, although promising, need to be better investigated, considering, when applicable, the safety of the participants, especially in vibrations with higher magnitudes (≥ 1 g).
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Affiliation(s)
| | - Raphael Gonçalves de Oliveira
- Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde, Universidade Estadual do Norte do Paraná (UENP), Alameda Padre Magno, CEP: 86.400-000, Jacarezinho, Nova Alcântara PR, 841, Brazil.
| | - Laís Campos de Oliveira
- Programa de Pós-Graduação em Ciências do Movimento Humano, Centro de Ciências da Saúde, Universidade Estadual do Norte do Paraná (UENP), Alameda Padre Magno, CEP: 86.400-000, Jacarezinho, Nova Alcântara PR, 841, Brazil
| | - Sebastião David Santos-Filho
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Danúbia Cunha Sá-Caputo
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Programa de Pós-Graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Mario Bernardo-Filho
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- Laboratório de Vibrações Mecânicas e Práticas Integrativas, Instituto de Biologia Roberto Alcântara Gomes e Policlínica Piquet Carneiro, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Li F, Xie W, Han Y, Li Z, Xiao J. Bibliometric and visualized analysis of exercise and osteoporosis from 2002 to 2021. Front Med (Lausanne) 2022; 9:944444. [PMID: 36569140 PMCID: PMC9773261 DOI: 10.3389/fmed.2022.944444] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 11/16/2022] [Indexed: 12/13/2022] Open
Abstract
Background Bibliometric analysis was designed to investigate a systematic understanding of developments in exercise and osteoporosis research over the past 20 years. Methods Relevant publications from the Web of Science Core Collection were downloaded on April 26, 2022. CiteSpace, VOSviewer, and the online bibliometric analysis platform were used to conduct this scientometric study. Results A total of 5518 publications were in 1202 academic journals with 137405 co-cited references in by 5637 institutions from 98 countries/regions. The country leading the research was the USA. The University of Melbourne was the most active institution. Osteoporosis International was the most productive journal concerning exercise and osteoporosis research. According to the burst references, "low-level vibration," "high-frequency" and "resistance exercise" have been recognized as the hotspots research in the domain. The keywords co-occurrence analysis identified "skeletal muscle," "sarcopenia" and "mesenchymal stem cell" as the important future research directions. Conclusion This study was the first comprehensive metrological and statistical analysis of exercise and osteoporosis research over the past 20 years. Our findings would provide guidance to understand the research frontiers and hot directions in the near future.
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Affiliation(s)
- Fan Li
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Weixin Xie
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Han
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhanchun Li
- Department of Orthopedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Zhanchun Li,
| | - Jie Xiao
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China,Jie Xiao,
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Effects of whole body vibration in postmenopausal osteopenic women on bone mineral density, muscle strength, postural control and quality of life: the T-bone randomized trial. Eur J Appl Physiol 2022; 122:2331-2342. [PMID: 35864343 PMCID: PMC9560973 DOI: 10.1007/s00421-022-05010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/07/2022] [Indexed: 12/03/2022]
Abstract
Purpose Osteopenia is common in postmenopausal women and effective interventions increasing or stabilizing bone mineral density (BMD) to prevent fractures are urgently needed. Methods Sixty-five postmenopausal women diagnosed with osteopenia (T-score between -1.0 and -2.5) were randomly assigned to either a vibration training group (VT), a resistance training group (RT), or a control group (CG). BMD T-score values (primary endpoint) were assessed at baseline (T0) and after 12 months (T12), secondary endpoints (muscle strength, postural control, and health-related quality of life) at baseline (T0), after 6 months (T6), after 12 months (T12), and as follow-up after 15 months (T15). Results After the intervention period, neither the VT nor the RT showed any significant changes in BMD T-score values compared to the CG. Isokinetic strength improved significantly within all training groups, with the exception of the flexors of VT at an angular velocity of 240°/s. Health-related quality of life as well as postural control improved significantly for the RT only. Conclusions We conclude that participants of all three groups were able to maintain their BMD. The improvements in quality of life and postural control after resistance training are nevertheless meaningful for postmenopausal osteopenic women and support the importance of regular loadings of the musculoskeletal system. This study was retrospectively registered in January 2022 at the DRKS (S00027816) as clinical trial. Supplementary Information The online version contains supplementary material available at 10.1007/s00421-022-05010-5.
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Beck B, Rubin C, Harding A, Paul S, Forwood M. The effect of low-intensity whole-body vibration with or without high-intensity resistance and impact training on risk factors for proximal femur fragility fracture in postmenopausal women with low bone mass: study protocol for the VIBMOR randomized controlled trial. Trials 2022; 23:15. [PMID: 34991684 PMCID: PMC8734256 DOI: 10.1186/s13063-021-05911-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 12/03/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The prevailing medical opinion is that medication is the primary (some might argue, only) effective intervention for osteoporosis. It is nevertheless recognized that osteoporosis medications are not universally effective, tolerated, or acceptable to patients. Mechanical loading, such as vibration and exercise, can also be osteogenic but the degree, relative efficacy, and combined effect is unknown. The purpose of the VIBMOR trial is to determine the efficacy of low-intensity whole-body vibration (LIV), bone-targeted, high-intensity resistance and impact training (HiRIT), or the combination of LIV and HiRIT on risk factors for hip fracture in postmenopausal women with osteopenia and osteoporosis. METHODS Postmenopausal women with low areal bone mineral density (aBMD) at the proximal femur and/or lumbar spine, with or without a history of fragility fracture, and either on or off osteoporosis medications will be recruited. Eligible participants will be randomly allocated to one of four trial arms for 9 months: LIV, HiRIT, LIV + HiRIT, or control (low-intensity, home-based exercise). Allocation will be block-randomized, stratified by use of osteoporosis medications. Testing will be performed at three time points: baseline (T0), post-intervention (T1; 9 months), and 1 year thereafter (T2; 21 months) to examine detraining effects. The primary outcome measure will be total hip aBMD determined by dual-energy X-ray absorptiometry (DXA). Secondary outcomes will include aBMD at other regions, anthropometrics, and other indices of bone strength, body composition, physical function, kyphosis, muscle strength and power, balance, falls, and intervention compliance. Exploratory outcomes include bone turnover markers, pelvic floor health, quality of life, physical activity enjoyment, adverse events, and fracture. An economic evaluation will also be conducted. DISCUSSION No previous studies have compared the effect of LIV alone or in combination with bone-targeted HiRIT (with or without osteoporosis medications) on risk factors for hip fracture in postmenopausal women with low bone mass. Should either, both, or combined mechanical interventions be safe and efficacious, alternative therapeutic avenues will be available to individuals at elevated risk of fragility fracture who are unresponsive to or unwilling or unable to take osteoporosis medications. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (www. anzctr.org.au ) (Trial number ANZCTR12615000848505, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id = 368962 ); date of registration 14/08/2015 (prospectively registered). Universal Trial Number: U1111-1172-3652.
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Affiliation(s)
- Belinda Beck
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Clinton Rubin
- Department of Biomedical Engineering, State University of New York at Stony Brook, New York, NY USA
| | - Amy Harding
- Menzies Health Institute Queensland, School of Health Sciences and Social Work, Griffith University, Gold Coast, QLD Australia
| | - Sanjoy Paul
- Melbourne EpiCentre, University of Melbourne and Melbourne Health, Melbourne, VIC Australia
| | - Mark Forwood
- School of Pharmacy and Medical Sciences, Gold Coast, QLD Australia
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Abdelatief EEM, Fathy KA. Effect of class IV laser therapy and Pilates exercises on bone density and pain in primary osteoporosis: a randomised controlled trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/aims Osteoporosis is a systemic disorder characterised by a decrease in bone quality and density. This causes the bones to become weak and unable to withstand mild stresses, and the associated pain is made worse with activities. The aim of this study was to investigate the effect of class IV laser therapy and Pilates exercises on bone mineral density and pain in patients with primary osteoporosis. Methods A total of 60 patients with osteoporosis (40 women and 20 men) participated in this study. Their age ranged between 40 and 60 years. They were allocated randomly to three groups: Group A (n=20) received multiwave locked system laser therapy, group B (n=20) patients received Pilates exercises and group C (n=20) received multiwave locked system laser therapy and Pilates exercises. The treatment programme took place three times a week for 8 weeks. Bone mineral density of the lumbar spine (L1–L4) was measured by dual-energy X-ray absorptiometry and pain intensity during activities was measured by using the Numeric Pain Rating Scale. Evaluation of lumbar bone mineral density and pain intensity were performed before and after 8 weeks. Results The statistical analysis of this study revealed there was a significant increase of T-scores post-treatment compared to pre-treatment within group A (P=0.0001; P<0.05), group B (P=0.0001; P<0.05), and group C (P=0.0001), with improvement percentages of 19.59, 34.69 and 50.66% respectively. There was a decrease of pain intensity during activities post-treatment compared to pre-treatment within group A (P=0.0001; P<0.05), group B (P=0.0001; P<0.05) and group C (P=0.0001), with improvement percentages of 41.28, 54.39 and 70.09% respectively. Conclusions Class IV laser therapy and Pilates exercises are useful therapeutic modalities to increase bone mineral density and decrease pain in patients with osteoporosis, but combining them is more effective than using them separately.
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Affiliation(s)
| | - Karim Ahmed Fathy
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, October 6 University, Cairo, Egypt
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Gloeckl R, Schneeberger T, Leitl D, Reinold T, Nell C, Jarosch I, Kenn K, Koczulla AR. Whole-body vibration training versus conventional balance training in patients with severe COPD-a randomized, controlled trial. Respir Res 2021; 22:138. [PMID: 33947416 PMCID: PMC8097810 DOI: 10.1186/s12931-021-01688-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training. METHODS 48 patients with severe COPD (FEV1: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5-26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses. RESULTS Static balance performance improved significantly more (p = 0.032) in favor of WBV (path length during semi-tandem stand: - 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more (p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. - 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s2, p = 0.018 vs. 0.01 ± 0.11 m/s2, p = 0.71). CONCLUSIONS WBV can improve balance performance and muscular power significantly more compared to conventional balance training. TRIAL REGISTRATION Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03157986&cntry=&state=&city=&dist = .
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Affiliation(s)
- Rainer Gloeckl
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany. .,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany.
| | - Tessa Schneeberger
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany
| | - Daniela Leitl
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany
| | - Tobias Reinold
- Department of Prevention, Rehabilitation and Sports Medicine, Technical University of Munich, Munich, Germany
| | - Christoph Nell
- Department of Internal Medicine, Division of Pulmonary Diseases, Philipps University of Marburg, Marburg, Germany
| | - Inga Jarosch
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany
| | - Klaus Kenn
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany
| | - Andreas R Koczulla
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, German Center for Lung Research, Malterhoeh 1, 83471 Schoenau Am Koenigssee, Marburg, Germany.,Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land - Schoenau am Koenigssee, Königsee, Germany.,Teaching Hospital, Paracelsus Medical University, Salzburg, Austria
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Sonza A, Sanada LS, de Oliveira LR, Bernardo-Filho M, de Sá-Caputo DDC, Zaro MA, Achaval M. Whole-body vibration mediates mechanical hypersensitivity through Aβ-fiber and C-fiber thermal sensation in a chronic pain model. Exp Biol Med (Maywood) 2021; 246:1210-1218. [PMID: 33593110 PMCID: PMC8142106 DOI: 10.1177/1535370221991147] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 01/08/2021] [Indexed: 01/20/2023] Open
Abstract
Whole-body vibration (WBV), which is widely used as a type of exercise, involves the use of vibratory stimuli and it is used for rehabilitation and sports performance programmes. This study aimed to investigate the effect of WBV treatment in a chronic pain model after 10 WBV sessions. An animal model (chronic pain) was applied in 60 male Wistar rats (±180 g, 12 weeks old) and the animals were treated with low intensity exercise (treadmill), WBV (vibrating platform), and a combined treatment involving both. The controls on the platform were set to a frequency of 42 Hz with 2 mm peak-to-peak displacement, g ≈ 7, in a spiral mode. Before and after the vibration exposure, sensitivity was determined. Aβ-fibers-mediated mechanical sensitivity thresholds (touch-pressure) were measured using a pressure meter. C-fibers-mediated thermal perception thresholds (hot pain) were measured with a hot plate. After each session, WBV influenced the discharge of skin touch-pressure receptors, reducing mechanical sensitivity in the WBV groups (P < 0.05). Comparing the conditions "before vs. after", thermal perception thresholds (hot pain) started to decrease significantly after the third WBV session (P < 0.05). WBV decreases mechanical hyperalgesia after all sessions and thermal sensitivity after the third session with the use of WBV.
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Affiliation(s)
- Anelise Sonza
- Post-graduate Program in Physiotherapy, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis 88080-350, Brazil
- Post-graduate Program in Human Movement Sciences, UDESC, Florianópolis 88080-350, Brazil
- Post-graduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90050-170, Brazil
| | - Luciana Sayuri Sanada
- Post-graduate Program in Physiotherapy, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis 88080-350, Brazil
| | - Luiza Raulino de Oliveira
- Post-graduate Program in Physiotherapy, Centro de Ciências da Saúde e do Esporte (CEFID), Universidade do Estado de Santa Catarina (UDESC), Florianópolis 88080-350, Brazil
| | - Mario Bernardo-Filho
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biología Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro 20551-030, Brazil
| | - Danúbia da Cunha de Sá-Caputo
- Laboratório de Vibrações Mecânicas, Policlínica Piquet Carneiro, Instituto de Biología Roberto Alcantara Gomes, Rio de Janeiro State University (UERJ), Rio de Janeiro 20551-030, Brazil
| | - Milton Antonio Zaro
- Post-graduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90050-170, Brazil
| | - Matilde Achaval
- Post-graduate Program in Neurosciences, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre 90050-170, Brazil
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Jepsen DB, Masud T, Holsgaard-Larsen A, Hansen S, Jørgensen NR, Ryg J. The combined effect of parathyroid hormone (1-34) and whole-body vibration exercise on physical performance in OSteoporotic women (PaVOS study): a secondary analysis from a randomised controlled trial. BMC Sports Sci Med Rehabil 2020; 12:54. [PMID: 32944251 PMCID: PMC7487945 DOI: 10.1186/s13102-020-00204-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 08/27/2020] [Indexed: 11/10/2022]
Abstract
Background The aim of this study was to investigate the effect on physical performance of combining whole-body vibration exercise (WBV) with parathyroid hormone 1-34 (teriparatide) compared to teriparatide alone. Methods A secondary analysis from a RCT where postmenopausal women with severe osteoporosis were randomised to WBV plus teriparatide (intervention) or teriparatide alone (control). WBV was applied three times/week (6x1min WBV:1 min rest, (peak acceleration 3.6 g)) for twelve months. Both groups received teriparatide 20 μg s.c./day. The primary endpoint (bone mineral density) is reported elsewhere. Physical performance measures (Short Physical Performance Battery (SPPB), Timed-Up-and-Go (TUG), leg extension power, and grip strength) were obtained at baseline, three-, six-, and twelve months, lean mass at baseline and twelve months. Data were analysed with mixed linear regression model or robust cluster regression in an intention to treat analysis. Results Thirty-five women aged (mean ± SD) 69 ± 7) years were recruited of which thirty-two (91%) completed the twelve months follow-up (WBV + teriparatide = 15, teriparatide = 17). SPPB score (mean ± SD) improved significantly at three months in the WBV + teriparatide group from 9.13 ± 2.03 to 10.35 ± 1.69 (p = 0.014) with a statistical trend towards a between-group change in favor of the WBV + teriparatide group (0.86 [95%CI(- 0.05,1.77), p = 0.065]). Both groups improved in leg extension power during the study period whereas no changes were seen in TUG, grip strength, or lean mass in either group. No statistical significant between-group differences were observed. Conclusion WBV may improve some short-term aspects of physical performance in severely osteoporotic postmenopausal women who are receiving teriparatide treatment. Trial Registration ClinicalTrials.gov, ID:NCT02563353.
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Affiliation(s)
- Ditte Beck Jepsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Tahir Masud
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Geriatric Medicine, Nottingham University Hospitals Trust NHS, Nottingham, UK
| | - Anders Holsgaard-Larsen
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Orthopaedics and Traumatology, Odense University Hospital, Odense, Denmark
| | - Stinus Hansen
- Department of Endocrinology, Hospital South West Jutland, Esbjerg, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.,OPEN- Odense Patient data Explorative Network, Odense University Hospital/ University of Southern Denmark, Odense, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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de Oliveira LC, de Oliveira RG, de Almeida Pires-Oliveira DA. Effects of Whole-Body Vibration Versus Pilates Exercise on Bone Mineral Density in Postmenopausal Women: A Randomized and Controlled Clinical Trial. J Geriatr Phys Ther 2020; 42:E23-E31. [PMID: 29443867 DOI: 10.1519/jpt.0000000000000184] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND PURPOSE Decreased bone mineral density (BMD) is a common condition in postmenopausal women that can be managed with impact activities. Among the activities studied are the whole-body vibration (WBV) and muscle-strengthening exercises. The purpose of this study was to compare the effects of WBV versus Pilates exercise on BMD in postmenopausal women. METHODS In this study, 51 postmenopausal women were randomized into 3 groups: vibration (n = 17), Pilates (n = 17), and control (n = 17). Outcomes were the areal bone mineral density (aBMD) (lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and ward's area) assessed by dual-energy x-ray absorptiometry at baseline and follow-up. The interventions were performed 3 times a week for 6 months, totaling 78 sessions. The analysis was performed with intention-to-treat and covariance analyses adjusted for baseline outcomes. RESULTS After 6 months, 96.1% of the participants completed the follow-up. The analyses demonstrated significant mean between-group differences in favor of the interventions: vibration versus control, for the aBMD of the lumbar spine (0.014 g/cm; 95% confidence interval [CI], 0.006-0.022; P = .018, d = 1.21) and trochanter (0.018 g/cm; 95% CI, 0.006-0.030; P = .012, d = 1.03); and Pilates versus control, for the aBMD of the lumbar spine (0.016 g/cm; 95% CI, 0.007-0.025; P = .008, d = 1.15) and trochanter (0.020 g/cm; 95% CI, 0.010-0.031; P = .005, d = 1.28). CONCLUSION In postmenopausal women, 3 weekly sessions of WBV or Pilates administered for 6 months provided an equal effect on BMD.
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Holsgrove TP, Zeeman ME, Welch WC, Winkelstein BA. Pain After Whole-Body Vibration Exposure Is Frequency Dependent and Independent of the Resonant Frequency: Lessons From an In Vivo Rat Model. J Biomech Eng 2020; 142:958443. [PMID: 31513714 DOI: 10.1115/1.4044547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Indexed: 12/24/2022]
Abstract
Occupational whole-body vibration (WBV) increases the risk of developing low back and neck pain; yet, there has also been an increased use of therapeutic WBV in recent years. Although the resonant frequency (fr) of the spine decreases as the exposure acceleration increases, effects of varying the vibration profile, including peak-to-peak displacement (sptp), root-mean-squared acceleration (arms), and frequency (f), on pain onset are not known. An established in vivo rat model of WBV was used to characterize the resonance of the spine using sinusoidal sweeps. The relationship between arms and fr was defined and implemented to assess behavioral sensitivity-a proxy for pain. Five groups were subjected to a single 30-min exposure, each with a different vibration profile, and a sham group underwent only anesthesia exposure. The behavioral sensitivity was assessed at baseline and for 7 days following WBV-exposure. Only WBV at 8 Hz induced behavioral sensitivity, and the higher arms exposure at 8 Hz led to a more robust pain response. These results suggest that the development of pain is frequency-dependent, but further research into the mechanisms leading to pain is warranted to fully understand which WBV profiles may be detrimental or beneficial.
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Affiliation(s)
- Timothy P Holsgrove
- Department of Engineering, University of Exeter, Harrison Building, Streatham Campus, Exeter EX4 4AG, UK
| | - Martha E Zeeman
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia PA 19104
| | - William C Welch
- Department of Neurosurgery, University of Pennsylvania, Pennsylvania Hospital, Washington Square West Building, 235 South 8th Street, Philadelphia, PA 19106
| | - Beth A Winkelstein
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, 210 South 33rd Street, Room 240 Skirkanich Hall, Philadelphia PA 19104; Department of Neurosurgery, University of Pennsylvania, Pennsylvania Hospital, Washington Square West Building, 235 South 8th Street, Philadelphia, PA 19106
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Iwamoto J, Takeda T, Sato Y, Uzawa M. Retraction Note to: Effect of whole-body vibration exercise on lumbar bone mineral density, bone turnover, and chronic back pain in post-menopausal osteoporotic women treated with alendronate. Aging Clin Exp Res 2019; 31:1855. [PMID: 31730223 DOI: 10.1007/s40520-019-01373-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The Editor-in-Chief has retracted this article [1] because an investigation by Keio University has concluded that there are inaccuracies in the data reported.
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Takanashi Y, Chinen Y, Hatakeyama S. Whole-body vibration training improves the balance ability and leg strength of athletic throwers. J Sports Med Phys Fitness 2019; 59:1110-1118. [DOI: 10.23736/s0022-4707.18.09012-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Wang XQ, Gu W, Chen BL, Wang X, Hu HY, Zheng YL, Zhang J, Zhang HY, Chen PJ. Effects of whole-body vibration exercise for non-specific chronic low back pain: an assessor-blind, randomized controlled trial. Clin Rehabil 2019; 33:1445-1457. [PMID: 31099264 DOI: 10.1177/0269215519848076] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To confirm the benefits of whole-body vibration exercise for pain intensity and functional disability in patients with non-specific chronic low back pain. DESIGN Single-blind randomized controlled trial. SETTING Outpatient. SUBJECTS Eighty-nine patients with non-specific chronic low back pain met the inclusion criteria, they were randomly allocated to either the intervention group (n = 45) or the control group (n = 44). INTERVENTION The intervention group received whole-body vibration exercises three times a week for 12 weeks. The control group received general exercise protocol three times a week for 12 weeks. MAIN OUTCOMES The primary outcome measures were pain intensity and functional disability measured by the visual analog scale scores and Oswestry Disability Index. The secondary outcome measures included lumbar joint position sense, quality of life (Short Form Health Survey 36) and overall treatment effect (Global Perceived Effect). RESULTS A total of 84 subjects completed the 12-week study program. After 12 weeks, compared with the control group, the mean visual analog scale and Oswestry Disability Index scores decreased by additional 1 point (95% confidence interval (CI) = -1.22 to -0.78; P < 0.001), 3.81 point (95% CI, -4.98, -2.63; P < 0.001) based on adjusted analysis in the intervention group. And the intervention group provided additional beneficial effects for in terms of lumbar joint position sense (P < 0.05), quality of life (P < 0.05), and Global Perceived Effect (P = 0.012). CONCLUSION The study demonstrated that whole-body vibration exercise could provide more benefits than general exercise for relieving pain and improving functional disability in patients with non-specific chronic low back pain.
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Affiliation(s)
- Xue-Qiang Wang
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.,2 Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
| | - Wei Gu
- 3 Department of Rehabilitation Medicine, Affiliated to Traditional Chinese Medicine Faculty, Changhai Hospital, Shanghai, China
| | - Bing-Lin Chen
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xin Wang
- 3 Department of Rehabilitation Medicine, Affiliated to Traditional Chinese Medicine Faculty, Changhai Hospital, Shanghai, China
| | - Hao-Yu Hu
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Yi-Li Zheng
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Juan Zhang
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Han-Yu Zhang
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Pei-Jie Chen
- 1 Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.,2 Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China
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Dong Y, Wang W, Zheng J, Chen S, Qiao J, Wang X. Whole Body Vibration Exercise for Chronic Musculoskeletal Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2019; 100:2167-2178. [PMID: 31004565 DOI: 10.1016/j.apmr.2019.03.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/15/2019] [Accepted: 03/16/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study systematically reviews previous work on the effects of whole body vibration exercise (WBVE) on pain associated with chronic musculoskeletal disorders. DATA SOURCES Seven electronic databases (PubMed, Embase, CINAHL, Web of Science, Cochrane, Physiotherapy Evidence Database [PEDro], and the China National Knowledge Infrastructure) were searched for articles published between January 1980 and September 2018. STUDY SELECTION Randomized controlled trials involving adults with chronic low back pain (CLBP), osteoarthritis (OA), or fibromyalgia were included. Participants in the WBVE intervention group were compared with those in the nontreatment and non-WBVE control groups. DATA EXTRACTION Data were independently extracted using a standardized form. Methodological quality was assessed using PEDro. DATA SYNTHESIS Suitable data from 16 studies were pooled for meta-analysis. A random effects model was used to calculate between-groups mean differences at 95% confidence interval (CI). The data were analyzed depending on the duration of the follow-up, common disorders, and different control interventions. RESULTS Alleviation of pain was observed at medium term (standardized mean difference [SMD], -0.67; 95% CI, -1.14 to -0.21; I2, 80%) and long term (SMD, -0.31; 95% CI, -0.59 to -0.02; I2, 0%). Pain was alleviated in osteoarthritis (OA) (SMD, -0.37; 95% CI, -0.64 to -0.10; P<.05; I2, 22%) and CLBP (SMD, -0.44; 95% CI, -0.75 to -0.13; P<.05; I2, 12%). Long-term WBVE could relieve chronic musculoskeletal pain conditions of OA (SMD, -0.46; 95% CI, -0.80 to -0.13; P<.05; I2, 0%). WBVE improved chronic musculoskeletal pain compared with the treatment "X" control (SMD, -0.37; 95% CI, -0.61 to -0.12; P<.05; I2, 26%), traditional treatment control (SMD, -1.02; 95% CI, -2.44 to 0.4; P>.05; I2, 94%) and no treatment control (SMD, -1; 95% CI, -1.76 to -0.24; P<.05; I2, 75%). CONCLUSIONS Evidence suggests positive effects of WBVE on chronic musculoskeletal pain, and long durations of WBVE could be especially beneficial. However, WBVE does not significantly relieve chronic musculoskeletal pain compared with the traditional treatment. Further work is required to identify which parameters of WBVE are ideal for patients with chronic musculoskeletal pain.
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Affiliation(s)
- Yulin Dong
- Department of Treatment, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Wu Wang
- Department of Treatment, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jiejiao Zheng
- Rehabilitation Medical Department, Hua Dong Hospital, Shanghai, China
| | - Su Chen
- Department of Treatment, The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Jun Qiao
- Department of Treatment, The Second Rehabilitation Hospital of Shanghai, Shanghai, China.
| | - Xueqiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
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The Effect of Mechanically-Generated Vibrations on the Efficacy of Hemodialysis; Assessment of Patients' Safety: Preliminary Reports. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040594. [PMID: 30781708 PMCID: PMC6406417 DOI: 10.3390/ijerph16040594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 11/24/2022]
Abstract
Muscle activity during a hemodialysis procedure improves its efficacy. We have formulated a hypothesis that vibrations generated by a specially-designed dialysis chair can, the same as physical exercise, affect the filtering of various fluids between fluid spaces during the hemodialysis procedure. This prospective and interventional study included 21 dialyzed patients. During a single dialysis session, each patient used a prototype device with the working name “vibrating chair”. The chair’s drive used a low-power cage induction motor, which, along with the worm gear motor, was a part of the low-frequency (3.14 Hz) vibration-generating assembly with an amplitude of 4 mm. Tests and measurements were performed before and after the vibration dialysis. After a single hemodialysis session including five 3-min cycles of vibrations, an increase in Kt/V in relation to non-vibration Kt/V (1.53±0.26 vs. 1.62±0.23) was seen. Urea reduction ratio increased significantly (0.73±0.03 vs. 0.75±0.03). A significant increase in systolic blood pressure was observed between the first and the third measurement (146±18 vs. 156±24). The use of a chair generating low-frequency vibrations increased dialysis adequacy; furthermore, it seems an acceptable and safe alternative to intradialytic exercise.
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Marin-Puyalto J, Gomez-Cabello A, Gonzalez-Agüero A, Gomez-Bruton A, Matute-Llorente A, Casajús JA, Vicente-Rodríguez G. Is Vibration Training Good for Your Bones? An Overview of Systematic Reviews. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5178284. [PMID: 30519579 PMCID: PMC6241242 DOI: 10.1155/2018/5178284] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 09/24/2018] [Accepted: 10/23/2018] [Indexed: 01/08/2023]
Abstract
Whole-body vibration (WBV) intervention studies and reviews have been increasing lately. However, the results regarding its effects on bone tissue in different populations are still inconclusive. The goal of this overview was to summarize systematic reviews assessing the effects of WBV training on bone parameters. Three electronic databases were scanned for systematic reviews and meta-analyses evaluating the effects of WBV on bone tissue. The search had no time restrictions and was limited to articles written in English. Vibration protocols and the main bone parameters included in each review were extracted. Methodological quality was assessed and analyses were conducted stratifying by age. 17 reviews and meta-analyses fulfilled the inclusion criteria. No increase or small improvements in bone mineral density (BMD) after WBV interventions were observed in reviews regarding postmenopausal women. One intervention study regarding young adults was included and reported no bone-related benefits from WBV. Most reviews including children and adolescents with compromised bone mass showed an improvement of BMD at lower limbs, lumbar spine, and whole body. In conclusion, WBV interventions seem to help children and adolescents with compromised bone mass to increase their BMD, but these improvements are limited in postmenopausal women and there is insufficient evidence for young adults. Further research is also needed to identify the ideal parameters of WBV training focused on bone health.
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Affiliation(s)
- Jorge Marin-Puyalto
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
| | - Alba Gomez-Cabello
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro Universitario de la Defensa, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - Alejandro Gonzalez-Agüero
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - Alejandro Gomez-Bruton
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - Angel Matute-Llorente
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - Jose A. Casajús
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
| | - German Vicente-Rodríguez
- Faculty of Health and Sport Science (FCSD), Department of Physiatry and Nursing. Universidad de Zaragoza, Ronda Misericordia 5, 22001 Huesca, Spain
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Zaragoza, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- EXERNET Red de Investigación en Ejercicio Físico y Salud para Poblaciones Especiales, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Spain
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Weissenfels A, Teschler M, Willert S, Hettchen M, Fröhlich M, Kleinöder H, Kohl M, von Stengel S, Kemmler W. Effects of whole-body electromyostimulation on chronic nonspecific low back pain in adults: a randomized controlled study. J Pain Res 2018; 11:1949-1957. [PMID: 30288089 PMCID: PMC6160275 DOI: 10.2147/jpr.s164904] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Purpose Low back pain (LBP) is one of the most frequent chronic conditions worldwide. Data from a recent meta-analysis indicated that whole-body electromyostimulation (WB-EMS), a time-effective, joint-friendly, and highly individualized training technology, demonstrated promising effects on LBP; however, methodologic limitations prevent definitive evidence for this result. Thus, the aim of this study was to conduct a randomized controlled WB-EMS trial to determine the corresponding effect on chronic, nonspecific LBP in people with chronic LBP. Patients and methods Thirty LBP patients, 40-70 years old, were randomly assigned into two groups (WB-EMS: 15; control [CG]: 15). While the nonactive CG maintained their lifestyle, the WB-EMS group completed a 12-week WB-EMS protocol (1×20 min/week) with slight movements, specifically dedicated to LBP. Pain intensity and frequency were determined by a 4-week pain diary before and during the last 4 weeks of intervention. Primary study endpoint was average pain intensity at the lumbar spine. Results At baseline, no group differences apart from nonregular exercise were observed. Mean intensity of LBP decreased significantly in the WB-EMS group (P=0.002) and remained unchanged in the CG (P=0.730), with a significant difference between both groups (P=0.027). Maximum isometric trunk extensors improved significantly in the WB-EMS group (P=0.005), while no significant difference was seen in the CG (P=0.683). In contrast to the significant difference between WB-EMS group and CG for the latter parameter (P=0.038), no intergroup difference was determined for maximum isometric trunk flexors (P=0.091). The WB-EMS group showed a significant increase of this parameter (P=0.003), while no significant change was determined in the CG (P=0.563). Conclusion WB-EMS is a time-effective training method for reducing chronic nonspecific LBP and increasing maximum trunk strength in people with such complaints. After this promising comparison with a nonactive CG, research needs to be extended to include comparisons with active groups (WB-Vibration, conventional back strengthening).
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Affiliation(s)
- Anja Weissenfels
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
| | - Marc Teschler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
| | - Sebastian Willert
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
| | - Michael Hettchen
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
| | - Michael Fröhlich
- Department of Sports Science, University of Kaiserslautern, Kaiserslautern, Germany
| | - Heinz Kleinöder
- Institute of Training Science and Sport Informatics, German Sport University Cologne, Cologne, Germany
| | - Matthias Kohl
- Department of Medical and Life Sciences University of Furtwangen, Villingen-Schwenningen, Germany
| | - Simon von Stengel
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
| | - Wolfgang Kemmler
- Institute of Medical Physics, Friedrich-Alexander University of Erlangen, Erlangen, Germany,
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Marín-Cascales E, Alcaraz PE, Ramos-Campo DJ, Martinez-Rodriguez A, Chung LH, Rubio-Arias JÁ. Whole-body vibration training and bone health in postmenopausal women: A systematic review and meta-analysis. Medicine (Baltimore) 2018; 97:e11918. [PMID: 30142802 PMCID: PMC6112924 DOI: 10.1097/md.0000000000011918] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The aims of the present systematic review and meta-analysis were to evaluate published, randomized controlled trials that investigate the effects on whole-body vibration (WBV) training on total, femoral neck, and lumbar spine bone mineral density (BMD) in postmenopausal women, and identify the potential moderating factors explaining the adaptations to such training. METHODS From a search of electronic databases (PubMed, Web of Science, and Cochrane) up until September 2017, a total 10 studies with 14 WBV groups met the inclusion criteria. Three different authors tabulated, independently, the selected indices in identical predetermined forms. The methodological quality of all studies was evaluated according to the modified PEDro scale. For each trial, differences within arms were calculated as mean differences (MDs) and their 95% confidence intervals between pre- and postintervention values. The effects on bone mass between exercise and control groups were also expressed as MDs. Both analyses were performed in the total sample and in a specific class of postmenopausal women younger than 65 years of age (excluding older women). RESULTS The BMD of 462 postmenopausal women who performed WBV or control protocol was evaluated. Significant pre-post improvements in BMD of the lumbar spine were identified following WBV protocols (P = .03). Significant differences in femoral neck BMD (P = .03) were also found between intervention and control groups when analyzing studies that included postmenopausal women younger than 65 years. CONCLUSIONS WBV is an effective method to improve lumbar spine BMD in postmenopausal and older women and to enhance femoral neck BMD in postmenopausal women younger than 65 years.
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Affiliation(s)
| | - Pedro E. Alcaraz
- Research Center for High Performance Sport
- Faculty of Sport Sciences – Catholic University of Murcia, UCAM, Murcia
| | - Domingo J. Ramos-Campo
- Research Center for High Performance Sport
- Faculty of Sport Sciences – Catholic University of Murcia, UCAM, Murcia
| | | | - Linda H. Chung
- Research Center for High Performance Sport
- Faculty of Sport Sciences – Catholic University of Murcia, UCAM, Murcia
| | - Jacobo Á. Rubio-Arias
- Research Center for High Performance Sport
- Faculty of Sport Sciences – Catholic University of Murcia, UCAM, Murcia
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Manage osteoporotic pain by treating osteoporosis and taking a multidimensional approach to pain management. DRUGS & THERAPY PERSPECTIVES 2018. [DOI: 10.1007/s40267-018-0504-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Baker MK, Peddle-McIntyre CJ, Galvão DA, Hunt C, Spry N, Newton RU. Whole Body Vibration Exposure on Markers of Bone Turnover, Body Composition, and Physical Functioning in Breast Cancer Patients Receiving Aromatase Inhibitor Therapy: A Randomized Controlled Trial. Integr Cancer Ther 2018; 17:968-978. [PMID: 29952241 PMCID: PMC6142085 DOI: 10.1177/1534735418781489] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: Women with breast cancer are often prescribed
aromatase inhibitors, which can cause rapid loss of bone mass leading to
significant potential for morbidity. Vibration training has been shown to be
helpful in reducing bone turnover in postmenopausal women without cancer.
Aim: To examine the effect of vibration stimulus on markers of
bone turnover in breast cancer patients receiving aromatase inhibitors.
Methods: Thirty-one breast cancer survivors undergoing
treatment with aromatase inhibitors were randomized to vibration stimulus (n =
14) or usual care control (n = 17). Low-frequency and low-magnitude vibration
stimulus (27-32 Hz, 0.3g) was delivered in supervised sessions
via standing on a vibration platform for 20 minutes, 3 times per week for 12
weeks. The primary outcome was blood markers of bone resorption (serum
N-telopeptide X/creatine) and formation (serum type 1 procollagen N-terminal
propeptide; P1NP). Other study outcomes body composition as well as measures of
physical functioning. Outcomes were compared between groups using analysis of
covariance adjusted for baseline values as well as time on aromatase inhibitors.
Outcomes: On average, participants were 61.5 years old and
overweight (ie, body mass index = 28.5 kg/m2). Following vibration
training, there was no significant difference between groups for bone resorption
(adjusted group difference 0.5, P = .929) or formation
(adjusted group difference 5.3, P = .286). There were also no
changes in any measure of physical functioning body composition.
Conclusions: Short-term low-magnitude vibration stimulus does
not appear to be useful for reducing markers of bone turnover secondary to
aromatase inhibitors in breast cancer patients; nor is it useful in improving
physical function or symptoms. However, further investigations with larger
samples and higher doses of vibration are warranted. Trial
Registration: Australian and New Zealand Clinical Trials Registry
(ACTRN12611001094965).
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Affiliation(s)
- Michael K Baker
- 1 Australian Catholic University, Strathfield, New South Wales, Australia
| | | | - Daniel A Galvão
- 2 Edith Cowan University, Joondalup, Western Australia, Australia
| | - Catherine Hunt
- 3 Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Nigel Spry
- 2 Edith Cowan University, Joondalup, Western Australia, Australia.,3 Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Robert U Newton
- 2 Edith Cowan University, Joondalup, Western Australia, Australia
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Shibamoto A, Ogawa T, Duyck J, Vandamme K, Naert I, Sasaki K. Effect of high-frequency loading and parathyroid hormone administration on peri-implant bone healing and osseointegration. Int J Oral Sci 2018. [PMID: 29531334 PMCID: PMC5944597 DOI: 10.1038/s41368-018-0009-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
The objective of this study is to examine the effect of low-magnitude, high-frequency (LMHF) loading, and anti-osteoporosis medications such as parathyroid hormone (PTH) and bisphosphonates on peri-implant bone healing in an osteoporosis model, and to assess their combined effects on these processes. Thirteen-week-old ovariectomized rats (n = 44) were divided into three groups: PTH, alendronate, and saline. After 3 weeks of drug administration, titanium implants were inserted into the tibiae. Each group was subdivided into two groups: with or without LMHF loading via whole-body vibration (50 Hz at 0.5 g, 15 min per day, 5 days per week). Rats were killed 4 weeks following implantation. Removal torque test, micro-CT analyses (relative gray (RG) value, water = 0, and implant = 100), and histomorphometric analyses (bone-to-implant contact (BIC) and peri-implant bone formation (bone volume/tissue volume (BV/TV))) were performed. Removal torque values and BIC were significantly differed by loading and drug administration (ANOVA). Post hoc analysis showed that PTH-treated groups were significantly higher than the other drug-treated groups. BV/TV was significantly enhanced by PTH administration. In cortical bone, RG values were significantly increased by loading. In trabecular bone, however, RG values were significantly increased by PTH administration. These findings suggest that LMHF loading and PTH can act locally and additively on the bone healing process, improving the condition of implant osseointegration. Whole-body vibration and administration of a hormone used to treat osteoporosis can enhance bone healing at the site of a titanium implant. Toru Ogawa of Tohoku University Graduate School of Dentistry in Sendai, Japan, and colleagues gave anti-osteoporosis medications, either parathyroid hormone or the bisphosphonate drug alendronate, to female rat models of osteoporosis. After three weeks of drug administration or a saline control, the researchers inserted titanium implants into the rats’ leg bones. Half the rats were then exposed to whole-body vibration, which applies low-magnitude, high-frequency mechanical forces. A multitude of tests showed that parathyroid hormone improved bone healing at the implant more than alendronate or saline did. The vibrational stimulus further increased the healing. The findings suggest that these treatments could aid in oral bone healing for patients receiving dental implants.
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Affiliation(s)
- Aya Shibamoto
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - Toru Ogawa
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - Joke Duyck
- Department of Oral Health Sciences, Prosthetic Dentistry, BIOMAT-Biomaterials, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Katleen Vandamme
- Department of Oral Health Sciences, Prosthetic Dentistry, BIOMAT-Biomaterials, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Ignace Naert
- Department of Oral Health Sciences, Prosthetic Dentistry, BIOMAT-Biomaterials, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Keiichi Sasaki
- Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Abstract
The high worldwide prevalence of osteoporosis means it is considered a serious public health concern, possibly leading to physical disability and an increased mortality rate. Although osteoporosis is known as a silent disease affecting aging populations, its primary symptom remains pain. Acute pain is reported by patients with osteoporosis-related fractures, but chronic pain, mainly back pain, is also a characteristic of severe osteoporosis. Pain is associated not only with fractures but also with bodily changes in patients with osteoporosis that may include sensory, affective, and cognitive aspects. Chronic pain leads to progressive loss of independence and the need for long-term care, especially in the elderly. Pain prevention is linked to the appropriate treatment of osteoporosis, and pain management in patients with osteoporosis requires a multidimensional approach to preserve and improve quality of life. Our aim was to review and discuss the main causes of pain in patients with osteoporosis and suggest possible strategies for its management and prevention.
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Kaeding TS, Moghaddamnia S, Kück M, Stein L. Deviations in frequency and mode of vibration in whole-body vibration training devices with long-term and regular use. Med Eng Phys 2018; 51:84-90. [DOI: 10.1016/j.medengphy.2017.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 10/14/2017] [Accepted: 10/29/2017] [Indexed: 10/18/2022]
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Kim YH, Yoon DH, Kim HK, Song W. Prevalence of Osteopenia According to Physical Fitness in Men: A Cross-Sectional Study. Ann Geriatr Med Res 2017. [DOI: 10.4235/agmr.2017.21.4.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Yong Hwan Kim
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Korea
| | - Dong Hyun Yoon
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Korea
| | - Hong Kyu Kim
- Health Promotion Center, Asan Medical Center, Seoul, Korea
| | - Wook Song
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul, Korea
- Institute on Aging, Seoul National University, Seoul, Korea
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Jepsen DB, Thomsen K, Hansen S, Jørgensen NR, Masud T, Ryg J. Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis. BMJ Open 2017; 7:e018342. [PMID: 29289937 PMCID: PMC6027066 DOI: 10.1136/bmjopen-2017-018342] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age. DESIGN A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2 statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions. DATA SOURCES The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA). RESULTS 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA. CONCLUSIONS WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls. PROSPERO REGISTRATION NUMBER CRD42016036320; Pre-results.
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Affiliation(s)
- Ditte Beck Jepsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Katja Thomsen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark
| | - Stinus Hansen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- OPEN-Odense Patient data Explorative Network, Odense University Hospital/ University of Southern Denmark, Odense, Denmark
| | - Tahir Masud
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
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Tseng SC, Shields RK. Limb Segment Load Inhibits the Recovery of Soleus H-Reflex After Segmental Vibration in Humans. J Mot Behav 2017; 50:631-642. [PMID: 29140761 DOI: 10.1080/00222895.2017.1394259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated the effects of vertical vibration and compressive load on soleus H-reflex amplitude and postactivation depression. We hypothesized that, in the presence of a compressive load, limb vibration induces a longer suppression of soleus H-reflex. Eleven healthy adults received vibratory stimulation at a fixed frequency (30 Hz) over two loading conditions (0% and 50% of individual's body weight). H-reflex amplitude was depressed ∼88% in both conditions during vibration. Cyclic application of compression after cessation of the vibration caused a persistent reduction in H-reflex excitability and postactivation depression for > 2.5 min. A combination of limb segment vibration and compression may offer a nonpharmacologic method to modulate spinal reflex excitability in people after CNS injury.
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Affiliation(s)
- Shih-Chiao Tseng
- a School of Physical Therapy , Texas Woman's University , 6700 Fannin, Houston , Texas , USA
| | - Richard K Shields
- b Department of Physical Therapy & Rehabilitation Science , University of Iowa, Carver College of Medicine , Iowa City , Iowa , USA
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Bidonde J, Busch AJ, van der Spuy I, Tupper S, Kim SY, Boden C. Whole body vibration exercise training for fibromyalgia. Cochrane Database Syst Rev 2017; 9:CD011755. [PMID: 28950401 PMCID: PMC6483692 DOI: 10.1002/14651858.cd011755.pub2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Exercise training is commonly recommended for adults with fibromyalgia. We defined whole body vibration (WBV) exercise as use of a vertical or rotary oscillating platform as an exercise stimulus while the individual engages in sustained static positioning or dynamic movements. The individual stands on the platform, and oscillations result in vibrations transmitted to the subject through the legs. This review is one of a series of reviews that replaces the first review published in 2002. OBJECTIVES To evaluate benefits and harms of WBV exercise training in adults with fibromyalgia. SEARCH METHODS We searched the Cochrane Library, MEDLINE, Embase, CINAHL, PEDro, Thesis and Dissertation Abstracts, AMED, WHO ICTRP, and ClinicalTrials.gov up to December 2016, unrestricted by language, to identify potentially relevant trials. SELECTION CRITERIA We included randomized controlled trials (RCTs) in adults with the diagnosis of fibromyalgia based on published criteria including a WBV intervention versus control or another intervention. Major outcomes were health-related quality of life (HRQL), pain intensity, stiffness, fatigue, physical function, withdrawals, and adverse events. DATA COLLECTION AND ANALYSIS Two review authors independently selected trials for inclusion, extracted data, performed risk of bias assessments, and assessed the quality of evidence for major outcomes using the GRADE approach. We used a 15% threshold for calculation of clinically relevant differences. MAIN RESULTS We included four studies involving 150 middle-aged female participants from one country. Two studies had two treatment arms (71 participants) that compared WBV plus mixed exercise plus relaxation versus mixed exercise plus relaxation and placebo WBV versus control, and WBV plus mixed exercise versus mixed exercise and control; two studies had three treatment arms (79 participants) that compared WBV plus mixed exercise versus control and mixed relaxation placebo WBV. We judged the overall risk of bias as low for selection (random sequence generation), detection (objectively measured outcomes), attrition, and other biases; as unclear for selection bias (allocation concealment); and as high for performance, detection (self-report outcomes), and selective reporting biases.The WBV versus control comparison reported on three major outcomes assessed at 12 weeks post intervention based on the Fibromyalgia Impact Questionnaire (FIQ) (0 to 100 scale, lower score is better). Results for HRQL in the control group at end of treatment (59.13) showed a mean difference (MD) of -3.73 (95% confidence interval [CI] -10.81 to 3.35) for absolute HRQL, or improvement of 4% (11% better to 3% worse) and relative improvement of 6.7% (19.6% better to 6.1% worse). Results for withdrawals indicate that 14 per 100 and 10 per 100 in the intervention and control groups, respectively, withdrew from the intervention (RR 1.43, 95% CI 0.27 to 7.67; absolute change 4%, 95% CI 16% fewer to 24% more; relative change 43% more, 95% CI 73% fewer to 667% more). The only adverse event reported was acute pain in the legs, for which one participant dropped out of the program. We judged the quality of evidence for all outcomes as very low. This study did not measure pain intensity, fatigue, stiffness, or physical function. No outcomes in this comparison met the 15% threshold for clinical relevance.The WBV plus mixed exercise (aerobic, strength, flexibility, and relaxation) versus control study (N = 21) evaluated symptoms at six weeks post intervention using the FIQ. Results for HRQL at end of treatment (59.64) showed an MD of -16.02 (95% CI -31.57 to -0.47) for absolute HRQL, with improvement of 16% (0.5% to 32%) and relative change in HRQL of 24% (0.7% to 47%). Data showed a pain intensity MD of -28.22 (95% CI -43.26 to -13.18) for an absolute difference of 28% (13% to 43%) and a relative change of 39% improvement (18% to 60%); as well as a fatigue MD of -33 (95% CI -49 to -16) for an absolute difference of 33% (16% to 49%) and relative difference of 47% (95% CI 23% to 60%); and a stiffness MD of -26.27 (95% CI -42.96 to -9.58) for an absolute difference of 26% (10% to 43%) and a relative difference of 36.5% (23% to 60%). All-cause withdrawals occurred in 8 per 100 and 33 per 100 withdrawals in the intervention and control groups, respectively (two studies, N = 46; RR 0.25, 95% CI 0.06 to 1.12) for an absolute risk difference of 24% (3% to 51%). One participant exhibited a mild anxiety attack at the first session of WBV. No studies in this comparison reported on physical function. Several outcomes (based on the findings of one study) in this comparison met the 15% threshold for clinical relevance: HRQL, pain intensity, fatigue, and stiffness, which improved by 16%, 39%, 46%, and 36%, respectively. We found evidence of very low quality for all outcomes.The WBV plus mixed exercise versus other exercise provided very low quality evidence for all outcomes. Investigators evaluated outcomes on a 0 to 100 scale (lower score is better) for pain intensity (one study, N = 23; MD -16.36, 95% CI -29.49 to -3.23), HRQL (two studies, N = 49; MD -6.67, 95% CI -14.65 to 1.31), fatigue (one study, N = 23; MD -14.41, 95% CI -29.47 to 0.65), stiffness (one study, N = 23; MD -12.72, 95% CI -26.90 to 1.46), and all-cause withdrawal (three studies, N = 77; RR 0.72, 95% CI -0.17 to 3.11). Adverse events reported for the three studies included one anxiety attack at the first session of WBV and one dropout from the comparison group ("other exercise group") due to an injury that was not related to the program. No studies reported on physical function. AUTHORS' CONCLUSIONS Whether WBV or WBV in addition to mixed exercise is superior to control or another intervention for women with fibromyalgia remains uncertain. The quality of evidence is very low owing to imprecision (few study participants and wide confidence intervals) and issues related to risk of bias. These trials did not measure major outcomes such as pain intensity, stiffness, fatigue, and physical function. Overall, studies were few and were very small, which prevented meaningful estimates of harms and definitive conclusions about WBV safety.
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Affiliation(s)
- Julia Bidonde
- Norwegian Institute of Public HealthPO Box 4404 NydalenOsloNorway0403
| | - Angela J Busch
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | - Ina van der Spuy
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | | | - Soo Y Kim
- University of SaskatchewanSchool of Physical Therapy104 Clinic PlaceSaskatoonCanadaS7N 2Z4
| | - Catherine Boden
- University of SaskatchewanLeslie and Irene Dube Health Sciences Library, University LibraryRm 1400 Health Sciences Building 104 Clinic PlaceSaskatoonCanadaS7N 5E5
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Vibration-related extrusion of capillary blood from the calf musculature depends upon directions of vibration of the leg and of the gravity vector. Eur J Appl Physiol 2017; 117:1107-1117. [DOI: 10.1007/s00421-017-3597-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 03/25/2017] [Indexed: 11/26/2022]
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Maddalozzo GF, Kuo B, Maddalozzo WA, Maddalozzo CD, Galver JW. Comparison of 2 Multimodal Interventions With and Without Whole Body Vibration Therapy Plus Traction on Pain and Disability in Patients With Nonspecific Chronic Low Back Pain. J Chiropr Med 2016; 15:243-251. [PMID: 27857632 PMCID: PMC5106425 DOI: 10.1016/j.jcm.2016.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 07/06/2016] [Accepted: 07/07/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE The purpose of this secondary data analysis was to compare the effect of 2 multimodal exercise-based physical therapy interventions (one with and one without whole-body vibration [WBV] therapy plus traction) on pain and disability in patients with nonspecific chronic low back pain (NSCLBP). METHODS We conducted a secondary analysis of data from 2 distinct samples. One sample was from the Focus on Therapeutic Outcomes Inc. (FOTO) group (n = 55, age 55.1 ± 19.0 years), and the other was the Illinois Back Institute (IBI) (n = 70, age 47.5 ± 13.4 years). Both groups of patients had NSCLBP for more than 3 months and a pain numeric rating scale (NRS) score of ≥7. Both groups received treatment consisting of flexibility or stretching exercises, core stability training, functional training, and postural exercises and strengthening exercises. However, the IBI group also received WBV plus traction. NSCLBP was measured before and after therapeutic trials using the NRS for pain and Oswestry Disability Index (ODI). RESULTS The NRS scores were significantly improved in both groups, decreasing by 2 points in the FOTO group and by 5 points in the IBI group. The ODI scores were significantly improved in both groups; the FOTO group score improved by 9 points and the IBI group improved by 22 points. CONCLUSIONS The results of this preliminary study suggest that NPS and ODI scores statistically improved for both NSCLBP groups receiving multimodal care. However, the group that included WBV therapy plus traction in combination with multimodal care had greater clinical results. This study had several limitations making it difficult to generalize the results from this study sample to the entire population.
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Affiliation(s)
| | - Brian Kuo
- School of Biological and Population Health Sciences, Corvallis, OR
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Luo X, Zhang J, Zhang C, He C, Wang P. The effect of whole-body vibration therapy on bone metabolism, motor function, and anthropometric parameters in women with postmenopausal osteoporosis. Disabil Rehabil 2016; 39:2315-2323. [PMID: 27718643 DOI: 10.1080/09638288.2016.1226417] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Xiaotian Luo
- Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
| | - Jifeng Zhang
- Department of General surgery Medicine, Datong Second People's Hospital, Datong, Shanxi, PR China
| | - Chi Zhang
- Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
| | - Chengqi He
- Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
| | - Pu Wang
- Rehabilitation Medicine Center, Sichuan University, West China Hospital, Chengdu, Sichuan, PR China
- Key Laboratory of Rehabilitation Medicine in Sichuan, Chengdu, Sichuan, PR China
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Oliveira LC, Oliveira RG, Pires-Oliveira DAA. Effects of whole body vibration on bone mineral density in postmenopausal women: a systematic review and meta-analysis. Osteoporos Int 2016; 27:2913-33. [PMID: 27145947 DOI: 10.1007/s00198-016-3618-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Accepted: 04/26/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED This systematic review and meta-analysis of randomized controlled trials (RCTs) identified significant effects of whole body vibration (WBV) on bone mineral density (BMD) of the lumbar spine (in the sensitivity analysis and seven subgroup analyses), femoral neck (in one subgroup analysis), and trochanter (four subgroup analyses) in postmenopausal women, but not other measurements of BMD. INTRODUCTION Interventions using WBV training have been conducted in postmenopausal women, aimed at increasing BMD; however, the results are contradictory. Our objective is to conduct a systematic review and meta-analysis of RCTs examining WBV effect on BMD. METHODS RCTs were considered eligible, with follow-up ≥6 months, which verified the effects of WBV on the BMD of postmenopausal women. The calculations of the meta-analysis were performed through the weighted mean difference between the WBV and control groups, or the WBV and combined training, through the absolute change between pre- and post-intervention in the areal bone mineral density (aBMD) or trabecular volumetric bone mineral density (vBMDt). RESULTS Fifteen RCTs were included in the meta-analysis. No differences were observed in the primary analysis. WBV was found to improve aBMD compared with the control group, after exclusion of studies with low quality methodological (lumbar spine), when excluding the studies which combined WBV with medication or combined training (lumbar spine), with the use of low frequency and high magnitude (lumbar spine and trochanter), high frequency and low magnitude (lumbar spine), high cumulative dose and low magnitude (lumbar spine), low cumulative dose and high magnitude (lumbar spine and trochanter), with semi-flexed knee (lumbar spine, femoral neck, and trochanter), and side-alternating type of vibration (lumbar spine and trochanter). CONCLUSIONS Despite WBV presenting potential to act as a coadjuvant in the prevention or treatment of osteoporosis, especially for aBMD of the lumbar spine, the ideal intervention is not yet clear. Our subgroup analyses helped to demonstrate the various factors which appear to influence the effects of WBV on BMD, contributing to clinical practice and the definition of protocols for future interventions.
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Affiliation(s)
- L C Oliveira
- Centro de Ciências Biológicas e da Saúde, Universidade Norte do Paraná (UNOPAR), Londrina, PR, Brazil.
- Centro de Ciências da Saúde, Universidade Estadual do Norte do Paraná (UENP), Alameda Padre Magno, 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, PR, Brazil.
| | - R G Oliveira
- Centro de Ciências Biológicas e da Saúde, Universidade Norte do Paraná (UNOPAR), Londrina, PR, Brazil
- Centro de Ciências da Saúde, Universidade Estadual do Norte do Paraná (UENP), Alameda Padre Magno, 841, Nova Alcântara, CEP: 86.400-000, Jacarezinho, PR, Brazil
| | - D A A Pires-Oliveira
- Centro de Ciências Biológicas e da Saúde, Universidade Norte do Paraná (UNOPAR), Londrina, PR, Brazil
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Hughes JM, Charkoudian N, Barnes JN, Morgan BJ. Revisiting the Debate: Does Exercise Build Strong Bones in the Mature and Senescent Skeleton? Front Physiol 2016; 7:369. [PMID: 27679578 PMCID: PMC5020082 DOI: 10.3389/fphys.2016.00369] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 08/10/2016] [Indexed: 12/18/2022] Open
Abstract
Traditional exercise programs seem to be less osteogenic in the mature and post-mature skeleton compared to the young skeleton. This is likely because of the decline in sensitivity of bone to mechanical loading that occurs with advancing age. Another factor contributing to the apparently diminished benefit of exercise in older adults is failure of widely used measurement techniques (i.e., DXA) to identify changes in 3-dimensional bone structure, which are important determinants of bone strength. Moreover, although hormonal contributors to bone loss in the elderly are well-recognized, the influence of age-related increases in sympathetic nervous system activity, which impacts bone metabolism, is rarely considered. In this Perspective, we cite evidence from animal and human studies demonstrating anabolic effects of exercise on bone across the lifespan and we discuss theoretical considerations for designing exercise regimens to optimize bone health. We conclude with suggestions for future research that should help define the osteogenic potential of exercise in older individuals.
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Affiliation(s)
- Julie M Hughes
- Military Performance Division, US Army Research Institute of Environmental Medicine Natick, MA, USA
| | - Nisha Charkoudian
- Thermal and Mountain Medicine Division, US Army Research Institute of Environmental Medicine Natick, MA, USA
| | - Jill N Barnes
- Bruno Balke Biodynamics Laboratory, Department of Kinesiology, University of Wisconsin-Madison Madison, WI, USA
| | - Barbara J Morgan
- John Rankin Laboratory of Pulmonary Medicine, Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison Madison, WI, USA
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Soltani S, Hunter GR, Kazemi A, Shab-Bidar S. The effects of weight loss approaches on bone mineral density in adults: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 2016; 27:2655-2671. [PMID: 27154437 DOI: 10.1007/s00198-016-3617-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/26/2016] [Indexed: 12/15/2022]
Abstract
UNLABELLED We assessed the impact of weight loss strategies including calorie restriction and exercise training on BMD in adults using a systematic review of randomized controlled trials. Weight reduction results in reduced BMD at the hip, but has less effect on the spine. Both calorie restriction and a combination of calorie restriction and exercise result in a decrease in hip bone density, whereas weight loss response to exercise training without dietary restriction leads to increased hip BMD. INTRODUCTION Findings are not consistent on the effect of weight loss on bone mineral density (BMD). We conducted a systematic review on the randomized controlled trials to assess the effect of weight loss strategies, including calorie restriction and exercise programs on BMD in adults. METHODS A structured and comprehensive search of MEDLINE and EMBASE databases was undertaken up to March 2016. Study-specific mean differences (MD) were pooled using a random-effects model. Subgroup analysis and meta-regression were used to find possible sources of between-study heterogeneity. RESULTS Thirty-two randomized controlled trials met predetermined inclusion criteria. The meta-analysis revealed no significant difference on total BMD (MD 0.007, 95 % CI -0.020-0.034, p = 0.608). In contrast, the pooled data of studies showed a significant effect of weight loss on hip BMD (MD -0.008, 95 % CI -0.09 to -0.006 g/cm(2), p < 0.001) and also lumbar spine BMD (MD -0.018 g/cm(2), 95 % CI -0.019 to -0.017, p < 0.001). BMD in the hip site decreased after more than 4 months, especially in those who were obese. Moreover, calorie restriction interventions longer than 13 months showed a significant decreased in lumbar spine BMD. CONCLUSION Weight loss led to significant decreases at the hip and lumbar spine BMD but not at the total. Weight loss response following calorie restriction resulted in a decrease in hip and lumbar spine bone density especially more than 1 year; whereas an exercise-induced weight loss did not.
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Affiliation(s)
- S Soltani
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Hemaat Highway, 1449614535, Tehran, Iran
| | - G R Hunter
- Department of Human Studies School of Education, University of Alabama at Birmingham, EB 205 1720 2nd Ave South, Birmingham, AL, 34294-1250, USA
| | - A Kazemi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box 14155/6117, Amir Abad, Keshavarz Boulevard, Tehran, Iran
| | - S Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P. O. Box 14155/6117, Amir Abad, Keshavarz Boulevard, Tehran, Iran.
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Swe M, Benjamin B, Tun AA, Sugathan S. Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review. Malays J Med Sci 2016; 23:8-16. [PMID: 27904420 PMCID: PMC5101982 DOI: 10.21315/mjms2016.23.5.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/23/2016] [Indexed: 02/08/2023] Open
Abstract
A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men.
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Affiliation(s)
- Myint Swe
- Orthopaedic Unit, Surgical-based Department, University Kuala Lumpur, Royal College of Medicine Perak, Jalan Green town, 30450 Ipoh, Perak, Malaysia
| | - Biju Benjamin
- Department of Orthopaedics, University Kuala Lumpur, Royal College of Medicine Perak, Jalan Green town, 30450 Ipoh, Perak, Malaysia
| | - Aye Aye Tun
- Department of Pathology, University Kuala Lumpur, Royal College of Medicine Perak, Jalan Green town, 30450 Ipoh, Perak, Malaysia
| | - Sandheep Sugathan
- Department of Public Health, University Kuala Lumpur, Royal College of Medicine Perak, Jalan Green town, 30450 Ipoh, Perak, Malaysia
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Paolucci T, Saraceni VM, Piccinini G. Management of chronic pain in osteoporosis: challenges and solutions. J Pain Res 2016; 9:177-86. [PMID: 27099529 PMCID: PMC4824363 DOI: 10.2147/jpr.s83574] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Osteoporosis (OP) is a pathological condition that manifests clinically as pain, fractures, and physical disability, resulting in the loss of independence and the need for long-term care. Chronic pain is a multidimensional experience with sensory, affective, and cognitive aspects. Age can affect each of these dimensions and the pain that is experienced. In OP, chronic pain appears to have sensory characteristics and properties of nociceptive and neuropathic pain. Its evaluation and treatment thus require a holistic approach that focuses on the specific characteristics of this population. Pain management must therefore include pharmacological approaches, physiotherapy interventions, educational measures, and, in rare cases, surgical treatment. Most rehabilitative treatments in the management of patients with OP do not evaluate pain or physical function, and there is no consensus on the effects of rehabilitation therapy on back pain or quality of life in women with OP. Pharmacological treatment of pain in patients with OP is usually insufficient. The management of chronic pain in patients with OP is complicated with regard to its diagnosis, the search for reversible secondary causes, the efficacy and duration of oral bisphosphonates, and the function of calcium and vitamin D. The aim of this review is to discuss the most appropriate solutions in the management of chronic pain in OP.
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Affiliation(s)
- Teresa Paolucci
- Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy
| | | | - Giulia Piccinini
- Physical Medicine and Rehabilitation Unit, Azienda Policlinico Umberto I, Rome, Italy
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Ma C, Liu A, Sun M, Zhu H, Wu H. Effect of whole-body vibration on reduction of bone loss and fall prevention in postmenopausal women: a meta-analysis and systematic review. J Orthop Surg Res 2016; 11:24. [PMID: 26888467 PMCID: PMC4758089 DOI: 10.1186/s13018-016-0357-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2015] [Accepted: 02/05/2016] [Indexed: 01/16/2023] Open
Abstract
Background To examine whole-body vibration (WBV) effect on bone mineral density (BMD) and fall prevention in postmenopausal women, we performed a meta-analysis and systematic review of prospective randomized controlled trials (RCTs) comparing change in BMD of the femoral neck and lumbar spine and related factors of falls between WBV group and control group. Methods EMBASE, PubMed, Cochrane Central Register of Controlled Trials, ISI Web of Science, and China National Knowledge Infrastructure (CNKI) were searched up to April 2015; search strategy was used as follows: (vibration) AND (osteoporo* OR muscle* OR bone mineral density OR BMD). All prospective randomized controlled trials comparing related factors of falls and BMD change in the femoral neck and lumbar spine between WBV group and control group were retrieved. Results Eight of 3599 studies with 1014 patients were included, 477 in the WBV group, and 537 in the control group. We found that there was no significant difference in all magnitude groups of the femoral neck (N = 936, WMD: 0.00 (–0.00, 0.01); p = 0.18). A statistical significance showed in the all magnitude groups (N = 1014, WMD: 0.01 (0.00, 0.01); p = 0.01) and low-magnitude group (N = 838, WMD: 0.01 (0.00, 0.01); p = 0.007) of the lumbar spine. No significant difference was found in high-magnitude group of the lumbar spine (N = 176, WMD: 0.00 (−0.01, 0.02); p = 0.47), low-magnitude group (N = 838, WMD: 0.00 (−0.00, 0.00); p = 0.92) and high-magnitude group (N = 98, WMD: 0.02 (−0.00, 0.05); p = 0.06) of the femoral neck. All the studies provided data of related factors of falls such as strength of the lower limb, balance, and fall rate reported effectiveness of WBV therapy. In addition, no complication was reported. Conclusions Low-magnitude whole-body vibration therapy can provide a significant improvement in reducing bone loss in the lumbar spine in postmenopausal women. Moreover, whole-body vibration can be used as an intervention for fall prevention.
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Affiliation(s)
- Chiyuan Ma
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - An Liu
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Miao Sun
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Hanxiao Zhu
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Haobo Wu
- Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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Tsukahara Y, Iwamoto J, Iwashita K, Shinjo T, Azuma K, Matsumoto H. What is the most effective posture to conduct vibration from the lower to the upper extremities during whole-body vibration exercise? Open Access J Sports Med 2016; 7:5-10. [PMID: 26793008 PMCID: PMC4708876 DOI: 10.2147/oajsm.s93047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Whole-body vibration (WBV) exercise is widely used for training and rehabilitation. However, the optimal posture for training both the upper and lower extremities simultaneously remains to be established. Objectives The objective of this study was to search for an effective posture to conduct vibration from the lower to the upper extremities while performing WBV exercises without any adverse effects. Methods Twelve healthy volunteers (age: 22–34 years) were enrolled in the study. To measure the magnitude of vibration, four accelerometers were attached to the upper arm, back, thigh, and calf of each subject. Vibrations were produced using a WBV platform (Galileo 900) with an amplitude of 4 mm at two frequencies, 15 and 30 Hz. The following three postures were examined: posture A, standing posture with the knees flexed at 30°; posture B, crouching position with no direct contact between the knees and elbows; and posture C, crouching position with direct contact between the knees and elbows. The ratio of the magnitude of vibration at the thigh, back, and upper arm relative to that at the calf was used as an index of vibration conduction. Results Posture B was associated with a greater magnitude of vibration to the calf than posture A at 15 Hz, and postures B and C were associated with greater magnitudes of vibration than posture A at 30 Hz. Posture C was associated with a vibration conduction to the upper arm that was 4.62 times and 8.26 times greater than that for posture A at 15 and 30 Hz, respectively. Conclusion This study revealed that a crouching position on a WBV platform with direct contact between the knees and elbows was effective for conducting vibration from the lower to the upper extremities.
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Affiliation(s)
- Yuka Tsukahara
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Jun Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Kosui Iwashita
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Takuma Shinjo
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichiro Azuma
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hideo Matsumoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
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McCann MR, Patel P, Pest MA, Ratneswaran A, Lalli G, Beaucage KL, Backler GB, Kamphuis MP, Esmail Z, Lee J, Barbalinardo M, Mort JS, Holdsworth DW, Beier F, Dixon SJ, Séguin CA. Repeated exposure to high-frequency low-amplitude vibration induces degeneration of murine intervertebral discs and knee joints. Arthritis Rheumatol 2015; 67:2164-75. [PMID: 25891852 DOI: 10.1002/art.39154] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 04/07/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVE High-frequency, low-amplitude whole-body vibration (WBV) is being used to treat a range of musculoskeletal disorders; however, there is surprisingly limited knowledge regarding its effect(s) on joint tissues. This study was undertaken to examine the effects of repeated exposure to WBV on bone and joint tissues in an in vivo mouse model. METHODS Ten-week-old male mice were exposed to vertical sinusoidal vibration under conditions that mimic those used clinically in humans (30 minutes per day, 5 days per week, at 45 Hz with peak acceleration at 0.3g). Following WBV, skeletal tissues were examined by micro-computed tomography, histologic analysis, and immunohistochemistry, and gene expression was quantified using real-time polymerase chain reaction. RESULTS Following 4 weeks of WBV, intervertebral discs showed histologic hallmarks of degeneration in the annulus fibrosus, disruption of collagen organization, and increased cell death. Greater Mmp3 expression in the intervertebral disc, accompanied by enhanced collagen and aggrecan degradation, was found in mice exposed to WBV as compared to controls. Examination of the knee joints after 4 weeks of WBV revealed meniscal tears and focal damage to the articular cartilage, changes resembling osteoarthritis. Moreover, mice exposed to WBV also demonstrated greater Mmp13 gene expression and enhanced matrix metalloproteinase-mediated collagen and aggrecan degradation in articular cartilage as compared to controls. No changes in trabecular bone microarchitecture or density were detected in the proximal tibia. CONCLUSION Our experiments reveal significant negative effects of WBV on joint tissues in a mouse model. These findings suggest the need for future studies of the effects of WBV on joint health in humans.
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Affiliation(s)
- Matthew R McCann
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Priya Patel
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Michael A Pest
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Anusha Ratneswaran
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Gurkeet Lalli
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Kim L Beaucage
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Garth B Backler
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Meg P Kamphuis
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Ziana Esmail
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Jimin Lee
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Michael Barbalinardo
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - John S Mort
- Shriners Hospital for Children and McGill University, Montreal, Quebec, Canada
| | - David W Holdsworth
- Robarts Research Institute and University of Western Ontario, Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Frank Beier
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - S Jeffrey Dixon
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
| | - Cheryle A Séguin
- University of Western Ontario Schulich School of Medicine and Dentistry, London, Ontario, Canada
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Effects of Whole-Body Vibration Therapy in Patients with Fibromyalgia: A Systematic Literature Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:719082. [PMID: 26351517 PMCID: PMC4553315 DOI: 10.1155/2015/719082] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Revised: 03/31/2015] [Accepted: 04/02/2015] [Indexed: 01/01/2023]
Abstract
Objective. To review the literature on the effects of whole-body vibration therapy in patients with fibromyalgia. Design. Systematic literature review. Patients. Patients with fibromyalgia. Methods. An electronic search of the literature in four medical databases was performed to identify studies on whole-body vibration therapy that were published up to the 15th of January 2015. Results. Eight articles satisfied the inclusion and exclusion criteria and were analysed. According to the Dutch CBO guidelines, all selected trials had a B level of evidence. The main outcomes that were measured were balance, fatigue, disability index, health-related quality of life, and pain. Whole-body vibration appeared to improve the outcomes, especially balance and disability index. Conclusion. Whole-body vibration could be an adequate treatment for fibromyalgia as a main therapy or added to a physical exercise programme as it could improve balance, disability index, health-related quality of life, fatigue, and pain. However, this conclusion must be treated with caution because the paucity of trials and the marked differences between existing trials in terms of protocol, intervention, and measurement tools hampered the comparison of the trials.
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Lark SD, Wadsworth DP. Physiological, psychological and functional changes with whole body vibration exercise in the elderly: FEVER methodology and protocols. Contemp Clin Trials 2015; 44:129-133. [PMID: 26275340 DOI: 10.1016/j.cct.2015.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 08/05/2015] [Accepted: 08/08/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND The FEVER (Frail Elderly Vibration Exercise Response) study aims to address a paucity of research focusing on the use of Whole Body Vibration (WBV) by frail elderly who, with the highest levels of dependence and fall-related hospitalisation/mortality, potentially stand to benefit most from such accessible exercise. METHODS FEVER is an open, randomised feasibility study, consisting of multiple parallel arms and a longitudinal element. Rest-home residents aged 70+years will be recruited, and assigned to a WBV-exercise group (WBV), a simulated-WBV-exercise group (SIM), or a control group (CON). WBV- and SIM-participants will undergo thrice-weekly sessions (<20-min each, including 1:1 ratio of exercise:rest) for a 16-week exercise intervention period, whilst CON-participants will receive no intervention beyond normal care. WBV-exercise will start with 5?1-minute sessions (6Hz, 2mm amplitude), progressing to 10?1-minute sessions at which time Hz/amplitude can be increased if desired. During WBV-exercise, participants will maintain an isometric knee flexion of ~20° (±5°), to dampen WBV further up the body. RESULTS Outcomes will include assessments of functionality (primary outcome), Quality of Life, bone health and cardiovascular function. Measures will be conducted at baseline, 8-weeks and 16-weeks of the intervention, and 3-, 6- and 12-months post-intervention. As a protocol paper, there are no specific results to present; our current purpose is to share the study design with the scientific community. CONCLUSIONS The FEVER study aims to investigate the beneficial effects of WBV-exercise in the frail elderly, ascertain an effective training regime and for the first-time identify a time-line of detraining.
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Affiliation(s)
- Sally D Lark
- School of Sport & Exercise, Massey University, New Zealand.
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Effects of Vibration Therapy on Immobilization-Induced Hypersensitivity in Rats. Phys Ther 2015; 95:1015-26. [PMID: 25655883 DOI: 10.2522/ptj.20140137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 01/28/2015] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cast immobilization induces mechanical hypersensitivity, which disturbs rehabilitation. Although vibration therapy can reduce various types of pain, whether vibration reduces immobilization-induced hypersensitivity remains unclear. OBJECTIVE The purpose of this study was to investigate the preventive and therapeutic effects of vibration therapy on immobilization-induced hypersensitivity. DESIGN The experimental design of the study involved conducting behavioral, histological, and immunohistochemical studies in model rats. METHODS Thirty-five Wistar rats (8 weeks old, all male) were used. The right ankle joints of 30 rats were immobilized by plaster cast for 8 weeks, and 5 rats were used as controls. The immobilized rats were divided randomly into the following 3 groups: (1) immobilization-only group (Im, n=10); (2) vibration therapy group 1, for which vibration therapy was initiated immediately after the onset of immobilization (Im+Vib1, n=10); and (3) vibration therapy group 2, for which vibration therapy was initiated 4 weeks after the onset of immobilization (Im+Vib2, n=10). Vibration was applied to the hind paw. The mechanical hypersensitivity and epidermal thickness of the hind paw skin were measured. To investigate central sensitization, calcitonin gene-related peptide (CGRP) expression in the spinal cord and dorsal root ganglion (DRG) was analyzed. RESULTS Immobilization-induced hypersensitivity was inhibited in the Im+Vib1 group but not in the Im+Vib2 group. Central sensitization, which was indicated by increases in CGRP expression in the spinal cord and the size of the area of CGRP-positive neurons in the DRG, was inhibited in only the Im+Vib1 group. Epidermal thickness was not affected by vibration stimulation. LIMITATIONS A limitation of this study is that the results were limited to an animal model and cannot be generalized to humans. CONCLUSIONS The data suggest that initiation of vibration therapy in the early phase of immobilization may inhibit the development of immobilization-induced hypersensitivity.
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Busch AJ, van der Spuy I, Tupper S, Kim SY, Bidonde J, Overend TJ. Whole body vibration exercise for fibromyalgia. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2015. [DOI: 10.1002/14651858.cd011755] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Whole-body vibration exercise in postmenopausal osteoporosis. MENOPAUSE REVIEW 2015; 14:41-7. [PMID: 26327887 PMCID: PMC4440196 DOI: 10.5114/pm.2015.48679] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Revised: 07/28/2014] [Accepted: 11/18/2014] [Indexed: 11/26/2022]
Abstract
The report of the World Health Organization (WHO) of 2008 defines osteoporosis as a disease characterized by low bone mass and an increased risk of fracture. Postmenopausal osteoporosis is connected to the decrease in estrogens concentration as a result of malfunction of endocrine ovarian function. Low estrogens concentration causes increase in bone demineralization and results in osteoporosis. Physical activity, as a component of therapy of patients with osteoporosis, has been used for a long time now. One of the forms of safe physical activity is the vibration training. Training is to maintain a static position or execution of specific exercises involving the appropriate muscles on a vibrating platform, the mechanical vibrations are transmitted to the body of the patient. According to the piezoelectric theory, pressure induces bone formation in the electrical potential difference, which acts as a stimulant of the process of bone formation. Whole body vibration increases the level of growth hormone and testosterone in serum, preventing sarcopenia and osteoporosis. The aim of this study was to review the literature on vibration exercise in patients with postmenopausal osteoporosis based on the PubMed and Medline database. While searching the database, the following key words were used ‘postmenopausal osteoporosis’ and ‘whole-body vibration exercise’.
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Horng CT, Hsieh YS, Tsai ML, Chang WK, Yang TH, Yauan CH, Wang CH, Kuo WH, Wu YC. Effects of horizontal acceleration on human visual acuity and stereopsis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:910-26. [PMID: 25607601 PMCID: PMC4306901 DOI: 10.3390/ijerph120100910] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 01/13/2015] [Indexed: 11/16/2022]
Abstract
The effect of horizontal acceleration on human visual acuity and stereopsis is demonstrated in this study. Twenty participants (mean age 22.6 years) were enrolled in the experiment. Acceleration from two different directions was performed at the Taiwan High-Speed Rail Laboratory. Gx and Gy (< and >0.1 g) were produced on an accelerating platform where the subjects stood. The visual acuity and stereopsis of the right eye were measured before and during the acceleration. Acceleration <0.1 g in the X- or Y-axis did not affect dynamic vision and stereopsis. Vision decreased (mean from 0.02 logMAR to 0.25 logMAR) and stereopsis declined significantly (mean from 40 s to 60.2 s of arc) when Gx > 0.1 g. Visual acuity worsened (mean from 0.02 logMAR to 0.19 logMAR) and poor stereopsis was noted (mean from 40 s to 50.2 s of arc) when Gy > 0.1 g. The effect of acceleration from the X-axis on the visual system was higher than that from the Y-axis. During acceleration, most subjects complained of ocular strain when reading. To our knowledge, this study is the first to report the exact levels of visual function loss during Gx and Gy.
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Affiliation(s)
- Chi-Ting Horng
- Medical Education Center, Kaohsiung Armed Forced General Hospital, Kaohsiung City 802, Taiwan.
| | - Yih-Shou Hsieh
- Institute of Biochemistry and Biotechnology, Chung Shang Medical University and Chung Shang Medical University Hospital, Taichung City 402, Taiwan.
| | - Ming-Ling Tsai
- Department of Ophthalmology, Taipei Buddhist Tzu Chi General Hospital, Taipei City 231, Taiwan.
| | - Wei-Kang Chang
- Medical Affairs Bureau, Ministry of National Defense, Taipei City 104, Taiwan.
| | - Tzu-Hung Yang
- Medical Education Center, Kaohsiung Armed Forced General Hospital, Kaohsiung City 802, Taiwan.
| | - Chien-Han Yauan
- Department of Ear-Nose-Throat, Kaohsiung Armed Forced General Hospital, Kaohsiung City 802, Taiwan.
| | - Chih-Hung Wang
- Medical Affairs Bureau, Ministry of National Defense, Taipei City 104, Taiwan.
| | - Wu-Hsien Kuo
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City 100, Taiwan.
| | - Yi-Chang Wu
- Medical Affairs Bureau, Ministry of National Defense, Taipei City 104, Taiwan.
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Hatori K, Camargos GV, Chatterjee M, Faot F, Sasaki K, Duyck J, Vandamme K. Single and combined effect of high-frequency loading and bisphosphonate treatment on the bone micro-architecture of ovariectomized rats. Osteoporos Int 2015; 26:303-13. [PMID: 25236876 DOI: 10.1007/s00198-014-2857-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Accepted: 08/13/2014] [Indexed: 01/23/2023]
Abstract
UNLABELLED Mechanical loading at high frequency affects bone. Whether this also applies to osteoporotic bone, combined or not with bisphosphonate therapy, was investigated in this animal study through imaging. An anabolic effect of high-frequency loading on osteoporotic bone, however non-synergistic with bisphosphonates, was found, thereby revealing its potential for treatment of osteoporosis. INTRODUCTION In an effort to elucidate the effect of high-frequency (HF) loading on bone and to optimize its potential for treatment osteoporosis, this study aimed to investigate the effect of HF loading via whole body vibration (WBV), alone or in association with bisphosphonate treatment (alendronate--ALN), on the micro-architecture of ovariectomy (OVX)-induced compromised bone. METHODS Eighty-four female Wistar rats were ovariectomized (OVX) or sham-operated (shOVX). OVX animals were treated either with ALN (3 days/week at a dose of 2 mg/kg) or with saline solution. Each group (shOVX, OVX, ALN) was further divided into subgroups relative to the loading status (sham-WBV versus WBV) and the duration of experimental period (4 days versus 14 days). (Sham)WBV loading was applied for 10 min/day using 10 consecutive steps of HF loading (130, 135, 140, 145, 150, 130, 135, 140, 145, 150 Hz). Tibial bone structural responses to WBV and/or ALN treatment were analyzed using ex vivo micro-computed tomography. RESULTS The animal's hormonal status displayed a major impact on the trabecular and cortical bone structural parameters. Furthermore, mechanical treatment with HF WBV increased the cortical thickness and reduced the medullar area in OVX rats. However, OVX trabecular bone was not affected by HF stimuli. Finally, ALN prevented OVX-associated bone loss, but the association of ALN with WBV did not lead to a synergistic bone response in OVX bone. CONCLUSIONS HF WBV mechanical stimulation displayed an anabolic effect on osteoporotic cortical bone, confirming its therapeutic properties for enhancing compromised bone. Additionally, its association with bisphosphonates' administration did not produce any additive effect on the bone micro-architecture in the present study.
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Affiliation(s)
- K Hatori
- Department of Oral Health Sciences, BIOMAT Research Group, KU Leuven & University Hospitals Leuven, Leuven, Belgium
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Erceg DN, Anderson LJ, Nickles CM, Lane CJ, Weigensberg MJ, Schroeder ET. Changes in Bone Biomarkers, BMC, and Insulin Resistance Following a 10-Week Whole Body Vibration Exercise Program in Overweight Latino Boys. Int J Med Sci 2015; 12:494-501. [PMID: 26078710 PMCID: PMC4466514 DOI: 10.7150/ijms.11364] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 05/25/2015] [Indexed: 01/22/2023] Open
Abstract
PURPOSE With the childhood obesity epidemic, efficient methods of exercise are sought to improve health. We tested whether whole body vibration (WBV) exercise can positively affect bone metabolism and improve insulin/glucose dynamics in sedentary overweight Latino boys. METHODS Twenty Latino boys 8-10 years of age were randomly assigned to either a control (CON) or 3 days/wk WBV exercise (VIB) for 10-wk. RESULTS Significant increases in BMC (4.5 ± 3.2%; p=0.01) and BMD (1.3 ± 1.3%; p<0.01) were observed for the VIB group when compared to baseline values. For the CON group BMC significantly increased (2.0 ± 2.2%; p=0.02), with no change in BMD (0.8 ± 1.3%; p=0.11). There were no significant between group changes in BMC or BMD. No significant change was observed for osteocalcin and (collagen type I C-telopeptide) CTx for the VIB group. However, osteocalcin showed a decreasing trend (p=0.09) and CTx significantly increased (p<0.03) for the CON group. This increase in CTx was significantly different between groups (p<0.02) and the effect size of between-group difference in change was large (-1.09). There were no significant correlations between osteocalcin and measures of fat mass or insulin resistance for collapsed data. CONCLUSION Although bone metabolism was altered by WBV training, no associations were apparent between osteocalcin and insulin resistance. These findings suggest WBV exercise may positively increase BMC and BMD by decreasing bone resorption in overweight Latino boys.
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Affiliation(s)
- David N Erceg
- 1. The Clinical Exercise Research Center, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, Los Angeles, USA
| | - Lindsey J Anderson
- 1. The Clinical Exercise Research Center, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, Los Angeles, USA
| | - Chun M Nickles
- 1. The Clinical Exercise Research Center, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, Los Angeles, USA
| | - Christianne J Lane
- 2. Center for Transdisciplinary Research on Energetics and Cancer, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Marc J Weigensberg
- 3. Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - E Todd Schroeder
- 1. The Clinical Exercise Research Center, Division of Biokinesiology and Physical Therapy at the School of Dentistry, University of Southern California, Los Angeles, USA
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Slatkovska L, Beyene J, Alibhai SMH, Wong Q, Sohail QZ, Cheung AM. Effect of whole-body vibration on calcaneal quantitative ultrasound measurements in postmenopausal women: a randomized controlled trial. Calcif Tissue Int 2014; 95:547-56. [PMID: 25388526 DOI: 10.1007/s00223-014-9920-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 10/14/2014] [Indexed: 12/01/2022]
Abstract
The purpose of this study was to examine the effect of whole-body vibration (WBV) on calcaneal quantitative ultrasound (QUS) measurements; which has rarely been examined. We conducted a single-centre, 12-month, randomized controlled trial. 202 postmenopausal women with BMD T score between -1.0 and -2.5, not receiving bone medications, were asked to stand on a 0.3 g WBV platform oscillating at either 90- or 30-Hz for 20 consecutive minutes daily, or to serve as controls. Calcium and vitamin D was provided to all participants. Calcaneal broadband attenuation (BUA), speed of sound, and QUS index were obtained as pre-specified secondary endpoints at baseline and 12 months by using a Hologic Sahara Clinical Bone Sonometer. 12-months of WBV did not improve QUS parameters in any of our analyses. While most of our analyses showed no statistical differences between the WBV groups and the control group, mean calcaneal BUA decreased in the 90-Hz (-0.4 [95% CI -1.9 to 1.2] dB MHz(-1)) and 30-Hz (-0.7 [95% CI -2.3 to 0.8] dB MHz(-1)) WBV groups and increased in the control group (1.3 [95% CI 0.0-2.6] dB MHz(-1)). Decreases in BUA in the 90-, 30-Hz or combined WBV groups were statistically different from the control group in a few of the analyses including all randomized participants, as well as in analyses excluding participants who had missing QUS measurement and those who initiated hormone therapy or were <80% adherent. Although there are consistent trends, not all analyses reached statistical significance. 0.3 g WBV at 90 or 30 Hz prescribed for 20 min daily for 12 months did not improve any QUS parameters, but instead resulted in a statistically significant, yet small, decrease in calcaneal BUA in postmenopausal women in several analyses. These unexpected findings require further investigation.
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Affiliation(s)
- Lubomira Slatkovska
- Osteoporosis Program, University Health Network/Mount Sinai Hospital, 200 Elizabeth Street, 7 Eaton North, Room 221, Toronto, ON, Canada
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Zhang J, Gao R, Cao P, Yuan W. Additive effects of antiresorptive agents and exercise on lumbar spine bone mineral density in adults with low bone mass: a meta-analysis. Osteoporos Int 2014; 25:1585-94. [PMID: 24566585 DOI: 10.1007/s00198-014-2644-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 11/26/2013] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Exercise has been recommended to increase bone mass and prevent osteoporosis. While current treatment of osteoporosis mainly involves the use of antiresorptive agents, it is unclear whether there are any additive effects in improving bone mass when antiresorptive agents and exercise are jointly used. METHODS A structured and comprehensive search of databases was undertaken along with hand searching of key journals and reference lists. The combined interventions of antiresorptive agents and exercise were examined for their additive effects on lumbar spine bone mineral density (BMD) among adults with low bone mass. Trial quality was assessed using the Jadad quality score. Study outcomes for analysis, absolute change (grams per square centimeter) or relative change (in percent) in BMD, at the lumbar spine were compared by calculating standardized mean difference (SMD) using fixed and random effect models. RESULTS Seven randomized controlled trials (RCT) met the predetermined inclusion criteria. The increase in lumbar spine BMD of the combined-intervention group was significantly greater than that of the antiresorptive agent-alone group (fixed effect model: SMD = 0.55; 95% confidence interval (CI) = 0.36, 0.75; overall effect Z-value = 5.51; p < 0.00001). Subgroup analyses also showed consistent results. Methodological quality of most included studies was scored 3 by the Jadad criterion, and publication bias was slight according to funnel plots. CONCLUSION It was found that combining antiresorptive agents with exercise had additive effects on improving lumbar spine bone mass gains in adults with low bone mass. To verify the additive effects further, more RCTs with longer duration and larger sample sizes are needed.
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Affiliation(s)
- J Zhang
- Evidence-Based Medicine Group, Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
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Wang XQ, Pi YL, Chen PJ, Chen BL, Liang LC, Li X, Wang X, Zhang J. Whole body vibration exercise for chronic low back pain: study protocol for a single-blind randomized controlled trial. Trials 2014; 15:104. [PMID: 24693945 PMCID: PMC4230279 DOI: 10.1186/1745-6215-15-104] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 03/06/2014] [Indexed: 12/19/2022] Open
Abstract
Background Low back pain affects approximately 80% of people at some stage in their lives. Exercise therapy is the most widely used nonsurgical intervention for low back pain in practice guidelines. Whole body vibration exercise is becoming increasingly popular for relieving musculoskeletal pain and improving health-related quality of life. However, the efficacy of whole body vibration exercise for low back pain is not without dispute. This study aims to estimate the effect of whole body vibration exercise for chronic low back pain. Methods/Design We will conduct a prospective, single-blind, randomized controlled trial of 120 patients with chronic low back pain. Patients will be randomly assigned into an intervention group and a control group. The intervention group will participate in whole body vibration exercise twice a week for 3 months. The control group will receive general exercise twice a week for 3 months. Primary outcome measures will be the visual analog scale for pain, the Oswestry Disability Index and adverse events. The secondary outcome measures will include muscle strength and endurance of spine, trunk proprioception, transversus abdominis activation capacity, and quality of life. We will conduct intention-to-treat analysis if any participants withdraw from the trial. Discussion Important features of this study include the randomization procedures, single-blind, large sample size, and a standardized protocol for whole body vibration in chronic low back pain. This study aims to determine whether whole body vibration exercise produces more beneficial effects than general exercise for chronic low back pain. Therefore, our results will be useful for patients with chronic low back pain as well as for medical staff and health-care decision makers. Trial registration Chinese Clinical Trial Registry: ChiCTR-TRC-13003708.
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Affiliation(s)
| | | | - Pei-Jie Chen
- Sport Medicine & Rehabilitation Center, Shanghai University of Sport, Shanghai 200438, China.
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