Effect of Low-Intensity Vibration on Bone Strength, Microstructure, and Adiposity in Pre-Osteoporotic Postmenopausal Women: A Randomized Placebo-Controlled Trial

Abstract

There has been evidence that cyclical mechanical stimulation may be osteogenic, thus providing opportunities for nonpharmacological treatment of degenerative bone disease. Here, we applied this technology to a cohort of postmenopausal women with varying bone mineral density (BMD) T‐scores at the total hip (−0.524 ± 0.843) and spine (−0.795 ± 1.03) to examine the response to intervention after 1 year of daily treatment with 10 minutes of vibration therapy in a randomized double‐blinded trial. The device operates either in an active mode (30 Hz and 0.3 g) or placebo. Primary endpoints were changes in bone stiffness at the distal tibia and marrow adiposity of the vertebrae, based on 3 Tesla high‐resolution MRI and spectroscopic imaging, respectively. Secondary outcome variables included distal tibial trabecular microstructural parameters and vertebral deformity determined by MRI, volumetric and areal bone densities derived using peripheral quantitative computed tomography (pQCT) of the tibia, and dual‐energy X‐ray absorptiometry (DXA)‐based BMD of the hip and spine. Device adherence was 83% in the active group (n = 42) and 86% in the placebo group (n = 38) and did not differ between groups (p = .7). The mean 12‐month changes in tibial stiffness in the treatment group and placebo group were +1.31 ± 6.05% and −2.55 ± 3.90%, respectively (group difference 3.86%, p = .0096). In the active group, marrow fat fraction significantly decreased after 12 months of intervention (p = .0003), whereas no significant change was observed in the placebo group (p = .7; group difference −1.59%, p = .029). Mean differences of the changes in trabecular bone volume fraction (p = .048) and erosion index (p = .044) were also significant, as was pQCT‐derived trabecular volumetric BMD (vBMD; p = .016) at the tibia. The data are commensurate with the hypothesis that vibration therapy is protective against loss in mechanical strength and, further, that the intervention minimizes the shift from the osteoblastic to the adipocytic lineage of mesenchymal stem cells. © 2020 American Society for Bone and Mineral Research (ASBMR).

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

“…Authors of reviews agree that large-scale randomized controlled trials of adequate duration are needed before recommendations can be made for the use of vibration as adjuvant osteoporosis therapy [36,76,77]. Trials examining bone mass and strength outcomes have compared WBV to very low-intensity aerobic activities unlikely to be osteogenic (walking) [79], to sham WBV [32,86], or compared nonequivalent WBV stimuli (e.g., high-versus low-intensity WBV therapy [47]), in community-dwelling postmenopausal women. Few studies have examined the synergist effect of vibration and exercise [39], or directly compared WBV with exercise [38] in postmenopausal women, using appropriately robust randomized controlled trial design.…”

Low Intensity Vibration Protects the Weight Bearing Skeleton and Suppresses Fracture Incidence in Boys with Duchenne Muscular Dystrophy

“…[44] Recent findings, using MRI as an assay of bone quality, show that LIV enhances bone mineral density in the weight-bearing skeleton of post-menopausal women as well as trabecular connectivity and bone microstructure. [69] Perhaps such improvements translate to a more robust skeleton and an overall decrease in susceptibility to fracture. [70]…”

Piezoelectric Microvibration Mitigates Estrogen Loss-Induced Osteoporosis and Promotes Piezo1, MicroRNA-29a, and Wnt3a Signaling in Osteoblasts

“…Accumulating studies of in vitro and in vivo models have uncovered that oscillatory mechanical stimulation changes osteoblastic activity or osteogenic differentiation of mesenchymal stem cells. Whole-body mechanical vibration intervention improves trabecular bone volume, marrow fat fraction, and trabecular BMD rather than stiffness of osteoporotic skeleton in menopausal women [18]. Oscillatory fluid flow promotes osteogenic lineage specification of mesenchymal stem cells [32].…”

“…Low intensity mechanical vibration produces oscillatory force which influences cell activity and tissue function. Whole-body vibration improves bone mineral density of tibia in postmenopausal women [18]; however, a study by Liphardt et al reveals that the bone quality of postmenopausal women with osteopenia is unimproved upon whole-body vibration for 12 months [19]. In experimental animals, low magnitude whole-body vibration represses osteoblast senescence and downregulates bone mass loss in aged mice [20] and promotes articular cartilage thickness in high fat diet-induced obese mice [21].…”