Whole-body vibration (WBV), as a method of exercise training, is becoming increasingly popular in physical therapy, rehabilitation, and professional sports, and is increasingly used in beauty and wellness applications due to its beneficial effects on the neuromusculoskeletal system. These benefits include improved strength, power, flexibility, jump height, and balance (1-4).However, little is known about the physiological mechanisms underlying the effects of WBV on muscular performance, although the presence of reflex muscle activity during WBV has been shown (4, 5). Tonic vibration reflex (TVR) is the most commonly cited mechanism to explain the effects of WBV on muscular performance, although there is no conclusive evidence that tonic vibration reflex (TVR) occurs (4-6). Studies have reported that direct vibration applied to a muscle or tendon stimulates muscle spindles, thereby causing a TVR to occur. As highlighted by these studies, muscle spindle Background: Whole-body vibration (WBV) induces reflex muscle activity and leads to increased muscle strength. However, little is known about the physiological mechanisms underlying the effects of whole-body vibration on muscular performance. Tonic vibration reflex is the most commonly cited mechanism to explain the effects of whole-body vibration on muscular performance, although there is no conclusive evidence that tonic vibration reflex occurs. The bone myoregulation reflex is another neurological mechanism used to explain the effects of vibration on muscular performance. Bone myoregulation reflex is defined as a reflex mechanism in which osteocytes exposed to cyclic mechanical loading induce muscle activity. Aims: The aim of this study was to assess whether bone tissue affected vibration-induced reflex muscle activity and vibration-induced muscle strength gain. Study Design: A prospective, randomised, controlled, double-blind, parallel-group clinical trial. Methods: Thirty-four participants were randomised into two groups. High-magnitude whole-body vibration was applied in the exercise group, whereas low-magnitude whole-body vibration exercises were applied in the control group throughout 20 sessions. Hip bone mineral density, isokinetic muscle strength, and plasma sclerostin levels were measured. The surface electromyography data were processed to obtain the Root Mean Squares, which were normalised by maximal voluntarily contraction. Results: In the exercise group, muscle strength increased in the right and left knee flexors (23.9%, p=0.004 and 27.5%, p<0.0001, respectively). However, no significant change was observed in the knee extensor muscle strength. There was no significant change in the knee muscle strength in the control group. The vibration-induced corrected Root Mean Squares of the semitendinosus muscle was decreased by 2.8 times (p=0.005) in the exercise group, whereas there was no change in the control group. Sclerostin index was decreased by 15.2% (p=0.031) in the exercise group and increased by 20.8% (p=0.028) in the control group. A change in th...