Effect of vibration or high-intensity exercise on osteoporosis in postmenopausal women
An important therapeutic element in osteoporosis is physical activity, which has a positive effect on muscle strength, balance and bone mineral density (BMD). For those who cannot perform intense exercise and do not want/ cannot use pharmacotherapy, whole-body vibration (WBV), a form of vibrotherapy, can help. WBV is an easy-to-use substitute for physical activity in many aspects. Previous research suggests that WBVs may reduce the risk of falls, so dangerous in osteoporosis, by improving neuromuscular parameters. Therefore, scientists from the University of Istanbul investigated the effectiveness of WBV versus high-intensity exercises on BMD, markers of bone turnover, mobility, and quality of life in postmenopausal osteoporotic women.
- After 6 months of vibrotherapy, BMD of the lumbar spine (L2-L4) and the femoral neck increased significantly (+1.3% or +5.0%, respectively). High-intensity exercises did not cause any significant changes.
- Quality of life and depression symptoms improved both after vibrotherapy (-28.2%, -41.9%, respectively) and high-intensity exercises (-29.5%, -5.5%, respectively).
- Improvements after vibrotherapy (-16.5%) or high-intensity exercises (-7.0%) were also seen in time of taking the TUG test.
Prepared on the basis of:
Effects of whole-body vibration and high impact exercises on the bone metabolism and functional mobility in postmenopausal women. Sen EI, Esmaeilzadeh S, Eskiyurt N. J Bone Miner Metab. 2020 May;38(3):392-404.
Study population
Using appropriate qualifying and exclusion criteria, 58 out of 235 postmenopausal women, aged 40-65, were enrolled in the presented study.
Test procedure
The study lasted 6 months and was randomized and controlled. The women were randomly assigned to 3 groups:
- WBV = introductory exercise + WBV (n = 19),
- high-intensity exercise = introductory exercise + skipping rope exercise (n = 19),
- control group = no exercise (n = 20).
Exercise groups performed 3 exercise sessions a week (1 daily) lasting 20-60 minutes each, for 24 weeks. In the following weeks, exercise intensity was increased. Each session began with a 20-40 minute introductory exercise session followed by WBV or high-intensity exercise. The introductory exercises were warm-up, e.g. cycling, stepping, posture and stretching. The high-intensity exercises consisted of two-legged vertical jumps on a skipping rope.
Bone mineral density (BMD) was measured by dual energy x-ray absorptiometry (DXA). Serum levels of osteocalcin (OC) and the C-terminal type I collagen telopeptide (CTX) were also measured. Mobility was assessed using the Timed Up and Go (TUG) test. The fall rate was investigated using static posturography. Finally, health-related quality of life and depressive symptoms were assessed.
Use of vibration in the study
A Power Plate pro5 vibration platform (Performance Health Systems, USA) and vibrations with a frequency of 30-35 Hz, an amplitude of 2-4 mm were used. Vibrations were delivered in 5 selected static positions. Initially, lower vibration parameters were used (from 30 Hz, 2 mm, 1 series during 30 s), which were gradually increased (to 35 Hz, 4 mm, 2 series of 5 min).
Results
After 6 months of vibrotherapy, BMD of the lumbar spine (L2-L4; +1.3%, p = 0.005) and of the femoral neck (+5.0%, p = 0.003) significantly increased compared to the control group. High-intensity exercise did not provide any significant changes. When analyzing the L1-L4 segment and the entire hip, BMD did not change in any of the exercise groups compared to the control.
The results of the questionnaire evaluating the quality of life showed a favorable reduction under the influence of WBV (-28.2%, p <0.001) and high-intensity exercise (-29.5%, p <0.001). Similarly, for the level of depression, a favorable reduction was observed both after WBV (-41.9%, p <0.001) and after high-intensity exercise (-5.5%, p <0.001). The results of these surveys did not differ statistically significantly between the exercise groups.
Both after vibrotherapy (-16.5%, p <0.001) and after high-intensity exercise (-7.0%, p = 0.008), the TUG test was performed faster, compared to the control group. However, there were no significant changes in the results of the fall rate.
Comment
6-month vibrotherapy resulted in a significant increase in BMD of the femoral neck and spine in the L2-L4 segment of postmenopausal women, while high-intensity exercise did not bring the desired effect. In addition, both WBV and high-intensity exercise improved functional performance, quality of life, and depressive symptoms in these women.
The authors of this study conclude that further studies with more participants and a longer follow-up period are needed to determine whether WBV or high-intensity exercise will suffice as a standalone method of preventing or treating bone loss or increased risk of falls.
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