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Osteoporosis International

, Volume 24, Issue 5, pp 1623–1636 | Cite as

Effect of whole body vibration (WBV) therapy on bone density and bone quality in osteopenic girls with adolescent idiopathic scoliosis: a randomized, controlled trial

  • T. P. Lam
  • B. K. W. Ng
  • L. W. H. Cheung
  • K. M. Lee
  • L. Qin
  • J. C. Y. Cheng
Original Article

Abstract

Summary

The aim of this randomized controlled trial was to determine whether whole body vibration (WBV) therapy was effective for treating osteopenia in adolescent idiopathic scoliosis (AIS) patients. Results showed that WBV was effective for improving areal bone mineral density (aBMD) at the femoral neck of the dominant side and lumbar spine BMC in AIS subjects.

Introduction

AIS is associated with osteopenia. Although WBV was shown to have skeletal anabolic effects in animal studies, its effect on AIS subjects remained unknown. The objective of this study was to determine whether WBV could improve bone mineral density (BMD) and bone quality for osteopenia in AIS subjects.

Methods

This was a randomized, controlled trial recruiting 149 AIS girls between 15 and 25 years old and with bone mineral density (BMD) Z-scores <−1. They were randomly assigned to the Treatment or Control groups. The Treatment group (n = 61) stood on a low-magnitude high-frequency WBV platform 20 min/day, 5 days/week for 12 months. The Control group (n = 63) received observation alone. Bone measurement was done at baseline and at 12 months: (1) aBMD and BMC at femoral necks and lumbar spine using dual-energy X-ray absorptiometry (DXA) and (2) bone quality including bone morphometry, volumetric BMD (vBMD), and trabecular bone microarchitecture using high-resolution peripheral quantitative computed tomography (HR-pQCT) for nondominant distal radius and bilateral distal tibiae.

Results

The Treatment group had numerically greater increases in all DXA parameters with a statistically significant difference being detected for the absolute and percentage increases in femoral neck aBMD at the dominant leg (0.015 (SD = 0.031)g/cm2, 2.15 (SD = 4.32)%) and the absolute increase in lumbar spine BMC (1.17 (SD = 2.05)g) in the Treatment group as compared with the Control group (0.00084 (SD = 0.026)g/cm2, 0.13 (SD = 3.62)% and 0.47 (SD = 1.88)g, respectively). WBV had no significant effect for other bone quality parameters.

Conclusions

WBV was effective for improving aBMD at the femoral neck of the dominant side and lumbar spine BMC in AIS subjects.

Keyword

Adolescent idiopathic scoliosis Low bone mass Treatment WBV Whole body vibration therapy 

Notes

Acknowledgments

The authors would like to express their gratitude towards the subjects and their families for participating in this study. We would also like to thank Ms. Fiona W.P. Yu, Ms. Queenie W.Y. Mak, Ms. Christy K.Y. Chan, and the entire research team in carrying out this project.

Funding

This study was supported by peer-reviewed General Research Fund, Research Grants Council of the Hong Kong S.A.R., China, (Project no: 467808). Juvent Medical, Inc. (Somerset, New Jersey) supplied 20 WBV platforms, while the rest were procured with the research fund. The funding source and Juvent Medical, Inc. were not involved in the design of the study; the collection, analysis, and interpretation of the data; and the decision to approve publication of the finished manuscript.

Conflicts of interest

None.

References

  1. 1.
    Luk K, Lee C, Cheung K, Cheng J, Ng B, Lam T, Mak K, Yip P, Fong D (2010) Clinical effectiveness of school screening for adolescent idiopathic scoliosis: a large population-based retrospective cohort study. Spine 35:1607–1614PubMedCrossRefGoogle Scholar
  2. 2.
    Cheung CSK, Lee WTK, Tse YK, Guo X, Qin L, Cheng JCY (2006) Generalized osteopenia in adolescent idiopathic scoliosis—association with abnormal pubertal growth, bone turnover, and calcium intake. Spine 31(3):330–338PubMedCrossRefGoogle Scholar
  3. 3.
    Cheng JC, Hung VW, Lee WT, Yeung HY, Lam TP, Ng BK, Guo X, Qin L (2006) Persistent osteopenia in adolescent idiopathic scoliosis—longitudinal monitoring of bone mineral density until skeletal maturity. Stud Health Technol Inform 123:47–51PubMedGoogle Scholar
  4. 4.
    Hung VW, Qin L, Cheung CS, Lam TP, Ng BK, Tse YK, Guo X, Lee KM, Cheng JC (2005) Osteopenia: a new prognostic factor of curve progression in adolescent idiopathic scoliosis. J Bone Joint Surg Br 87(12):2709–2716CrossRefGoogle Scholar
  5. 5.
    Bowden SA, Robinson RF, Carr R, Mahan JD (2008) Prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis referred to a pediatric metabolic bone clinic. Pediatrics 121(6):2007–2111CrossRefGoogle Scholar
  6. 6.
    Cheng JC, Guo X (1997) Osteopenia in adolescent idiopathic scoliosis. A primary problem or secondary to the spinal deformity. Spine (Phila Pa 1976) 22(15):1716–1721CrossRefGoogle Scholar
  7. 7.
    Cheng JC, Guo X, Sher AH (1999) Persistent osteopenia in adolescent idiopathic scoliosis. A longitudinal follow up study. Spine (Phila Pa 1976) 24(12):1218–1222CrossRefGoogle Scholar
  8. 8.
    Loro ML, Sayre J, Roe TF, Goran MI, Kaufman FR, Gilsanz V (2000) Early identification of children predisposed to low peak bone mass and osteoporosis later in life. J Clin Endocrinol Metab 85(10):3908–3918PubMedCrossRefGoogle Scholar
  9. 9.
    Fehlings D, Switzer L, Agarwal P, Wong C, Sochett E, Stevenson R, Sonnenberg L, Smile S, Young E, Huber J, Milo-Manson G, Kuwaik GA, Gaebler D (2012) Informing evidence-based clinical practice guidelines for children with cerebral palsy at risk of osteoporosis: a systematic review. Dev Med Child Neurol 54(2):106–116PubMedCrossRefGoogle Scholar
  10. 10.
    Wysocki A, Butler M, Shamliyan T, Kane RL (2011) Whole-body vibration therapy for osteoporosis: state of the science. Ann Intern Med 155(10):680–686PubMedCrossRefGoogle Scholar
  11. 11.
    Rubin C, Turner AS, Bain S, Mallinckrodt C, McLeod K (2001) Low mechanical signals strengthen long bones. Nature 412(6847):603–604PubMedCrossRefGoogle Scholar
  12. 12.
    Rubin C, Turner AS, Muller R, Mittra E, McLeod K, Lin W, Qin YX (2002) Quantity and quality of trabecular bone in the femur are enhanced by a strongly anabolic, noninvasive mechanical intervention. J Bone Miner Res 17(2):349–357PubMedCrossRefGoogle Scholar
  13. 13.
    Gilsanz V, Wren TA, Sanchez M, Dorey F, Judex S, Rubin C (2006) Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res 21(9):1464–1474PubMedCrossRefGoogle Scholar
  14. 14.
    Rubin C, Recker R, Cullen D, Ryaby J, McCabe J, McLeod K (2004) Prevention of postmenopausal bone loss by a low-magnitude, high-frequency mechanical stimuli: a clinical trial assessing compliance, efficacy, and safety. J Bone Miner Res 19(3):343–351PubMedCrossRefGoogle Scholar
  15. 15.
    Pitukcheewanont P, Safani D (2006) Extremely low-level, short-term mechanical stimulation increases cancellous and cortical bone density and muscle mass of children with low bone density: a pilot study. Endocrinologist 16:128–132CrossRefGoogle Scholar
  16. 16.
    Ward K, Alsop C, Caulton J, Rubin C, Adams J, Mughal Z (2004) Low magnitude mechanical loading is osteogenic in children with disabling conditions. J Bone Miner Res 19(3):360–369PubMedCrossRefGoogle Scholar
  17. 17.
    Verschueren SM, Roelants M, Delecluse C, Swinnen S, Vanderschueren D, Boonen S (2004) Effect of 6-month whole body vibration training on hip density, muscle strength, and postural control in postmenopausal women: a randomized controlled pilot study. J Bone Miner Res 19(3):352–359PubMedCrossRefGoogle Scholar
  18. 18.
    Slatkovska L, Alibhai SM, Beyene J, Cheung AM (2010) Effect of whole-body vibration on BMD: a systematic review and meta-analysis. Osteoporos Int 21(12):1969–1980PubMedCrossRefGoogle Scholar
  19. 19.
    Yu WS, Chan KY, Yu FWP, Yeung HY, Lee KM, Ng BKW, Lam TP, Cheng JCY Deranged bone microarchitecture and osteopenia in girls with adolescent idiopathic scoliosis. In: The 8th combined congress of the spine and pediatric section, Asia Pacific Orthopaedic Association (APOA), Gifu, Japan, Jun 1–4 2011. p 72Google Scholar
  20. 20.
    Lee WT, Cheung CS, Tse YK, Guo X, Qin L, Ho SC, Lau J, Cheng JC (2005) Generalized low bone mass of girls with adolescent idiopathic scoliosis is related to inadequate calcium intake and weight bearing physical activity in peripubertal period. Osteoporos Int 16(9):1024–1035PubMedCrossRefGoogle Scholar
  21. 21.
    Kohrt WM (2001) Aging and the osteogenic response to mechanical loading. Int J Sport Nutr Exerc Metab 11(Suppl):S137–S142PubMedGoogle Scholar
  22. 22.
    Rubin C, Pope M, Fritton JC, Magnusson M, Hansson T, McLeod K (2003) Transmissibility of 15-hertz to 35-hertz vibrations to the human hip and lumbar spine: determining the physiologic feasibility of delivering low-level anabolic mechanical stimuli to skeletal regions at greatest risk of fracture because of osteoporosis. Spine (Phila Pa 1976) 28(23):2621–2627CrossRefGoogle Scholar
  23. 23.
    Weinstein SL, Dolan LA, Cheng JC, Danielsson A, Morcuende JA (2008) Adolescent idiopathic scoliosis. Lancet 371(9623):1527–1537PubMedCrossRefGoogle Scholar
  24. 24.
    Ylikoski M (2003) Height of girls with adolescent idiopathic scoliosis. Eur Spine J 12(3):288–291PubMedGoogle Scholar
  25. 25.
    Cheng JCY, Leung SSF, Lau J (1996) Anthropometric measurements and body proportions among Chinese children. Clin Orthop Relat Res 323:22–30PubMedCrossRefGoogle Scholar
  26. 26.
    Alonso AC, Brech GC, Bourquin AM, Greve JM (2011) The influence of lower-limb dominance on postural balance. Sao Paulo Med J 129(6):410–413PubMedGoogle Scholar
  27. 27.
    Lee WT, Cheung CS, Tse YK, Guo X, Qin L, Lam TP, Ng BK, Cheng JC (2005) Association of osteopenia with curve severity in adolescent idiopathic scoliosis: a study of 919 girls. Osteoporos Int 16(12):1924–1932PubMedCrossRefGoogle Scholar
  28. 28.
    Cheng JCY, Sher HL, Guo X, Hung VWY, Cheung AYK (2001) The effect of vertebral rotation of the lumbar spine on dual energy x-ray absorptiometry measurements: observational study. Hong Kong Med J 7:241–245PubMedGoogle Scholar
  29. 29.
    Boutroy S, Bouxsein ML, Munoz F, Delmas PD (2005) In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab 90(12):6508–6515PubMedCrossRefGoogle Scholar
  30. 30.
    Li EK, Zhu TY, Hung VY, Kwok AW, Lee VW, Lee KK, Griffith JF, Li M, Wong KC, Leung PC, Qin L, Tam LS (2010) Ibandronate increases cortical bone density in patients with systemic lupus erythematosus on long-term glucocorticoid. Arthritis Res Ther 12(5):R198PubMedCrossRefGoogle Scholar
  31. 31.
    Laib A, Hauselmann HJ, Ruegsegger P (1998) In vivo high resolution 3D-QCT of the human forearm. Technol Health Care 6(5–6):329–337PubMedGoogle Scholar
  32. 32.
    MacNeil JA, Boyd SK (2007) Accuracy of high-resolution peripheral quantitative computed tomography for measurement of bone quality. Med Eng Phys 29(10):1096–1105PubMedCrossRefGoogle Scholar
  33. 33.
    Laib A, Ruegsegger P (1999) Calibration of trabecular bone structure measurements of in vivo three-dimensional peripheral quantitative computed tomography with 28-microm-resolution microcomputed tomography. Bone 24(1):35–39PubMedCrossRefGoogle Scholar
  34. 34.
    MacNeil JA, Boyd SK (2008) Improved reproducibility of high-resolution peripheral quantitative computed tomography for measurement of bone quality. Med Eng Phys 30(6):792–799PubMedCrossRefGoogle Scholar
  35. 35.
    Pols MA, Peeters PH, Bueno-De-Mesquita HB, Ocke MC, Wentink CA, Kemper HC, Collette HJ (1995) Validity and repeatability of a modified Baecke questionnaire on physical activity. Int J Epidemiol 24(2):381–388PubMedCrossRefGoogle Scholar
  36. 36.
    Lau J (2005) The knowledge and practice of physical activities amongst the pregnant women in Hong Kong. The Chinese University of Hong Kong, Hong KongGoogle Scholar
  37. 37.
    Leung SSF, Ho SC, Woo J, Lam TH, Janus ED (1997) Hong Kong Adult Dietary Survey 1995. Department of Paediatrics, The Chinese University of Hong Kong, Hong KongGoogle Scholar
  38. 38.
    Woo J, Leung SSF, Ho SC, Lam TH, Janus ED (1997) A food frequency questionnaire for use in the Chinese population in Hong Kong: description and examination of validity. Nutr Res 17:1633–1641CrossRefGoogle Scholar
  39. 39.
    Institute of Nutrition and Food Safety (2002) China food composition. Peking University Medical Press, People’s Republic of ChinaGoogle Scholar
  40. 40.
    Benjamini Y, Hochberg Y (1995) Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc B 57(1):289–300Google Scholar
  41. 41.
    Benjamini Y, Hochberg Y (2000) On the adaptive control of the false discovery rate in multiple testing with independent statistics. J Educ Behav Stat 25(1):60–83Google Scholar
  42. 42.
    Slatkovska L, Alibhai SM, Beyene J, Hu H, Demaras A, Cheung AM (2011) Effect of 12 months of whole-body vibration therapy on bone density and structure in postmenopausal women: a randomized trial. Ann Intern Med 155(10):668–679PubMedCrossRefGoogle Scholar
  43. 43.
    Kiiski J, Heinonen A, Jarvinen TL, Kannus P, Sievanen H (2008) Transmission of vertical whole body vibration to the human body. J Bone Miner Res 23(8):1318–1325PubMedCrossRefGoogle Scholar
  44. 44.
    Torvinen S, Kannus P, Sievanen H, Jarvinen TA, Pasanen M, Kontulainen S, Nenonen A, Jarvinen TL, Paakkala T, Jarvinen M, Vuori I (2003) Effect of 8-month vertical whole body vibration on bone, muscle performance, and body balance: a randomized controlled study. J Bone Miner Res 18(5):876–884PubMedCrossRefGoogle Scholar
  45. 45.
    Bemben DA, Palmer IJ, Bemben MG, Knehans AW (2010) Effects of combined whole-body vibration and resistance training on muscular strength and bone metabolism in postmenopausal women. Bone 47(3):650–656PubMedCrossRefGoogle Scholar
  46. 46.
    Hoffman M, Schrader J, Applegate T, Koceja D (1998) Unilateral postural control of the functionally dominant and nondominant extremities of healthy subjects. J Athl Train 33(4):319–322PubMedGoogle Scholar
  47. 47.
    Harris ST, Watts NB, Genant HK, McKeever CD, Hangartner T, Keller M, Chesnut CH, Brown J 3rd, Eriksen EF, Hoseyni MS, Axelrod DW, Miller PD (1999) Effects of risedronate treatment on vertebral and nonvertebral fractures in women with postmenopausal osteoporosis: a randomized controlled trial. Vertebral Efficacy With Risedronate Therapy (VERT) Study Group. JAMA 282(14):1344–1352PubMedCrossRefGoogle Scholar
  48. 48.
    Black DM, Cummings SR, Karpf DB, Cauley JA, Thompson DE, Nevitt MC, Bauer DC, Genant HK, Haskell WL, Marcus R, Ott SM, Torner JC, Quandt SA, Reiss TF, Ensrud KE (1996) Randomised trial of effect of alendronate on risk of fracture in women with existing vertebral fractures. Fracture Intervention Trial Research Group. Lancet 348(9041):1535–1541PubMedCrossRefGoogle Scholar
  49. 49.
    Lau E, Al-Dujaili S, Guenther A, Liu D, Wang L, You L (2010) Effect of low-magnitude, high-frequency vibration on osteocytes in the regulation of osteoclasts. Bone 46(6):1508–1515PubMedCrossRefGoogle Scholar
  50. 50.
    Burrows M, Liu D, Moore S, McKay H (2010) Bone microstructure at the distal tibia provides a strength advantage to males in late puberty: an HR-pQCT study. J Bone Miner Res 25(6):1423–1432PubMedGoogle Scholar
  51. 51.
    Lynn HS, Lau EM, Au B, Leung PC (2005) Bone mineral density reference norms for Hong Kong Chinese. Osteoporos Int 16(12):1663–1668PubMedCrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2012

Authors and Affiliations

  • T. P. Lam
    • 1
    • 4
    • 5
  • B. K. W. Ng
    • 1
    • 4
  • L. W. H. Cheung
    • 1
  • K. M. Lee
    • 3
    • 4
  • L. Qin
    • 1
    • 2
  • J. C. Y. Cheng
    • 1
    • 4
  1. 1.Department of Orthopaedics and TraumatologyThe Chinese University of Hong KongShatinChina
  2. 2.Bone Quality and Health Assessment Centre, Department of Orthopaedics and TraumatologyThe Chinese University of Hong KongShatinChina
  3. 3.Lee Hysan Clinical Research LaboratoriesThe Chinese University of Hong KongShatinChina
  4. 4.Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing UniversityShatinChina
  5. 5.Department of Orthopaedics and TraumatologyPrince of Wales Hospital, 5/F., Clinical Science Building, Prince of Wales HospitalShatin NTChina

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