Osteoporosis International

, Volume 21, Issue 12, pp 1969–1980 | Cite as

Effect of whole-body vibration on BMD: a systematic review and meta-analysis

  • L. Slatkovska
  • S. M. H. Alibhai
  • J. Beyene
  • A. M. Cheung



Our systematic review and meta-analysis of randomized controlled trials (RCTs) examining whole-body vibration (WBV) effect on bone mineral density (BMD) found significant but small improvements in hip areal BMD (aBMD) in postmenopausal women and in tibia and spine volumetric BMD in children/adolescents, but not in other BMD measurements in postmenopausal women and young adults.


Animal experiments report anabolic bone changes in response to WBV, but data in humans are limited. Our objective is to conduct a systematic review and meta-analysis of RCTs examining WBV effect on BMD.


Eligible RCTs included randomized or quasi-randomized trials, with follow-up of ≥6 months, examining WBV effects on BMD in ambulatory individuals without secondary causes of osteoporosis. The weighted mean differences between WBV and control groups in absolute pre-post change in spine and hip aBMD, and in spine and tibia trabecular volumetric BMD (vBMD) were calculated.


Eight RCTs in postmenopausal women (five RCTs), young adults (one RCT), and children and adolescents (two RCTs) were included. The regimens were heterogeneous, study durations were relatively short, and available data was mostly per-protocol. In postmenopausal women, WBV was found to significantly increase hip aBMD (0.015 g cm−2; 95% confidence interval (CI), 0.008–0.022; n = 131) versus controls, but not spine aBMD (n = 181) or tibia trabecular vBMD (n = 29). In young adults, WBV did not increase spine or hip bone mineral content, or tibia trabecular vBMD (n = 53). In children and adolescents, WBV significantly increased spine (6.2 mg cm−3; 95% CI, 2.5–10.0; n = 65) and tibia (14.2 mg cm−3; 95% CI, 5.2–23.2; n = 17) trabecular vBMD.


We found significant but small improvements in BMD in postmenopausal women and children and adolescents, but not in young adults. WBV is a promising new modality, but before recommendations can be made for clinical practice, large-scale long-term studies are needed to determine optimal magnitude, frequency, and duration.


Bone mineral density Meta-analysis Quantitative computed tomography Whole-body vibration 


  1. 1.
    Eisman JA (2001) Good, good, good... good vibrations: the best option for better bones? Lancet 358:1924–1925CrossRefPubMedGoogle Scholar
  2. 2.
    Rubin C, Judex S, Qin YX (2006) Low-level mechanical signals and their potential as a non-pharmacological intervention for osteoporosis. Age Ageing 35:ii32–ii36CrossRefPubMedGoogle Scholar
  3. 3.
    Flieger J, Karachalios T, Khaldi L, Raptou P, Lyritis G (1998) Mechanical stimulation in the form of vibration prevents postmenopausal bone loss in ovariectomized rats. Calcif Tissue Int 63:510–514CrossRefPubMedGoogle Scholar
  4. 4.
    Rubin C, Xu G, Judex S (2001) The anabolic activity of bone tissue, suppressed by disuse, is normalized by brief exposure to extremely low-magnitude mechanical stimuli. FASEB J 15:2225–2229CrossRefPubMedGoogle Scholar
  5. 5.
    Rubinacci A, Marenzana M, Cavani F, Colasante F, Villa I, Willnecker J, Moro GL, Spreafico LP, Ferretti MGF, Marrotti G (2008) Ovariectomy sensitizes rat cortical bone to whole-body vibration. Calcif Tissue Int 82:316–326CrossRefPubMedGoogle Scholar
  6. 6.
    Judex S, Boyd S, Qin YX, Turner S, Ye K, Muller R, Rubin C (2003) Adaptations of trabecular bone to low magnitude vibrations result in more uniform stress and strain under load. Ann Biomed Eng 31:12–20CrossRefPubMedGoogle Scholar
  7. 7.
    Rubin C, Turner AS, Mallinckrodt C, Jerome C, McLeod K, Bain S (2002) Mechanical strain, induced noninvasively in the high-frequency domain, is anabolic to cancellous bone, but not cortical bone. Bone 30:445–452CrossRefPubMedGoogle Scholar
  8. 8.
    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 17:349–357CrossRefPubMedGoogle Scholar
  9. 9.
    Christiansen BA, Silva MJ (2006) The effect of varying magnitudes of whole-body vibration on several skeletal sites in mice. Ann Biomed Eng 34:1149–1156CrossRefPubMedGoogle Scholar
  10. 10.
    Judex S, Zhong N, Squire ME, Ye K, Donahue LR, Hadjiargyrou M, Rubin CT (2005) Mechanical modulation of molecular signals which regulate anabolic and catabolic activity in bone tissue. J Cell Biochem 94:982–994CrossRefPubMedGoogle Scholar
  11. 11.
    Xie L, Jacobson J, Choi ES, Busa B, Donahue LR, Miller LM, Rubin C, Judex S (2006) Low-level mechanical vibrations can influence bone resorption and bone formation in the growing skeleton. Bone 39:1059–1066CrossRefPubMedGoogle Scholar
  12. 12.
    Rubin C, Turner AS, Bain S, Mallinckrodt C, McLeod K (2001) Anabolism. Low mechanical signals strengthen long bones. Nature 412:603–604CrossRefPubMedGoogle Scholar
  13. 13.
    Kolata G (2007) Low buzz may give mice better bones and less fat. N Y Times 10:F6Google Scholar
  14. 14.
    Wikimedia Foundation Inc (2009) Whole-body vibration. In: Wikipedia The Free Encyclopedia. Available via http://en.wikipedia.org/wiki/Whole_body_vibration. Accessed 10 Jul 2009
  15. 15.
    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 23:1318–1325CrossRefPubMedGoogle Scholar
  16. 16.
    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 28:2621–2627CrossRefPubMedGoogle Scholar
  17. 17.
    Fritton JC, McLeod K, Rubin B (2000) Quantifying the strain history of bone: spatial uniformity and self-similarity of low-magnitude strains. J Biomech 33:317–325CrossRefPubMedGoogle Scholar
  18. 18.
    Prisby RD, Lafage-Proust MH, Malaval L, Belli A, Vico L (2008) Effects of whole-body vibration on the skeleton and other organ systems in man and animal models: what we know and what we need to know. Ageing Res Rev 7:319–329CrossRefPubMedGoogle Scholar
  19. 19.
    Higgins J, Green S (2008) Cochrane's handbook for systematic reviews of interventions version 5.0.1. In: The Cochrane Collaboration. Available via http://www.cochrane-handbook.org. Accessed 10 Jul 2009
  20. 20.
    Moher D, Cook D, Eastwood S, Olkin I, Rennie D, Stroup D (1999) Improving the quality of reports of meta-analyses of randomized controlled trials: the QUOROM statement. Lancet 354:1896–1900CrossRefPubMedGoogle Scholar
  21. 21.
    Nelson DA, Norris SA, Gilsanz V (2006) Childhood and adolescence. In: Rosen CJ (ed) Primer on the metabolic bone diseases and disorders of mineral metabolism, 7th edn. American Society for Bone and Mineral Research, Washington, pp 55–63Google Scholar
  22. 22.
    Reid IR (2006) Menopause. In: Rosen CJ (ed) Primer on the metabolic bone diseases and disorders of mineral metabolism, 7th edn. American Society for Bone and Mineral Research, Washington, pp 68–70Google Scholar
  23. 23.
    Juni P, Altman G, Egger M (2001) Assessing the quality of controlled clinical trials. Br Med J 323:42–46CrossRefGoogle Scholar
  24. 24.
    Gilsanz V, Wren TAL, 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 21:1464–1474CrossRefPubMedGoogle Scholar
  25. 25.
    Gusi N, Raimundo A, Leal A (2006) Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial. BMC Musculoskelet Disord 7:92CrossRefPubMedGoogle Scholar
  26. 26.
    Iwamoto J, Takeda T, Sato Y, Uzawa M (2005) 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 17:157–163PubMedGoogle Scholar
  27. 27.
    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 19:343–351CrossRefPubMedGoogle Scholar
  28. 28.
    Russo CR, Lauretani F, Bandinelli S, Bartali B, Cavazzini C, Guralnik JM, Ferrucci L (2003) High-frequency vibration training increases muscle power in postmenopausal women. Arch Phys Med Rehabil 84:1854–1857CrossRefPubMedGoogle Scholar
  29. 29.
    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 18:876–884CrossRefPubMedGoogle Scholar
  30. 30.
    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 19:352–359CrossRefPubMedGoogle Scholar
  31. 31.
    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 19:360–369CrossRefPubMedGoogle Scholar
  32. 32.
    Tang B, Eslick G, Nowson C, Smith C, Bensoussan A (2007) Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: a meta-analysis. Lancet 370:657–666CrossRefPubMedGoogle Scholar
  33. 33.
    Bonnick SL (2004) Changes in bone density. In: Bone densitometry in clinical practice: application and interpretation, 2nd edn. Human Press Inc, Totowa, p 279Google Scholar
  34. 34.
    Ward KA, Roberts SA, Adams JE, Lanhan-New S, Mughal MZ (2007) Calcium supplementation and weight bearing physical activity—do they have a combined effect on the bone density of pre-pubertal children? Bone 41:496–504CrossRefPubMedGoogle Scholar
  35. 35.
    Judex S, Donahue LR, Rubin C (2002) Genetic predisposition to osteoporosis is paralleled by an enhanced sensitivity to signals anabolic to the skeleton. FASEB J 16:1280–1282PubMedGoogle Scholar
  36. 36.
    Wolff J (1986) The law of bone remodeling. Springer, BerlinGoogle Scholar
  37. 37.
    Ruan XY, Jin FY, Liu Y, Peng ZL, Sundelin YG (2008) Effects of vibration therapy on bone mineral density in postmenopausal women with osteoporosis. Chin Med J 121:1155–1158PubMedGoogle Scholar
  38. 38.
    Cheung AM, Tile L, Lee Y, Tomlinson G, Hawker G, Scher J, Hu H, Vieth R, Thompson L, Jamal S, Josse R (2008) Vitamin K supplementation in postmenopausal women with osteopenia (ECKO trial): a randomized controlled trial. PLoS Med 5:e196CrossRefPubMedGoogle Scholar
  39. 39.
    Martyn-St James M, Carroll S (2006) High-intensity resistance training and postmenopausal bone loss: a meta-analysis. Osteoporos Int 17:1225–1240CrossRefPubMedGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2010

Authors and Affiliations

  • L. Slatkovska
    • 1
    • 2
    • 5
  • S. M. H. Alibhai
    • 1
    • 3
    • 4
    • 5
  • J. Beyene
    • 8
  • A. M. Cheung
    • 1
    • 2
    • 3
    • 4
    • 5
    • 6
    • 7
  1. 1.Osteoporosis ProgramUniversity Health Network/Mount Sinai HospitalTorontoCanada
  2. 2.Women’s Health ProgramUniversity Health NetworkTorontoCanada
  3. 3.Department of MedicineUniversity of TorontoTorontoCanada
  4. 4.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  5. 5.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  6. 6.Centre of Excellence in Skeletal Health AssessmentUniversity of TorontoTorontoCanada
  7. 7.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  8. 8.Department of Clinical Epidemiology and BiostatisticsMcMaster UniversityHamiltonCanada

Personalised recommendations