<table><tr><th>From:</th><th>Karyna Shuliak</th></tr><tr><td>Sent:</td><td>Tuesday, December 29, 2015 4:43 AM</td></tr><tr><td>To:</td><td>Jeffrey</td></tr><tr><td>Subject:</td><td>Low-frequency vibratory exercise reduces the risk of bone fracture more than walking:
a randomized controlled trial</td></tr></table>

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/

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	- BMC Musculoskelet Disord

	- v.7; 2006 <http://www.ncbi.nlm.nih.gov/pmc/issues/126480/>

	- PMC1693558

BMC =usculoskelet Disord. 2006; 7: 92.
Published online 2006 Nov =0. doi: 10.1186/1471-2474-7-92
PMCID: PMC1693558
<=div>

trial

Low-frequency =ibratory exercise reduces the risk of bone fracture more than walking: = randomized controlled

Narcis =usi,1 Armando =aimundo,2 and Alejo Leal3 Author information ►Article notes ►Copyright and License information ► This article has been cited by other =rticles in PMC. Go =o:

Abstract

## Background

Whole-body vibration (WBV) is a new type of exercise =hat has been increasingly tested for the ability to prevent bone =ractures and osteoporosis in frail people. There are two currently =arketed vibrating plates: a) the whole plate oscillates up and down; b) =eciprocating vertical displacements on the left and right side of a =ulcrum, increasing the lateral accelerations. A few studies have shown =ecently the effectiveness of the up-and-down plate for increasing Bone =ineral Density (BMD) and balance; but the effectiveness of the =eciprocating plate technique remains mainly unknown. The aim was to =ompare the effects of WBV using a reciprocating platform at frequencies =ower than 20 Hz and a walking-based exercise programme on BMD and =alance in post-menopausal women.

## Methods

Twenty-eight physically untrained post-menopausal women were =ssigned at random to a WBV group or a Walking group. Both experimental =rogrammes consisted of 3 sessions per week for 8 months. Each vibratory =ession included 6 bouts of 1 min (12.6 Hz in frequency and 3 cm in =mplitude with 60' of knee flexion) with 1 min rest between bouts. =ach walking session was 55 minutes of walking and 5 minutes of =tretching. Hip and lumbar BMD (g•cm-2) were measured using =ual-energy X-ray absorptiometry and balance was assessed by the blind =lamingo test. ANOVA for repeated measurements was adjusted by baseline =ata, weight and age.

## Results

After 8 months, BMD at the femoral neck in the WBV group was =ncreased by 4.3% (P = 0.011) compared to the =alking group. In contrast, the BMD at the lumbar spine was unaltered in =oth groups. Balance was improved in the WBV group (29%) but not in the =alking group.

## Conclusion

The 8-month course of vibratory exercise using a =eciprocating plate is feasible and is more effective than walking to =mprove two major determinants of bone fractures: hip BMD and =alance. Go to:

## Background

Bone fracture is among the =ommonest and most expensive health problems in the population, =articularly in postmenopausal women [1]. The =ajor determinants of bone fractures are falls, bone fragility, loss of =alance and decrease of lower limb strength[2,3J. =hysical exercise is considered as an effective strategy, frequently =ecommended in general practice, for the prevention and management of =ostmenopausal osteoporosis[4,5]. =erobics, weight bearing and resistance exercises were all effective =ncreasing bone mass density[6]. =owever, arduous bone stress induced by vigorous weight-bearing =ctivities can increase the risk of injuries, particularly in the =Iderly[7]. =herefore, alternative strategies with a lower risk of injury have been =ought and usually included in the medical advice, such as walking

## Background (cont.)

=rogrammes(81. =alking and moderate-intensity aerobic exercise programmes have been shown to reduce bone loss although they did not increase significantly =one mineral density (BMD) compared to controls in the first few years =f menopause[4] and =hey showed limited effects on bone in postmenopausal women[9].

Vibration could be a viable alternative in frail people(10,111. =hole-body vibration (WBV) is a new type of exercise that has been =ncreasingly tested for the ability to prevent bone fractures and =steoporosis[3,12-15J. =ecent studies of WBV have shown a positive effect of controlled WBV on =ait, body balance and motor capacity[16]. =owever, the treatment has to follow specific safety guidelines[17] to =revent exercise-related injuries (back pain, muscular discomfort, =tc.), such as limiting the exposure to vibration to a maximum of 10 =inutes and maintaining the posture of the participant in a semi-squat =tance with knees flexed, with active involvement of the leg muscles to =educe the transmission of vibration to the head.

The currently marketed =evices that deliver sinusoidal vibration to the whole body use two =ifferent types of vibrating plates[171: a) =he whole plate oscillates up and down; b) reciprocating vertical =isplacements on the left and right side of a fulcrum, increasing the =ateral accelerations. A few studies have shown recently that there is =carce evidence of the effectiveness of the up-and-down plate for =ncreasing BMD in experimental animals[13j or =umans(15J; but =he literature is largely lacking studies of the effect of the =eciprocating plate technique.

Currently available WBV exercise devices deliver vibrations =t frequencies of 15-60 Hz. Investigators usually administered =requencies at 15-35 Hz to obtain the maximum transmissibility =f the mechanical stimulus produced by the vibrating plate[18J. On =he other hand, since the resonance frequency for the WBV is in the =ange of 5-10 Hz [191, the =requencies lower than 20 Hz has been usually avoided. However, some =ecent studies have included in their protocols frequencies at 10—=5 Hz to allow for gentle adaptation in frail populations (nursing home =esidents, elder, rehabilitation programs, etc.)116,201. But, =o our knowledge, none of them have reported the specific effect of =hese low frequencies on bone mass. This knowledge could specially =ontribute to make decisions on the WBV programs to frail people. =owever, prior to administer these WBV programs in frail people, these =rograms have to be tested in healthy population.

The purpose of the current =tudy is to determine whether 8 months of WBV exercise at 12.6 Hz using = reciprocating plate is more effective than walking for improving BMD =nd balance in healthy postmenopausal women. Go to:

## Methods

## Subjects and study design

Figure <=pan class="figpopup-sensitive-area" style="cursor: pointer; =ext-decoration: none; position: absolute; top: Opx; opacity: 0; color: =ransparent; background-color: transparent; left: =3em;">Figurell shows that 36 postmenopausal =omen recruited through advertisements in local newspapers volunteered =o participate in the study; however, only the 28 who completed the =rial are included in the analysis. Informed consent was obtained from =11 qualified volunteers. The inclusion criteria were: at least 5 years =rom the last menstruation; adequate nutritional status according to WHO =orms (as determined by questionnaire); non-smoker; consumption of no =ore than four alcoholic beverages per week; the ability to follow the =rotocol; free from disease or medication known to affect bone =etabolism or muscle strength. A questionnaire designed to gather =nformation about current and previous dietary factors, including intake =f calcium and vitamin D, was administered. At baseline, serum =steocalcin and urinary deoxypyridinoline crosslinks and creatinine were =etermined as markers of bone formation and resorption, respectively[211.

## Figure 1

Flow-chart of =articipants throughout trial.

Exclusion criteria were: acute hernia; =hrombosis; any pharmacologic intervention for osteopenia within the =revious 6 months; any history of severe musculoskeletal problems; =ngaged in high-impact activity at least twice a week (any =eight-bearing activity or exercise more intense than brisk =alking).

All =ubjects were assigned at random to one of the study groups. A total of =4 women trained for 8 months on a vibrating plate via reciprocation =the WBV group). The other 14 women participated in a walking activity =the Walking

## Figure 1 (cont.)

group). The WBV programme consisted of 96 training sessions =ithin a period of 32 weeks. The frequency of training was three times a =eek, with at least 1day of rest between sessions in both experimental =roups.

This study =as approved by the University's Bioethics Committee according to the =elsinki declaration.

## The WBV =roup

The subjects =n the WBV group performed the vibration exercise in a standing =osition. In each session, vibration was provided by a commercially =vailable device (Galileo 2000, Novotec GmbH, Pforzheim, Germany). The =ubjects stood with feet side-by-side on the board, which produced =ateral oscillations of the whole body. During the vibration training =essions, the subjects were barefoot to eliminate any damping of the =ibration caused by footwear. The angle of flexion of the knees during =he vibration exercise was set at 60*. The tridimensional =cceleration was monitored by a triaxial accelerometer (TSD109F, =riaxial accelerometer 5G, Biopac Systems, USA) attached to the skin at =he level of the lumbar spine (L3) and normalised by body weight =g).

During the =irst 2 weeks of training, the WBV group performed three sets of 1 =inute vibration with a frequency of 12.6 Hz of vibration stimulus, =eparated by 1 minute resting periods. The training load was increased =ystematically during the following 6 weeks, increasing by one set each =eek until the 6 sets of WBV that we consider to be the load of this =ntervention. The resting period between sets was 1 minute. The vertical =mplitude of WBV was set at 3 mm. The duration of the WBV programme was =bout 30 minutes, which included 10 minutes warm-up consisting of S =inutes of bicycling at 50 W and 5 minutes of static stretching for the =uadriceps and triceps surae muscle.

## The =alking group

The =alking group trained outdoors. Each 1-hour session of walking was =nterspaced with two periods of S minutes each that included stretching =xercises. Two research assistants, who were experienced physical =ducation graduates, supervised this group.

## BMD =ssessment

At =aseline and at 8 months, BMD (g•cm-2) of the right proximal =emur (femoral neck, trochanter and Ward's triangle) and lumbar spine =ere assessed using dual-energy X-ray absorptiometry (DXA, Norland =xcell Plus; Norland Inc., Fort Atkinson, USA).

Standard positioning was used with =nterior-posterior scanning of the right proximal femur and the lumbar =olumn. The same experienced technician performed all the scans. In our =aboratory, the day-to-day precision (Coefficient of Variation %) was =bout 1% at lumbar and femoral neck sites, and it was about 1.2% at the =est of femoral sites.

## Balance =ssessment

Postural =alance was assessed with a blind flamingo test, in which the barefoot =ubject stood on one leg, while the other leg was flexed at knee level =nd held at the ankle by the hand of the same side of the body, and with =yes closed. The number of trials that the subject needed to complete 30 = of the static position (the chronometer was stopped whenever the =ubject did not comply with the protocol conditions) was measured. The =utcome was expressed as number of trials (= number of falls + 1). In =ur group, the test-retest intra-observer reliability coefficient of =his test calculated (Intra Class Coefficient = 0.83) can be =onsidered as acceptable for field testing in Spanish adults [22].

## Statistical analysis

Mean and standard deviation (SD) are given as descriptive =tatistics. Baseline characteristics were compared using =tudent's t-test for independent samples. The =ffects between groups were tested by ANOVA for repeated measurements, =djusted by body weight, age and baseline data. All analyses were =erformed with SPSS version 13.0 software. A result was considered =tatistically significant when the P value =as < 0.05 for primary outcomes (BMD) and < 0.01 for secondary =utcomes.

## Statistical analysis (cont.)

Go to:

Results

No difference in the =ompliance of programmes was detected, and 78% of participants completed =he exercise vibration-related programmes. =ide-effect In the or WBV any group, adverse the reaction mean frequency was observed. of =ttendance In the Walking was 2.7 group, (SD 0.7) =he mean times attendance per week, and was no 2.8(SD 0.8) days per week.

The baseline characteristics =f both groups are given in Table Table1.1. The groups were matched by age and =eight, which are major determinant anthropometric variables on the =train in WBV training. However, the WBV group had a trend (p > .200) =f higher weight and BMI than the walking group. Table Table22 also shows some imbalances =etween the groups, so the changes were analysed by adjusting baseline =ata and age. After 8 months, the BMD at the femoral neck of the WBV =roup was increased 4.3% (P = 0.011) compared =o the Walking group. The comparison of the changes in BMD at other =ices on the hip showed a trend for the higher effectiveness of the =ibratory exercise, but the difference did not reach statistical =ignificance. In contrast, BMD at the lumbar spine was unaltered in both =roups. The WBV group showed improved balance (29%), while the Walking =roup did not. The WBV group reduced more the BMI than the Walking group =3%; P = 0.049).

Table 1

Baseline =haracteristics of the sample

Table 2

Comparative effects =f vibratory (N = 14) and walking-based exercise (N = 14) programs =n postmenopausal women.

The lateral acceleration received by the WBV group at =he lumbar spine (L3) (median 3.3 g, SD 1.3; maximal 11.6 g, SD 6.5) was =reater (P < 0.001) than the vertical =cceleration (median: 0.7 g, SD 0.5; maximal 6.4, SD =.6). Go to: <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/#>

Discussion

Summary of main findings

The main finding of the study was that the =ibratory exercise on a reciprocating plate was more effective than =alking for improving balance and BMD at the femoral neck. The =daptation of bone to physical activity and mechanical loading is =rucial to the improvement and/or maintenance of bone mass and =trength[18,231. =ccording to conventional wisdom, the stimulus should be different from =hat usually occurs in daily living to stimulate an adaptation of the =one tissue[24). =owever, recent studies suggested that extremely low magnitude but =igh-frequency mechanical vibration can strongly influence bone =orphology[13,25I =ecause of the reverberation. Lodder et al. [26] =alculated that with increasing age, BMD in women decreases 0.005 =/cm2 per year at femoral neck (95% CI, 0.001 to =.006 decreases) and 0.006 g/cm2 per year at lumbar spine (95% CI, =.00 to 0.007 decreases) excluding the influence of corticosteroid use. =herefore, preventing bone loss is a clinically relevant effect. The =urrent study showed a significantly (P = =.011) and clinically relevant mean effect preventing bone loss at =emoral neck (0.02 g/cm2 increase) but the mean effect at lumbar spine =0.01 g/cm2 decrease) was not clinically relevant. More in =etail, seven participants in the vibratory group and three in the =alking group prevented bone mass density loss (no change or improvement =n BMD) at femoral neck. A similar trend of the number of preventions =as observed at the lumbar spine, but the mean of improvements were =ower. In a whole, walking program did not prevent bone loss. The other =ositive finding of the current vibrating training programme was the =igh frequency of attendance at sessions (90%) of the participants who =ompleted the programme. The profile of the sample (highly sedentary =ostmenopausal women) showing retention of the current programmes (78%) =s similar but slightly lower than that of previous community =roup-based strategies to promote exercise in the elderly population =80-90%)[27J. =owever, strategies to improve retention of the programme should be =ursued (musical environment, behavioural education, =tc.).

## Statistical analysis (cont.)

## Bone mass density

Although moderate-intensity aerobic exercise =nterventions usually documented positive, but not statistically =ignificant, increases in bone mass[28]; =erschueren et al. 1151 =eported positive effects on hip BMD but not in total body or lumbar =pine BMD after 6 months of WBV using an up-and-down plate, lower =mplitudes (1.7-2.5 mm) and higher frequencies (35-40 =z) than the current study. However, these results reflected a similar =rend of adaptation to the current study. Russo et al[20] did =ot find any improvement in bone characteristics after 6 months of WBV =raining with a reciprocating plate with two sessions per week. =herefore, the number of sessions per week seems to play an important role to obtain the desired effect.

Torvinen et al[3] =eported no effect on bones of healthy young adults after 8 months of =ertical WBV with 3-5 sessions per week using a lower amplitude =2 mm), different frequencies (15-45 Hz) and a multidirectional =ibration exposure of the body by variation of body position on the =late. The variability of the program contributed to make standing on =he platform less monotonous, but distributed the mechanical strains in =ifferent body sites. Therefore, the lack of effects on bone in the =tudy reported by Torvinen et al[3] could =e explained partially because the study used lower vertical amplitudes =han the current study, which are associated to a less mechanical =mpact, and the number of mechanical strains were shared by more =natomical sites. In addition, the sample population was younger than =hat of the current study.

On the other hand, the non-significance at the lumbar level =an be attributed to the partial knee flexion during the vibratory =xercise reducing the effects of the mechanical impact [3]. =evertheless, Rubin et al[18] found =reater up-and-down. strain in =n the contrast, vertical the axis current than in study the lateral had higher axis using lateral =ifferent than vertical devices =cceleration based on platforms by using a oscillating reciprocating the plate plate that oscillated on a central =xis so that, when half of the platform is up the other half is down, =ausing a continuous balance of hips.

Yamazaki et al[8] =emonstrated that moderate or walking exercise in postmenopausal women =ith osteopenia/osteoporosis maintained lumbar BMD via a suppression of =one turnover. Several studies showed that the effect of exercise on =umbar BMD in postmenopausal women seems to be quite modest (exercise =gt; 1% versus control < 1%)129] or =ven non-existent[30], and =he walking program of the current study did not induce any effect, =hich could be attributed, in part, to the better health status of the =ubjects of the current study (no case of =steopenia/osteoporosis).

## Balance

Six-week WBV programs with =he use of a reciprocating plate at 3 sessions per week could reduce the =eclining balance in the elderly using 4-6 sets of 30-60 = at 35-40 Hz[10] or 4 =ets of 60 s at 10-26 Hz [16]. The =urrent 8-month trial showed that a vibrating exercise with a =eciprocating plate could improve balance in postmenopausal women. In =ontrast, studies of 8 months using an up-and-down plate did not show =ny improvement of balance[3]. This =ifference between devices could be explained, in part, because: a) the =alance and the strength of lower limbs declines with age, particularly =n the lateral direction[31], the =irection in which the reciprocating plate used in the current study =howed the greater mechanical acceleration; b) the studies differed in =he methodology of balance assessment. Therefore, further research is =equired to determine the adequate dose-response of vibration training =eeded to improve balance.

## Body mass =ndex

The current =tudy reported a positive effect of WBV at 12.6 Hz on BMI compared to =alking group. This amelioration could be partly attributable to the =rend of the higher BMI of WBV group at baseline. Other previous study =id not find this positive effect (p < .05) on weight loss using WBV =t higher frequencies (25-45 Hz) compared to a control group =lthough they also found a trend of weight loss[3]. Other =uthors also reported that vibratory training at 35-40 Hz was =ore effective to reduce fat mass than resistance training [15]. In =ontrast, another WBV at 35-40 Hz

## Body mass =ndex (cont.)

program in untrained young =emales did not show a change in weight and authors reported a small but =ignificant increase of fat free mass[321. On =he whole, further research combining the analysis of the changes of fat =ree mass and lean mass is needed to elucidate this controversy and the =echanisms of weight change.

## Limitations

The main limitations of the current study are the sample =ize, the characteristics of the sample and the type of device employed. =he size of sample could limit the chance of finding a significant =ffect on the BMD of the lumbar spine, but the mean of change (-0.01=r/cm2) and the mean effect compared to walking group (0%) =acked of clinical relevance. In addition, this lack of effect is =onsistent with previous studies115]. =hanger of BMD at the trochanter and Ward's triangle were close to reach =tatistical significance, possibly due to the small sample size because =he statistical power was 30%. In addition, the observed mean effect =3-5%) was greater than the reliability of the measurements =1.2%). Therefore, we could consider that the WBV was more effective to =revent the bone mass density loss at hip area (femoral neck, Ward's Triangle and trochanter) than the walking programme.

The generalisation of results =as to be largely confined to healthy postmenopausal women, because we =ecruited this type of population to reduce the influence of some =otentially contaminant variables (hormone replacement therapy, =etabolic disorders, malnutrition etc.)1211. =ubin et al. 125] and =orvinen et al. 131 =peculated that a population with osteopenia or osteoporosis could =btain greater increases of BMD due to low baseline scores. In this =ense, the Walking group showed a trend of lowers BMI, BMD and balance =t baseline because the randomisation procedure applied to sample was =ot blocked by means of these variables. The imbalance of BMD could =ifficult to find more positive effects of the WBV group compared to the =alking group, but the imbalance of BMI could benefit to find =omparative ameliorations in WBV.

On the other hand, the results obtained has to be =estricted to devices designed to produce reciprocating vertical =isplacements on the left and right side of a fulcrum, which increases =he lateral accelerations. Nevertheless, this type of device is one of =he most frequently chosen for clinical use and for sport training. In =ddition, because the vertical strain was lower than the lateral strain, =he effects of vibratory training on the lumbar spine could require a =onger period of training or extra loading (e.g. a back-pack with =eights, a higher amplitude of vibration or less knee flexion to reduce =he attenuation of vibration throughout the body).

## Implications and future research

Professionals could expect =reater reductions of bone fracture risk by prescribing WBV exercise =ather than a walking program alone. Therefore, a vibration loading with =ow amplitude (3 mm) and medium intensity (12.6 Hz), could be used to =revent age-related bone loss at the hip, specially in frail =opulations. However, knowledge of the optimal dosage of vibratory =xercise requires further research. In addition, the effects of =ifferent doses of vibratory exercise and the effects of a mixed =ibratory and walking exercise are unknown.

Go to:

## Conclusion

The 8-month vibratory =xercise is feasible and more effective than walking to improve two =ajor determinants of bone fractures: hip BMD and =alance.

Go to: <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/#>

Competing =nterests

The =uthor(s) declare that they have no competing interests. Go to:

Authors' =ontributions

## Conclusion (cont.)

NG was =nvolved in the conception, planning and designing this study, the =cquisition of data, analysis and interpretation of data, and writing =he manuscript. AR was involved in the planning and organising this =esearch, the acquisition of data, analysis and interpretation of data, =nd drafting the manuscript. AL was involved in the acquisition of data =nd assisting in the writing of manuscript. All authors read and =pproved the final manuscript.

Go to:

Pre-publication =istory

The re-publication history for this paper can be accessed here: http://www.biomedcentral.com/1471-2474/7/92/prepub Go to: <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/#>

Acknowledgements

This research was supported =y the Health Department of the Government of Extremadura (Socio =anitary Research SCSS0466) in Spain and the Portuguese Fundation =uganio d'Almeida.

Go to: <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/#>

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• Delmas PD. Eastell R. =arnero P. Seibel M.I. Stepan J. Committe of Scientific Advisors of the =nternational Osteoporosis Foundation The use of biochemichal markers of =one turnover in osteoporosis. Committe of Scientific Advisors of the =nternational Osteoporosis Foundation. Osteoporos Int. 2000;11:52-17. doi: =0.1007/s001980070002. [PubMed] [Cross Ref]

` Rodriguez FA, Valenzuela =, Gusi N, Nacher S, Gallardo I. [Evaluation of the health-related =itness in adults (II): reliability, feasibility and reference norms by =eans of the AFISAL-INEFC] Apunts =ducacion Fisica y Deportes. 1998;54:54-65. Spanish..

• Eisman J Good, good, =ood... good vibrations: the best option for better =ones? Lancet. 2001;358:1924- 1925. doi: =0.1016/50140-6736(01)06975-6. [PubMed][Cross Ref]

• Frost HM Skeletal =tructural adaptations to mechanical usage (STAMU): 1 Redefining Wolff's =aw: The bone modelling problem. Anat =ec. 1990;226:403-413. =oi: 10.1002/ar.1092260402. [PubMed] [Cross Ref]

• Rubin C. Xu G. Judex S =he anabolic activity of bone tissue, suppressed by disuse, is =ormalized by brief exposure to extremely low-magnitude mechanical =timuli. Faseb =. 2001;15:2225-2229. =oi: 10.1096/fi.01-0166com. [PubMed] [Cross Ref]

• Lodder MC. Lems WF. Ader =J. Marthinsen AE. Coeverden SC. Lips P. Netelenbos JC. Dijkmans BA. =oos JC Reproducibility of bone mineral density measurement in daily =ractice. Ann Rheum =is. 2004;63:285-289. =oi: 10.1136/ard.2002.005678. [PMC free article] =span class="ref nowrap pubmed" style="white-space: nowrap;">[PubMed] [Cross Ref]

` King AC. Rejeski WJ. =uchner DM Physical activity interventions targeting older adults. A =ritical review and recommendations. Am = Prey Med. 1998;15:316—=33. doi: 10.1016/50749-3797(98)00085-3. [PubMed] [Cross Ref]

## Conclusion (cont.)

• Chubak J. Ulrich CM. =woroger SS. Sorensen B. Yasui Y. Irwin ML. Stanczyk FZ. Potter JD. =cTiernan A Effect of exercise on bone mineral density and lean mass in =ostmenopausal women. Med Sci Sports =xerc. 2006;38:1236-124=. doi: 10.1249/01.mss.0000227308.11278.d7. [PubMed] [Cross Ref]

• Kelley GA. Kelley KS. =ran ZV Exercise and lumbar spine bone mineral density in postmenopausal =omen: a meta-analysis of individual patient data. J Gerontol A Biol Sci Med =ci. 2002;57:559-604.&n=sp; [PubMed <http://www.ncbi.nlm.nih.gov/pubmed/12196498> I

• Wolff I. van Croonenborg J. Kemper =. Kostense P. Twisk J The effect of exercise training programs on bone =ass: a meta-analysis of published controlled trials in pre- and =ostmenopausal women. Osteoporos =nt. 1999;9:1- 12. =oi: 10.1007/s001980050109. [PubMed] [Cross Ref]

* Mille ML. Johnson ME. Martinez KM. Rogers MW Age-dependent differences in lateral balance recovery through protective stepping. Clin Biomech. 2005;20:607–616. doi: 10.1016/j.clinbiomech.2005.03.004. [PubMed] [Cross Ref]

• Roelants M. Delecluse C. =oris M. Verschueren S Effects of 24 weeks of whole body vibration =raining on body composition and muscle strength in untrained =emales. Int J Sports =ed. 2004;25:1-5. =oi: 10.1055/s-2003-45238. [PubMed][Cross =efj

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## Conclusion (cont.)

• Effect of 6-month whole body vibration training on =ip density, muscle strength, and postural control in
postmenopausal =omen: a randomized controlled pilot study.11 Bone Miner =es. 2004]

• Effect of 12 months of whole-body vibration therapy =n bone density and structure in postmenopausal
women: a randomized =rial.(Ann Intern Med. 2011)

	• [Effect of whole body vibration exercise on =steoporotic risk factors].[Dtsch Med Wochenschr. =009]

	• Exercise for health for early postmenopausal women: a =ystematic review of randomised controlled

trials.[Sports Med. 2004]

* Effectiveness and safety of vitamin Din relation to =one health.[Evid Rep Technol Assess (Full =..]

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## Conclusion (cont.)

PubMed

See =ore...

• The feasibility of Whole Body Vibration in =nstitutionalised elderly persons and its influence on muscle =erformance, balance and mobility: a randomised controlled trial =ISRCTN62535013].[BMC Geriatr. 2005]

• The effects of random whole-body-vibration on motor =ymptoms in Parkinson's disease.[NeuroRehabilitation. 2006]

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.(J Bone Miner Res. 2003]

See more...

* Review Vibration exercise makes your muscles and =ones stronger: fact or fiction?[J Br Menopause =oc. 2006]

	• Anabolism. Low mechanical signals strengthen long =ones.[Nature. 2001)

• Effect of 6-month whole body vibration training on =ip density, muscle strength, and postural control in postmenopausal =omen: a randomized controlled pilot study.[J Bone Miner Res. =004)

• Transmissibility of 15-hertz to 35-hertz vibrations =o the human hip and lumbar spine: determining the physiologic =easibility of delivering low-level anabolic mechanical stimuli to =keletal regions at greatest risk of fracture because of =steoporosis.[Spine (Phila Pa 1976). =003]

	• Vibration training: benefits and risks.[) Biomech. 2006]

• Controlled whole body vibration to decrease fall risk =nd improve health-related quality of life of nursing home =esidents.[Arch Phys Med Rehabil. =005]

• High-frequency vibration training increases muscle =ower in postmenopausal women.[Arch Phys Med =ehabil. 2003]

• Review The use of biochemical markers of bone =urnover in osteoporosis. Committee of Scientific Advisors of the =nternational Osteoporosis Foundation.[Osteoporos =nt. 2000]

• Transmissibility of 15-hertz to 35-hertz vibrations =o the human hip and lumbar spine: determining the physiologic =easibility of delivering low-level anabolic mechanical stimuli to =keletal regions at greatest risk of fracture because of =steoporosis.[Spine (Phila Pa 1976). =003]

• Review Good, good, good... good vibrations: the best =ption for better bones?[Lancet. =001] • Review Skeletal structural adaptations to mechanical =sage (SATMU): 1. Redefining Wolff's law: the bone modeling =roblem.[Anat Rec. 1990]

• Anabolism. Low mechanical signals strengthen long =ones.[Nature. 2001] • The anabolic activity of bone tissue, suppressed by =isuse, is normalized by brief exposure to extremely low-magnitude =echanical stimuli.[FASEB J. 2001]

• Reproducibility of bone mineral density measurement =n daily practice.[Ann Rheum Dis. 2004] • Review Physical activity interventions targeting =lder adults. A critical review and recommendations.[Am J Prey Med. =998]

• Effect of exercise on bone mineral density and lean =ass in postmenopausal women.[Med Sci Sports =xerc. 2006]

• Effect of 6-month whole body vibration training on =ip density, muscle strength, and postural control in postmenopausal =omen: a randomized controlled pilot study.[J Bone Miner Res. 2004]

• High-frequency vibration training increases muscle =ower in postmenopausal women.[Arch Phys Med =ehabil. 2003]

## Conclusion (cont.)

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.(1 Bone Miner Res. =003]

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.[J Bone Miner Res. 2003]

• Transmissibility of 15-hertz to 35-hertz vibrations =o the human hip and lumbar spine: determining the physiologic =easibility of delivering low-level anabolic mechanical stimuli to =keletal regions at greatest risk of fracture because of =steoporosis.[Spine (Phila Pa 1976). =003)

• Effect of walking exercise on bone metabolism in =ostmenopausal women with osteopenia/osteoporosis.[J Bone Miner Metab. 2004]

• Exercise and lumbar spine bone mineral density in =ostmenopausal women: a meta-analysis of individual patient =ata.[J Gerontol A Biol Sci Med Sci. =002]

* The effect of exercise training programs on bone =ass: a meta-analysis of published controlled trials in pre- and =ostmenopausal women.[Osteoporos Int. =999]

• The feasibility of Whole Body Vibration in =nstitutionalised elderly persons and its influence on muscle =erformance, balance and mobility: a randomised controlled trial =ISRCTN62535013].[BMC Geriatr. 2005]

- Controlled whole body vibration to decrease fall risk =nd improve health-related quality of life of nursing home =esidents.[Arch Phys Med Rehabil. =005]

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.[J Bone Miner Res. 2003]

• Age-dependent differences in lateral balance recovery =hrough protective stepping.[Clin Biomech =Bristol, Avon). 2005]

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.[J Bone Miner Res. 2003]

• Effect of 6-month whole body vibration training on =ip density, muscle strength, and postural control in postmenopausal =omen: a randomized controlled pilot study.[) Bone Miner Res. 2004]

• Effects of 24 weeks of whole body vibration training =n body composition and muscle strength in untrained females.[Int J Sports Med. =004]

• Effect of 6-month whole body vibration training on =ip density, muscle strength, and postural control in postmenopausal =omen: a randomized controlled pilot study.[) Bone Miner Res. =004]

• Review The use of biochemical markers of bone =urnover in osteoporosis. Committee of Scientific Advisors of the =nternational Osteoporosis Foundation.[Osteoporos =nt. 2000]

• The anabolic activity of bone tissue, suppressed by =isuse, is normalized by brief exposure to extremely low-magnitude =echanical stimuli.[FASEB J. 2001]

• Effect of 8-month vertical whole body vibration on =one, muscle performance, and body balance: a randomized controlled =tudy.[1 Bone Miner Res. =003]

You are here: NCBI <http://www.ncbi.nlm.nih.gov/guide/» Literature > PubMed Central =PMC) Write to the Help Desk External =ink. Please review our privacy policy. NLM NIH DHHS USA.gov Copyright I Disclaimer I Privacy I Browsers I Accessibility I Contact National Center for Biotechnology =nformation, U.S. National Library of =edicine8600 Rockville Pike, Bethesda MD, 20894 USA

## Conclusion (cont.)