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From: Karyna Shuliak Sent: Tuesday, December 29, 2015 4:43 AM To: Jeffrey Subject: Low-frequency vibratory exercise reduces the risk of bone fracture more than walking: a randomized controlled trial http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1693558/ • NCBI <http://www.ncbi.nlm.nih.gov/> • Skip to main content • Skip to navigation • Resources • How To • About NCBI =ccesskeys Sign =n to NCBI PMC US National Library of =edicine <http://www.nlm.nih.gov/> National Institutes of =ealth chttp://www.nih.govi> Search databasePMCAll DatabasesAssemblyBioProjectBioSampleBioSystemsBooksClinVarCloneConserved DomainsdbGaPdbVarEpigenomicsESTGeneGenomeGEO DataSetsGEO =rofilesGSSGTRHomoloGeneMedGenMeSHNCBI Web SiteNLM =atalogNucleotideOMIMPMCPopSetProbeProteinProtein ClustersPubChem =ioAssayPubChem CompoundPubChem =ubstancePubMedPubMed HealthSNPSRAStructureTaxonomyToolKitToolKitAllToolKitBookUniGene Search =erm Search Limits <http://www.ncbi.nlm.nih.gov/pmc/limits/> Advanced Journal list Help Journal List 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> EFTA_R1_01261995 EFTA02330378 Low-frequency =ibratory exercise reduces the risk of bone fracture more than walking: = randomized controlled trial 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 2 EFTA_R1_01261996 EFTA02330379 =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 3 EFTA_R1_01261997 EFTA02330380 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 1 day 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. 4 EFTA_R1_01261998 EFTA02330381 Go to: Results No difference in the =ompliance of programmes was detected, and 78% of participants completed =he exercise programmes. In the WBV group, the mean frequency of =ttendance was 2.7 (SD 0.7) times per week, and no vibration- related =ide-effect or any adverse reaction was observed. In the Walking group, =he mean attendance was 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.). 5 EFTA_R1_01261999 EFTA02330382 Comparison with the =iterature 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 strain in the vertical axis than in the lateral axis using =ifferent devices based on platforms oscillating the plate up-and- down. =n contrast, the current study had higher lateral than vertical =cceleration by using a reciprocating 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 6 EFTA_R1_01262000 EFTA02330383 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/PMC1693558/1O Competing =nterests The =uthor(s) declare that they have no competing interests. Go to: Authors' =ontributions 7 EFTA_R1_01262001 EFTA02330384 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: chttp://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/#> References * Roudsari BS, Ebel BE, Corso PS, Molinari NA, Koepsell =D. The acute medical care costs of fall-related injuries among the U.S. =lder adults. Injury. 2005;36:1316-1322. doi: =0.1016/j.injury.2005.05.024. 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[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 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] 9 EFTA_R1_01262003 EFTA02330386 • 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. =artinez KM. Rogers MW Age-dependent differences in lateral balance =ecovery through protective stepping. Clin Biomech. 2005;20:607-616. doi: =0.1016/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 Articles from BMC Musculoskeletal =isorders are provided here courtesy of BioMed Central Formats: Article PubReader ePub =beta) PDF =266K) Citation Share • Facebook * Twitter * Google+ Save =tems Add to FavoritesView more =ptions Similar articles in PubMed 10 EFTA_R1_01262004 EFTA02330387 • 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 =..] See reviews...See =11... Cited by =ther articles in PMC • Effects of Whole-Body Vibration Therapy in Patients with =ibromyalgia: A Systematic Literature Review[Evidence-based Complementary a...] • Changes in Bone Biomarkers, BMC, and Insulin Resistance =ollowing a 10-Week Whole Body Vibration Exercise Program in Overweight =atino BoyslInternational Journal of Medic...] • Whole-body vibration exercise in postmenopausal =steoporosis[Przeglad Menopauzalny = =enop...] • Vibration stimuli and the differentiation of musculoskeletal =rogenitor cells: Review of results in vitro and in vivo[World Journal of Stem Cells. 2...] • Effects of Whole Body Vibration and Resistance Training on Bone =ineral Density and Anthropometry in Obese Postmenopausal Women[Journal of Osteoporosis. 2014] See all... Links • Cited in =ooks • Compound • PubMed • Recent Activity ClearTurn Off Low-frequency vibratory exercise reduces the risk of bone =racture more than wal... Low-frequency vibratory exercise reduces the =isk of bone fracture more than walking: a randomized controlled =rial BMC Musculoskeletal Disorders. 2006; =()92 High-frequency, low-intensity vibrations increase bone mass and =uscle strength ... High-frequency, low-intensity vibrations =ncrease bone mass and muscle strength in upper limbs, improving =utonomy in disabled children. J Bone Miner Res. 2011 =ug ;26(8):1759-66. doi: 10.1002/jbmr.402. PubMed The use of anaferon (pediatric formulation) for prophylaxis of =cute respiratory... The use of anaferon (pediatric formulation) =or prophylaxis of acute respiratory viral infections in preschool =hildren. Bull Exp Biol Med. 2009 Aug =148(2):266-9. 11 EFTA_R1_01262005 EFTA02330388 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] 12 EFTA_R1_01262006 EFTA02330389 • 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 13 EFTA_R1_01262007 EFTA02330390 = 14 EFTA_R1_01262008 EFTA02330391

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AI-generated factual descriptions of embedded images (llava:13b). These are searchable across the corpus.

[Image 1] The image is a photograph of a printed document, specifically a page from a scientific or medical journal. The text is dense and includes references to various studies, articles, and authors. The document appears to be a compilation of research findings or a review of literature related to a specific topic, possibly within the field of medicine or health sciences. The visible text includes names o [Image 2] The image appears to be a photograph of a document, specifically a page from a research paper or article. The text is dense and includes references to scientific studies and research findings. The document is written in English and contains paragraphs with headings such as "Introduction," "Methods," "Results," and "Discussion." There are also sections titled "Background," "Hypothesis," "Methods," [Image 3] The image shows a document with text, which appears to be a scientific or medical paper. The document is titled "Comparison with the literature" and includes a subtitle "Effect of a moderate-intensity aerobic exercise program on the bone health of postmenopausal women with osteopenia." The text discusses the results of a study related to the effects of exercise on bone health in postmenopausal wom [Image 4] The image shows a page from a document, which appears to be a research paper or a report. The text is dense and includes various sections such as "Introduction," "Methods," "Results," and "Discussion." There are also tables and figures with numerical data. The document is structured with headings and subheadings, and it includes references at the end. The text is in English, and the font is standa [Image 5] The image is a photograph of a document with text. The document appears to be a research paper or report, as indicated by the title "Research Paper" at the top. The text is in English and discusses topics related to training, performance, and statistical analysis. There are sections titled "Introduction," "Methods," "Results," "Discussion," and "Conclusion." The document includes references to sta [Image 6] The image shows a document with text, which appears to be a scientific or medical paper. The text is dense and discusses topics related to exercise, weight loss, and health. There are no visible names, dates, places, or logos that can be discerned from the image. The document is not a photograph but a scanned page of text.