Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis.

Author: Jepsen DB1,2, Thomsen K2,3, Hansen S2,4, Jørgensen NR5,6, Masud T1,2,7, Ryg J1,2
1Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
2Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.
3Department of Geriatric Medicine, Odense University Hospital, Svendborg, Denmark.
4Department of Endocrinology, Odense University Hospital, Odense, Denmark.
5Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark.
6OPEN-Odense Patient data Explorative Network, Odense University Hospital/ University of Southern Denmark, Odense, Denmark.
7Department of Geriatric Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Conference/Journal: BMJ Open.
Date published: 2017 Dec 29
Other: Volume ID: 7 , Issue ID: 12 , Pages: e018342 , Special Notes: doi: 10.1136/bmjopen-2017-018342. , Word Count: 326

OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age.

DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2 statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions.

DATA SOURCES: The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA).

RESULTS: 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA.

CONCLUSIONS: WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls.


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KEYWORDS: accidental falls; exercise; fractures; meta-analysis; wbv; whole-body vibration

PMID: 29289937 DOI: 10.1136/bmjopen-2017-018342