Effect of Low Intensity Vibration on Bone Strength, Microstructure, and Adiposity in Pre-Osteoporotic Postmenopausal Women: A Randomized Placebo-Controlled Trial

Author: Chamith S Rajapakse1,2, Alyssa J Johncola1, Alexandra S Batzdorf1, Brandon C Jones1, Mona Al Mukaddam2,3, Kelly Sexton1, Justine Shults4, Mary B Leonard5,6, Peter J Snyder3, Felix W Wehrli1
1 Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
2 Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
3 Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
4 Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, Pennsylvania.
5 Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, Pennsylvania.
6 Current Affiliation: Department of Pediatrics, Stanford University School of Medicine, Stanford, California.
Conference/Journal: J Bone Miner Res
Date published: 2020 Dec 13
Other: Special Notes: doi: 10.1002/jbmr.4229. , Word Count: 305

There has been evidence that cyclical mechanical stimulation may be osteogenic, thus providing opportunities for non-pharmacological treatment of degenerative bone disease. Here, we applied this technology to a cohort of postmenopausal women with varying bone mineral density (BMD) T-scores at the total hip (-0.524 ± 0.843) and spine (-0.795 ± 1.03) to examine the response to intervention after one year of daily treatment with ten minutes of vibration therapy in a randomized double-blinded trial. The device operates either in an active mode (30 Hz and 0.3 g) or placebo. Primary endpoints were changes in bone stiffness at the distal tibia and marrow adiposity of the vertebrae, based on 3 Tesla high-resolution MRI and spectroscopic imaging, respectively. Secondary outcome variables included distal tibial trabecular microstructural parameters and vertebral deformity determined by MRI, volumetric and areal bone densities derived using peripheral quantitative computed tomography (pQCT) of the tibia, and dual-energy X-ray absorptiometry (DXA)-based BMD of the hip and spine. Device adherence was 83% in the active group (n = 42) and 86% in the placebo group (n = 38), and did not differ between groups (p = 0.7). The mean 12-month changes in tibial stiffness in the treatment group and placebo group were + 1.31 ± 6.05 and - 2.55 ± 3.90%, respectively (group difference 3.86%, p = 0.0096). In the active group, marrow fat fraction significantly decreased after 12 months of intervention (p = 0.0003), while no significant change was observed in the placebo group (p = 0.7; group difference - 1.59%, p = 0.029). Mean differences of the changes in trabecular bone volume fraction (p = 0.048) and erosion index (p = 0.044) were also significant, as was pQCT-derived trabecular volumetric BMD (vBMD; p = 0.016) at the tibia. The data are commensurate with the hypothesis that vibration therapy is protective against loss in mechanical strength, and further, that the intervention minimizes the shift from the osteoblastic to the adipocytic lineage of mesenchymal stem cells. This article is protected by copyright. All rights reserved.

Keywords: Bone; MRI; Osteoporosis; Vibration Therapy.

PMID: 33314313 DOI: 10.1002/jbmr.4229