Whole Body Vibration Therapy for Osteoporosis
By Marcus M. Reidenberg, MD, FACP
Weill Cornell CERT
Vibration therapy devices are being promoted and sold for treating low bone density and osteoporosis. These devices are platforms that people stand on which vibrate their bodies. Good evidence that this works is lacking. There is good evidence that it does not work and there are side effects.
The background for vibration therapy relates to early space flight. The lack of gravity in space caused the early astronauts to have great trouble walking when they re-entered the earth. This is because their muscles got de-conditioned without gravity forces to keep them strong. They also lost bone mass from lack of gravity forces on the bone. Normally small amounts of bone are destroyed and reformed each day, a process called remodeling of the bone. Mild stresses and strains such as those from normal physical activity on earth stimulate the bone cells to function. Lack of activity, either by bed rest or not having gravity forces on the body leads to loss of bone. Experiments showed that causing the body to shake up and down 25-40 times per second with a force of about 1/3 the force of gravity decreased this bone loss (1).
Studies with reproductive age female sheep found that putting their hind legs on a platform that vibrated vertically 30 times a second with a force of 1/3 of gravity for 20 minutes a day, 5 days a week for a year increased the bone in the hind legs compared to the front legs of these animals or control animals (2). This led to the interest in osteoporosis.
Some studies have been done in young people without osteoporosis but with various conditions leading to less than normal physical activity and finding some increase in bone density after vibration treatment. Studies in postmenopausal women with osteoporosis have usually not found any improvement. Most of the studies are weak in some aspect(s) of the methods employed so the certainty of occasional positive conclusions is open to question. In a recent good study, 202 postmenopausal women were divided into 3 groups. One group was the controls. Another got vibration therapy at 1/3 gravity at 30 vibrations per minute for 20 minutes a day and the third group got it at 90 vibrations per minute. At the end of a year, there was no difference between any of the groups (3).
Adverse effects of this intervention in these trials were such things as dizziness or faintness due to passive standing for 20 minutes. If this causes falling, injuries can result. The studies described were done with low intensity vibration using a force of 1/3 that of gravity. Some vibrating platforms work at a force of over 1 times gravity. These are promoted as exercise equipment. Risks of harm from them are much greater than from those using only 1/3 gravity force (4).
Vibration therapy is being strongly promoted and sold over the Internet for many purposes. There is no F.D.A. oversight or regulation of these devices. What seems clear now is that it is of no value for treating postmenopausal osteoporosis. What is of value for treating this condition is an adequate intake of calcium and vitamin D and certain medicines that have been shown through definitive clinical trials to be effective in reducing fractures in women with osteoporosis.References:
- de Zepetnek JOT, Giangregorio LM, Craven BC. Whole-body vibration as a potential intervention for people with low bone mineral density and osteoporosis: a review. J Rehab Research and Development 2009; 46: 529-542
- Rubin C, Turner AS, Bain S, Mallinkcrodt C, McLeod K. Low mechanical signals strengthen long bones. Nature 2001; 412: 603-4
- Slatkovska L, Alibhai SMH, Beyene J, Hu H, Demaras A, Cheung AM. Effect of 12 months of whole-body vibration therapy on bone density and structure in postmenopausal women. Ann Intern Med 2011; 155: 668-79
- Wysocki A, Butler M, Shamliyan T, Kane R. Whole-body vibration therapy for osteoporosis: state of the science. Ann Intern Med 2011; 155: 680-6
Posted 11/30/2011
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