Slatkovska L, Alibhai S M H, Beyene J, Cheung A M
Osteoporosis Program, University Health Network/Mount Sinai Hospital, Toronto, ON, Canada.
Osteoporos Int. 2010 Dec;21(12):1969-80. doi: 10.1007/s00198-010-1228-z. Epub 2010 Apr 21.
Our systematic review and meta-analysis of randomized controlled trials (RCTs) examining whole-body vibration (WBV) effect on bone mineral density (BMD) found significant but small improvements in hip areal BMD (aBMD) in postmenopausal women and in tibia and spine volumetric BMD in children/adolescents, but not in other BMD measurements in postmenopausal women and young adults.
Animal experiments report anabolic bone changes in response to WBV, but data in humans are limited. Our objective is to conduct a systematic review and meta-analysis of RCTs examining WBV effect on BMD.
Eligible RCTs included randomized or quasi-randomized trials, with follow-up of ≥ 6 months, examining WBV effects on BMD in ambulatory individuals without secondary causes of osteoporosis. The weighted mean differences between WBV and control groups in absolute pre-post change in spine and hip aBMD, and in spine and tibia trabecular volumetric BMD (vBMD) were calculated.
eight RCTs in postmenopausal women (five RCTs), young adults (one RCT), and children and adolescents (two RCTs) were included. The regimens were heterogeneous, study durations were relatively short, and available data was mostly per-protocol. In postmenopausal women, WBV was found to significantly increase hip aBMD (0.015 g cm(-2); 95% confidence interval (CI), 0.008-0.022; n = 131) versus controls, but not spine aBMD (n = 181) or tibia trabecular vBMD (n = 29). In young adults, WBV did not increase spine or hip bone mineral content, or tibia trabecular vBMD (n = 53). In children and adolescents, WBV significantly increased spine (6.2 mg cm(-3); 95% CI, 2.5-10.0; n = 65) and tibia (14.2 mg cm(-3); 95% CI, 5.2-23.2; n = 17) trabecular vBMD.
We found significant but small improvements in BMD in postmenopausal women and children and adolescents, but not in young adults. WBV is a promising new modality, but before recommendations can be made for clinical practice, large-scale long-term studies are needed to determine optimal magnitude, frequency, and duration.
我们对研究全身振动(WBV)对骨密度(BMD)影响的随机对照试验(RCT)进行的系统评价和荟萃分析发现,绝经后女性的髋部面积骨密度(aBMD)以及儿童/青少年的胫骨和脊柱体积骨密度有显著但较小的改善,但绝经后女性和年轻人的其他骨密度测量指标未见改善。
动物实验报告了全身振动后骨骼的合成代谢变化,但人体数据有限。我们的目的是对研究全身振动对骨密度影响的随机对照试验进行系统评价和荟萃分析。
符合条件的随机对照试验包括随机或准随机试验,随访时间≥6个月,研究全身振动对无继发性骨质疏松原因的非卧床个体骨密度的影响。计算全身振动组与对照组在脊柱和髋部面积骨密度以及脊柱和胫骨小梁体积骨密度(vBMD)绝对前后变化方面的加权平均差异。
纳入了八项针对绝经后女性(五项随机对照试验)、年轻人(一项随机对照试验)以及儿童和青少年(两项随机对照试验)的随机对照试验。治疗方案各异,研究持续时间相对较短,现有数据大多为符合方案数据。在绝经后女性中,与对照组相比,发现全身振动显著增加髋部面积骨密度(0.015 g/cm²;95%置信区间(CI),0.008 - 0.022;n = 131),但未增加脊柱面积骨密度(n = 181)或胫骨小梁体积骨密度(n = 29)。在年轻人中,全身振动未增加脊柱或髋部骨矿物质含量,也未增加胫骨小梁体积骨密度(n = 53)。在儿童和青少年中,全身振动显著增加脊柱(6.2 mg/cm³;95% CI,2.5 - 10.0;n = 65)和胫骨(14.2 mg/cm³;95% CI,5.2 - 23.2;n = 17)的小梁体积骨密度。
我们发现绝经后女性以及儿童和青少年的骨密度有显著但较小的改善,而年轻人未见改善。全身振动是一种有前景的新方法,但在能够为临床实践提出建议之前,需要进行大规模长期研究以确定最佳强度、频率和持续时间。