J Musculoskelet Neuronal Interact 2016; 16(3):193-203
Journal of Musculoskeletal and Neuronal Interactions
Review Article
Effects of whole body vibration exercises on bone mineral density of women with postmenopausal osteoporosis without medications: novel findings and literature review C.F. Dionello1,2, D. Sá-Caputo2,3, H.V.F.S. Pereira2, C.R. Sousa-Gonçalves2, A.I. Maiworm2, D.S. Morel1,2, E. Moreira-Marconi2,3, L.L. Paineiras-Domingos1,2, D. Bemben4, M. Bernardo-Filho2 Programa de Pós-graduação em Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil; 2Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 3Programa de Pós-graduação em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil; 4Department of Health and Exercise Science, Oklahoma University, USA 1
Abstract Objectives: The aim of this study was to review the literature about the effect of whole body vibration exercise in the BMD in patients with postmenopausal osteoporosis without medications. Methods: A systematic review was performed. Results: The frequency of the mechanical vibration used in the protocols has varied from 12 to 90 Hz. The time used in the protocols varied from 2 up to 22 months. Techniques with X-rays were used in nine of the twelve publications analyzed, the Dual energy X-ray absorptiometry (DEXA) in eight studies and the High resolution peripheral quantitative computed tomography (HR-pQCT) in one publication. The concentration of some biomarkers was determined, as the sclerostin, the bone alkaline phosphatase, N-telopeptide X and 25-hydroxyvitamin D. Among the twelve articles analyzed, seven of them have shown an improvement of the BMD of some bone of postmenopausal women exposed to whole body vibration exercises not associated to medications; as well as modifications in biomarkers. Keywords: Postmenopausal Women, Osteoporosis, Bone Mineral Density, Whole Body Vibration Exercise
Introduction Menopause is one of the most important events in the life of a woman that brings several permanent physiological changes with health consequences. Menopause occurs in the climacteric cycle, which is the transition from reproductive to non-reproductive period. Menopause is a clinical condition defined retrospectively. It is the time of the final menstrual period, followed by amenorrhea for 12 months.
The authors have no conflict of interest. Corresponding author: Carla F. Dionello, Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Av. 28 de setembro, 87, fundos, 4º. andar, Vila Isabel, Rio de Janeiro, RJ, 20551-030, Brazil E-mail:
[email protected] Edited by: F. Rauch Accepted 25 March 2016
Postmenopausal (PM) describes the period following the final menstruation1. With the increase in the proportion of elderly populations in the world, and in consequence the number of postmenopausal woman (PMW), sarcopenia (the loss in skeletal muscle mass and muscle strength) and osteoporosis (low bone mass and structural deterioration of bone tissue) are important public health issues2,3. Between the ages of 40 and 80 years, muscle mass decreases by 30% to 50%2, leading to physical frailty, increased risk of falls, impaired mobility, and a possible contribution to several age related chronic disorders (e.g., osteoporosis, type 2 diabetes, insulin resistance, obesity and cardiovascular diseases)4. Dalal and Agarwal, 20155 consider that the major consequences of menopause are related primarily to estrogen deficiency and that is very difficult to distinguish the consequences of this deficiency from those of aging, since aging and menopause are strongly related. It is considered that the estrogen deficiency exacerbates bone demineralization processes resulting in bone abnormal microarchitecture6. Osteoporosis (OP) is a systemic skeletal disease that af193
C.F. Dionello et al.: Novel findings on WBV on postmenopausal OP
fects millions of people around the world7 and it is mostly observed in female population, where a significant increase in incidence is recorded after MP4. The World Health Organization (WHO) describes OP as a disease characterized by low bone mass and structural deterioration of bone tissue, leading to bone fragility and increased susceptibility to fractures of the hip, spine, and wrist4. OP has been defined by the WHO on the basis of BMD assessment, as a BMD that lies 2.5 standard deviations or more below the average value for young healthy women (a T-score of
