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REVIEW ARTICLE
Year : 2020  |  Volume : 8  |  Issue : 1  |  Page : 52-58

Does whole-body vibration and exercise training improve bone mineral density in postmenopausal women? A mini review


Department of Biomedicine and Prevention, Faculty of Medicine and Surgery, University of Roma Tor Vergata, Roma, Italy

Date of Submission13-Dec-2019
Date of Decision09-May-2020
Date of Acceptance13-May-2020
Date of Web Publication31-Jul-2020

Correspondence Address:
Dr. Chidiebere Emmanuel Okechukwu
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njecp.njecp_36_19

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  Abstract 


Whole-body vibration (WBV) training has been projected as a feasible tactic for the prevention and treatment of osteoporosis, and possible therapy for improving bone mass and strength in postmenopausal women. Moreover, regular exercise training could improve bone mineral density (BMD) and bone formation in postmenopausal women. The aim of this review was to evaluate the effectiveness of WBV and exercise training in improving BMD in postmenopausal women, based on the findings from systematic reviews and meta-analyses. Relevant systematic reviews and meta-analyses that reported on the effects of WBV and exercise training on BMD in postmenopausal women from 1998 to 2019 were evaluated. PubMed database was utilized. The MeSH system was used to extract the relevant research studies from PubMed. Based on the findings from the systematic reviews and meta-analyses, WBV training and supervised exercise regimen consisting of aerobic and resistance training improved BMD among postmenopausal women, respectively.

Keywords: Bone loss, bone mineral density, exercise, menopause, whole-body vibration


How to cite this article:
Okechukwu CE. Does whole-body vibration and exercise training improve bone mineral density in postmenopausal women? A mini review. Niger J Exp Clin Biosci 2020;8:52-8

How to cite this URL:
Okechukwu CE. Does whole-body vibration and exercise training improve bone mineral density in postmenopausal women? A mini review. Niger J Exp Clin Biosci [serial online] 2020 [cited 2020 Nov 28];8:52-8. Available from: https://www.njecbonline.org/text.asp?2020/8/1/52/291200




  Introduction Top


Whole-body vibration (WBV) training has been projected as a feasible tactic for the prevention and treatment of osteoporosis, and possible therapy for improving bone mass and strength in postmenopausal women. Moreover, regular exercise training could improve bone mineral density (BMD) and bone formation in postmenopausal women. A combination of physical activity and WBV might yield more positive results in the improvement of bone health in older women. WBV was effective in improving lumbar spine BMD in women; WBV also improved femoral neck BMD in postmenopausal women younger than 65 years.[1] WBV training could be a potential therapy in the treatment of osteoporosis because it improves BMD of the lumbar spine.[2]

According to the results of the meta-analysis conducted by Simas et al.,[3] they found a significant difference between water-based exercise (WBE) group and the control group, there were improvements in BMD in the lumbar spine among subjects in the WBE group. An exercise program which involved the combination of different exercises significantly increased lumbar spine, femoral neck, total hip, and total body BMD; however, combined exercise training regimen had a more positive effect on femoral neck BMD in women who are 60 and below, and lumbar spine BMD was more improved in women 60 years and above, this showed that combined exercise training was effective in improving the BMD in postmenopausal women at the lumbar spine, femoral neck, total hip, and total body.[4] Physical activity achieved by walking enhanced-body composition in premenopausal and postmenopausal women.[5] Exercise might lessen bone loss by preserving cortical and trabecular BMD in postmenopausal women.[6] Combined exercise training achieved by integrating jogging with other low-intensity physical activities and resistance exercises was a potential therapy for reducing bone loss at the hip and spine in postmenopausal women.[7]

The aim of this review was to evaluate the effectiveness of WBV and exercise training in improving BMD in postmenopausal women, based on the findings from systematic reviews and meta-analyses, which showed that WBV and exercise training could be a potential adjunct therapy in improving BMD and minimizing bone loss among postmenopausal women.


  Materials and Methods Top


Relevant systematic reviews and meta-analyses that reported on the effects of WBV and exercise training on BMD among postmenopausal women from 1998 to 2019 were evaluated. PubMed database was utilized. The MeSH system was used to extract the relevant research studies from PubMed using the following keywords; WBV, exercise, BMD, bone loss, menopause, osteoporosis, systematic review, and meta-analysis.


  Results Top


Exercise training programs were effective in improving bone mass at the lumbar spine and femoral neck in postmenopausal women, impact exercise programs seems to have a positive effect at the femoral neck in postmenopausal women, and exercise prevented bone loss in premenopausal women; however, both impact and nonimpact exercise training improved the lumbar spine in pre and postmenopausal women.[8]

Slatkovska et al. found significant improvement in BMD among postmenopausal women after participating in WBV training.[9] Resistance exercise was effective in improving forearm bone mass.[10] WBV prevents fall rate among older people, thereby minimizing fractures, but its physiological mechanisms, with respect to the improvement in BMD have not been proven.[11] High-impact exercise and WBV training significantly improved the lumbar and femoral neck BMD.[12] WBV at the low magnitude was enough to reduce bone loss in the lumbar spine in postmenopausal women.[13] WBV prevented the decrease in bone density among postmenopausal women, this shows that WBV can be used to support the treatment and prevention of osteoporosis among postmenopausal women.[14]

Resistance exercise training significantly increased femoral neck BMD and lumbar spine BMD in postmenopausal women; moreover, combined resistance training programs significantly improved both the hip BMD and spine BMD.[15] A well-planned resistance training regimen is very effective in increasing muscle strength and functional capacity in older people, whereas WBV is advantageous for increasing neuromuscular and physical performance.[16]

Combined exercise program should be planned in such a way that it will be effective in improving BMD of the femoral neck, hip, and spines; moreover, strengthening of muscles of the legs and back is necessary for preventing falls in older women.[17] WBV is an adjunct therapy that can be used to prevent osteoporosis in postmenopausal women.[18] WBV training is a prospective tool for the prevention of bone fractures and falls in older women.[19]

Aerobic exercise is a potential intervention for improving bone density at the hip in postmenopausal women.[20] However, resistance training had significant effects on BMD at the lumbar spine of all women and at the femur and radius positions for postmenopausal women.[21] Exercise generally might be effective in reducing the rate of bone loss in postmenopausal women.[22] Aerobic exercise was effective in maintaining lumbar spine BMD in postmenopausal women.[23] Exercise does not only prevent BMD loss; it also prevents functional limitations which is usually affected due to BMD loss in postmenopausal women.[24] The effectiveness of exercise training in improving bone strength in osteoporotic conditions is yet to be ascertained.[25]

Wolff et al.[26] found that exercise training prevented and reversed 1% of bone loss in lumbar spine and femoral spine per year from 1966 to 1996, in both pre- and post-menopausal women. Walking which is a form of physical activity improved the BMD in the femoral neck, in postmenopausal women, this shows the importance of regular physical activity among postmenopausal women.[27]

WBV according to Merriman and Jackson[28] improved BMD in the hip and tibia, but not in the lumbar spine, while it is certain that exercise improves BMD at the lumbar spine. However, combining aerobic exercise, resistant exercise, and WBV training as a single regimen could be an effective therapy in improving bone health in postmenopausal women. Moreover, weight-bearing exercises could help to prevent the loss of BMD in postmenopausal women and to increase BMD at the spine and hip in women with osteoporosis.[29] Combined exercise training could improve bone mass, bone quality, and bone microarchitecture in postmenopausal women, thus minimizing the musculoskeletal changes associated with aging.[30],[31],[32],[33]

Exercise regimen for the improvement of bone-mineral density in postmenopausal women

Zhao et al. conducted a systematic review of studies carried out up to January 2016. They found 11 randomized controlled trials that included 1061 women, with an average age of 55 years. Women were postmenopausal, did not exercise regularly (<2 h/week), and did not have chronic disease or use drugs that could affect bone density. Combined exercise regimen which includes resistance training/body strengthening exercises and aerobic exercises such as walking, jogging and dancing, balance exercises and stretching which were supervised or partially supervised by a medical expert and mostly performed in outdoor centres, combined exercises were mostly carried out for 3–4 days/week (range 2–6 days/week) for 12 months or more (range 8–30 months) at moderate intensity to improve BMD among postmenopausal women [Figure 1].[4] However, it is important to personalize exercise training based on individual's functional capacity and clinical status. According to Daly et al., a well-planned and supervised multimodal programs that incorporate short bouts of diverse weight-bearing impact loading activities, progressive resistance exercises targeting muscles attached to or crossing the hip and spine, balance and mobility activities are effective in improving BMD in postmenopausal women [Table 1].[34]
Figure 1: Role of exercise training in the improvement of bone quality in postmenopausal women

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Table 1: Exercise regimen for the improvement of bone mineral density in post-menopausal women, adapted from Daly et al., 2019

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Whole-body vibration regimen for the improvement of bone mineral density in postmenopausal women

Fratini et al.[14] conducted a meta-analysis in which nine studies satisfied the inclusion criteria, comprising 527 postmenopausal women and diverse vibration delivery designs. Cumulative dose, amplitudes, and frequency of treatments as well as subject posture during the treatment vary generally among studies; some of the studies included an allied exercise training regime. Both randomized and controlled clinical trials were included; the dose of WBV used in the improvement of BMD among postmenopausal women is illustrated in [Table 2]. WBV could possibly stimulate the osteocytes leading to bone mineralization [Figure 2] and [Figure 3].
Table 2: Whole body vibration dose for the improvement of bone mineral density in postmenopausal women

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Figure 2: Possible mechanism involved in the improvement of bone-mineral density through whole-body vibration training

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Figure 3: Role of whole-body vibration training in improving bone health and neuromuscular performance among postmenopausal women

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  Summary Top


According to Howe et al.,[35] the most effective intervention for improving BMD at the spine was combined exercise intervention. However, aerobic, weight-bearing exercise program and combined aerobic and weight-bearing exercise interventions were all effective in improving BMD.[36] Moreover, a combination of WBV, and low-to-moderate intensity physical activity could be more effective in the improvement of bone health and leg muscle strength among postmenopausal women.[37],[38] An exercise regimen consisting of resistance, aerobic, and flexibility exercises have been proven to be the best form of exercise training that should be recommended for individuals with osteoporosis and for the improvement of BMD in postmenopausal women.[39] Exercise can also be recommended for the prevention of falls in older women,[40] most especially Tai chi, because of its role in improving BMD.[41],[42],[43] WBV could be recommended alongside a combined exercise training for the improvement of balance and mobility in older women.[44],[45]


  Conclusion Top


Based on the overall findings from the systematic reviews and meta-analyses, a supervised WBV training and exercise regimen consisting of aerobic and resistance training improved BMD among postmenopausal women, respectively. However, further studies are needed to investigate the long-term effects of combined WBV and exercise training on BMD in postmenopausal women.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]



 

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