Bone Strength & Density

There is strong clinical evidence on the use of Vibration Training (VT) to increase bone strength especially in the elderly. Those that would benefit most from VT are those most at risk of fractures, particularly hip fractures. This group is postmenopausal women. They are at risk of becoming a mortality statistic. Age related reductions in Human Growth Hormone (HGH), testosterone, IGF-1, and oestrogen do not help as these hormones play an important role in the maintenance of bones. (See „Hormones‟ page to see the way VT increases these hormones).

The most serious fracture an older person can have is a hip fracture. In the 1990‟s there were 1.7 million world-

wide (1). The mortality rate in these people is between 12-20% comparing them to people of similar age and gender without fractures (2). This is obviously at great cost to the person their family and friends.

What is the solution? It generally seems that non-impact type training is not the solution as there have been no clinically recorded significant benefits (3). The only form of training that result in bone strength is impact training (4). One researcher showed that 100 minutes of VT was equivalent to 200 drop jumps (a high impact exercise) from 60cm two times a week for 12 months (5). Older people due to the lack of movement in most cases help to solicited bone decalcification. This is a natural process by which the body gets rid of what it doesn‟t need. If the person is not weight bearing sufficiently and intensely enough bone resorption takes place. The result of age and inactivity is weaker bones, muscles, joints and general body structure which leads to a significantly high risk of osteoporosis, falls and fractures.

The loss of bone and muscle strength in space is a known fact. In space a reduction in gravity to zero means that the natural load bearing mechanism by which we maintain our physical structure is taken to a value of zero. The result in healthy astronauts is a sudden decrease of Bone Mineral Density (BMD), muscle mass and strength. The same effect is seen in bedridden patients. VT has been tested on this condition by the European Space Agency. Twenty healthy males were given „strict‟ bed rest for 8 weeks. In that time half were given twice daily six-minute sessions of VT. The VT group limited bone loss up to 1/8 that of the control group (6).

It is clearly clinically documented that VT builds and tones muscles. VT also strengthens joints, tendons and ligaments. These are the essential building blocks of good postural structure and stability. Structure and stability prevent falls, which in turn prevent fractures in the elderly. This is a huge benefit to the elderly trainee: 143% improvement in physical function (12).

VT also supplies the bones with added gravitational force from the acceleration imposed by the oscillation speed. The higher the speed and amplitude the greater this superficial gravitational/weight bearing effect. The muscles, tendons and ligaments are stretched/pulled vigorously during VT and because they are attached to the bones, the bones are thus subjected to this extra strain, which helps strengthen them or at least make them maintain their BMD (Bone Mineral Density) (6). The opposite of VT is a sedentary/inactive lifestyle has the opposite effect: the bone is resorbed/dissolved from the inside. This effect is accelerated with age and post-menopause.

One study on post-menopausal women over six months concluded that with VT there is a slight decrease in bone strength after 3 months followed by a strongly significant increase after 6 months (7, 8). The same group of people at risk of osteoporosis: elderly, postmenopausal, injured etc would suffer from muscle atrophy/wasting and subsequently a reduction in muscle power. VT by muscular contractions and the weight bearing acceleration factor increases muscular power in postmenopausal women (9).

The association between osteoporosis and arterial atherosclerosis (hardening and deposition of cholesterol and plaque in arteries) has been identified. It has been clinically concluded that VT increases mean blood flow velocity directly related to the widening of small vessels in extremities. This leads to better bone perfusion. Accompanied with the VT induced improved lymphatic drainage, the result is improved leg hemodynamics (8).

Peripheral vascular disease is caused by smoking, diabetes, cholesterol that in turn causes osteoporosis (10). Drugs that target cardiovascular disease also have a clinically proven beneficial effect on osteoporosis (11). These drugs improve bone turnover, bone mineral density and bone fracture rates. VT works like these heart drugs that help re-establish blood flow in the arteries in the heart as well as arteries that supply bone perfusion. VT increases circulation, improves lymphatic drainage and provides an efficient way to burn calories and reduce artery blocking cholesterol building up.

Positioning/stance effects the way the VT transmits its vibrations to the all important hip area and to the lower back. These are the areas most at risk of a crippling osteoporosis related fracture. What has been shown to be most efficient at transmitting the vibration is a stiff/flexed stance on a vibration platform on the highest amplitude at frequencies/speeds below 20 Hz: 15-20Hz. This transmits above 100% of the vibration to the hip area.

Frequencies/speeds above 25 Hz transmit approx 80%. This decreases to 60% in a relaxed stance and this is

reduced to about 30% with knee flexion (13). It is therefore advantages to stand erect and stiff at 15 Hz using a high amplitude to maximise VT's osteogenic potential.

REFERENCES

1. COOPER, C., G. CHAMPION, L.J. III. MELTON. Hip fractures in the elderly: A worldwide projection. Osteoporosis Int. 2:285-289. 1992.

2. AUTIER, P., P. HAENTJENS, J. BENTIN, J.M. BAILLOM, A.R. GRIVEGNEE, M.C. CLOSON, S. BOONEN. Costs induced by hip fractures: A prospective controlled study in Belgium. Belgian Hip Study Fracture Group. Osteoporosis Int. 11:373-380. 2000.

3. SUOMINEN, H., Bone mineral density and long term exercise. An overview of cross-sectional athlete studies. Sports Med. 16: 316-330. 1993.

4. HEINONEN, A., P. OJA, P. KANNUS, H. SIEVANEN, I. VUORI. Bone mineral density in athletes of different sports. Bone Miner. 23: 1-14. 1993.

5. BOSCO, C., M. CARDINALE, R. COLLI, J. TIHANYI, S.P. DUVILLARD, A. VIRU. The influence of whole- body vibration on skeletal muscle.

6. BLOTTNER, S., M. SALANOVA, B. PUTTMANN, G. SCHIFFL, D. FELSENBERG, B. BUECHRING, J. RITTWEGER. Human skeletal muscle structure and function preserved by vibration muscle exercise following 55 days of bed rest. Eur. J. Appl. Physiol. 97: 261-271. (2006).

7. HARING, S., M. HARTARD, M. SCHLITTER. Long-term effects of Galileo 2000 - a new training device.

8. VERSCHUEREN, S.M.P., M. ROELANTS, C. DELECLUSE, S. SWINNEN, D. VANDERSCHUEREN, S. BOONEN. Effect of 6-month whole body vibration training on hip density muscle strength, and postural control in postmenopausal women: a randomised controlled pilot study. J. Bone Miner. 19(3): 352-359. (2004)

9. RUSSO, C.R., F. LAURENTANI, S. BANDINELLI, B. BARTALI, C. CAVAZZINI, J.M. GURALNIK, L. FERRUCCI. High frequency vibration training increases muscle power in postmenopausal women. Arch. Phys. Med. Rehabil. 84(12): 1854-1857. 2003.

10. MCFARLANE, S.I., R. MUNIYAPPA, J.J. SHIN, G. BAHTIYAR, J.R. SOWERS. Osteoporosis and cardiovascular disease: brittle bones and boned arteries, is there a link? Endocrine. 23: 1-10. 2004.

11. JORDAN, J., Good vibrations and strong bones? Am. J. Reul. Integr. Comp. Physiol. 288: R555-R556. 2005.

12. MANN, D., Vibration therapy improves walk, balance in elderly, Rheumawire, November 3, 2003.

13. RUBIN, C., M. MALCOLM, C. FRITTON, M. MAGNUSSON, T. HANSSON, K. McLEOD. Transmissibility of 15-Hertz to 35-Hertz vibrations to the human hip and lumbar spine: Determining the physiologic feasibility of delivering low-level anabolic mechanical stimuli to skeletal regions at greatest risk of fracture because of osteoporosis. Spine 28(23): 2621-2627. 2003.