title: High-frequency, low-intensity vibrations increase bone mass and muscle strength in upper limbs, improving autonomy in disabled children.
abstract: Disuse osteoporosis in children is a progressive disease that can affect quality of life. High-frequency, low-magnitude vibration (HFLMV) acts as an anabolic signal for bone and muscle. We undertook a prospective, randomized, double-blind, placebo-controlled clinical trial to assess the efficacy and safety of regional HFLMV in disabled children. Sixty-five children 6 to 9 year of age were randomized into three groups: placebo, 60 Hz, and 90 Hz. In the two active groups, a 0.3-g mechanical vibration was delivered to the radii and femurs for 5 minutes each day. After 6 months, the main endpoint was bone mineral density (BMD) at the ultradistal radius (UDR), 33% radii (33%R), and femoral necks (FN). Secondary endpoints were area and bone mineral content (BMC) at the UDR, 33%R, and FN; grip force of the upper and lower limbs; motor function; and PedsQL evaluation. An intention-to-treat analysis was used. Fifty-seven children (88%) completed the protocol. A significant increase was observed in the 60-Hz group relative to the other groups in BMD at the UDR (p = .011), in grip force of the upper limbs (p = .035), and in the "daily activities item" (p = .035). A mixed model to evaluate the response to intervention showed a stronger effect of 60 Hz on patients with cerebral palsy on the UDR and that between-subject variability significantly affected the response. There were no reported side effects of the intervention. This work provides evidence that regional HFLMV is an effective and safe strategy to improve bone mass, muscle strength, and possibly independence in children with motor disabilities.
authors.affiliation: Endocrine Unit, Pediatrics Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile. mlreyes@med.puc.cl
authors.forename: M Loreto
authors.initials: ML
authors.lastname: Reyes
authors.forename: Marta
authors.initials: M
authors.lastname: Hernández
authors.forename: Luz J
authors.initials: LJ
authors.lastname: Holmgren
authors.forename: Enrique
authors.initials: E
authors.lastname: Sanhueza
authors.forename: Raúl G
authors.initials: RG
authors.lastname: Escobar
mesh_terms: D015519:Bone Density / Q000502:physiology; D001842:Bone and Bones / Q000473:pathology* / Q000503:physiopathology*; D002648:Child; D019988:Children with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D053580:Muscle Strength / Q000502:physiology*; D009929:Organ Size; D010349:Patient Compliance; D011788:Quality of Life; D016896:Treatment Outcome; D034941:Upper Extremity / Q000473:pathology* / Q000503:physiopathology*; D014732:Vibration / Q000009:adverse effects / Q000627:therapeutic use*