title: Low-Magnitude Mechanical Stimulation to Improve Bone Density in Persons of Advanced Age: A Randomized, Placebo-Controlled Trial.
abstract: Nonpharmacologic approaches to preserve or increase bone mineral density (BMD) include whole-body vibration (WBV), but its efficacy in elderly persons is not clear. Therefore, we conducted the Vibration to Improve Bone in Elderly Subjects (VIBES) trial, a randomized, placebo-controlled trial of 10 minutes of daily WBV (0.3g at 37 Hz) in seniors recruited from 16 independent living communities. The primary outcomes were volumetric BMD of the hip and spine measured by quantitative computed tomography (QCT) and biochemical markers of bone turnover. We randomized 174 men and women (89 active, 85 placebo) with T-scores -1 to -2.5 who were not taking bone active drugs and had no diseases affecting the skeleton (mean age 82 ± 7 years, range 65 to 102). Participants received daily calcium (1000 mg) and vitamin D (800 IU). Study platforms were activated using radio frequency ID cards providing electronic adherence monitoring; placebo platforms resembled the active platforms. In total, 61% of participants in the active arm and 73% in the placebo arm completed 24 months. The primary outcomes, median percent changes (interquartile range [IQR]) in total volumetric femoral trabecular BMD (active group (2.2% [-0.8%, 5.2%]) versus placebo 0.4% [-4.8%, 5.0%]) and in mid-vertebral trabecular BMD of L1 and L2 (active group (5.3% [-6.9%, 13.3%]) versus placebo (2.4% [-4.4%, 11.1%]), did not differ between groups (all p values > 0.1). Changes in biochemical markers of bone turnover (P1NP and sCTX) also were not different between groups (p = 0.19 and p = 0.97, respectively). In conclusion, this placebo-controlled randomized trial of daily WBV in older adults did not demonstrate evidence of significant beneficial effects on volumetric BMD or bone biomarkers; however, the high variability in vBMD changes limited our power to detect small treatment effects. The beneficial effects of WBV observed in previous studies of younger women may not occur to the same extent in elderly individuals.
authors.affiliation: Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Kiel
authors.affiliation: Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.|Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.|Harvard Medical School, Boston, MA, USA.
authors.forename: Marian T
authors.initials: MT
authors.lastname: Hannan
authors.affiliation: Division of Biostatistics, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Barton
authors.affiliation: Harvard Medical School, Boston, MA, USA.|Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.
authors.forename: Mary L
authors.initials: ML
authors.lastname: Bouxsein
authors.affiliation: Boston University School of Public Health, Data Coordinating Center, Boston, MA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Sisson
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Fransisco, San Francisco, CA, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Lang
authors.affiliation: Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, and Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA.
authors.forename: Brett
authors.initials: B
authors.lastname: Allaire
authors.affiliation: Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
authors.forename: Dawn
authors.initials: D
authors.lastname: Dewkett
authors.affiliation: Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA.
authors.forename: Danette
authors.initials: D
authors.lastname: Carroll
authors.affiliation: Division of Gerontology, Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Baltimore, MD, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Magaziner
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shane
authors.affiliation: Pacific Biomarkers, Seattle, WA, USA.|ETL Consulting, Seattle, WA, USA.
authors.forename: Elizabeth Teng
authors.initials: ET
authors.lastname: Leary
authors.affiliation: Program on Aging, Disability, and Long-Term Care, Cecil G Sheps Center for Health Services Research and School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Sheryl
authors.initials: S
authors.lastname: Zimmerman
authors.affiliation: Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
authors.forename: Clinton T
authors.initials: CT
authors.lastname: Rubin
mesh_terms: D000368:Aged; D015519:Bone Density; D024042:Collagen Type I / Q000097:blood; D005260:Female; D005269:Femur / Q000502:physiology; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D010919:Placebos; D011347:Procollagen / Q000097:blood; D013131:Spine / Q000502:physiology; D014732:Vibration
chemical_list: D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D010919:Placebos; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide
keywords: BONE MINERAL DENSITY; BONE TURNOVER; ELDERLY; RANDOMIZED CONTROLLED TRIAL; WHOLE-BODY VIBRATION