title: Effects of whole-body vibration exercise on bone mineral content and density in thermally injured children.
abstract: BACKGROUND
  Loss of bone mass, muscle mass, and strength leads to significant disability in severely burned children. We assessed the effects of exercise combined with whole-body vibration (WBV) on bone mass, lean mass (LM), and muscle strength in children recovering from burns.
  
  
  METHODS
  Nineteen burned children (≥30% total body surface area [TBSA] burns) were randomly assigned to a 6-week exercise regimen either alone (EX; n=10) or in combination with a 6-week WBV training regimen (EX+WBV; n=9). WBV was performed concurrent to the exercise regimen for 5days/week on a vibrating platform. Dual-energy X-ray absorptiometry quantified bone mineral content (BMC), bone mineral density (BMD), and LM; knee extension strength was assessed using isokinetic dynamometry before and after training. Alpha was set at p<0.05.
  
  
  RESULTS
  Both groups were similar in age, height, weight, TBSA burned, and length of hospitalization. Whole-body LM increased in the EX group (p=0.041) and trended toward an increase in the EX+WBV group (p=0.055). On the other hand, there were decreases in leg BMC for both groups (EX, p=0.011; EX+WBV, p=0.047), and in leg BMD for only the EX group (EX, p<0.001; EX+WBV, p=0.26). Truncal BMC decreased in only the EX group (EX, p=0.009; EX+WBV, p=0.61), while BMD decreased in both groups (EX, p<0.001; EX+WBV group, p<0.001). Leg strength increased over time in the EX group (p<0.001) and the EX+WBV group (p<0.001; between-group p=0.31).
  
  
  CONCLUSIONS
  Exercise in combination with WBV may help attenuate regional bone loss in children recovering from burns. Studies are needed to determine the optimal magnitude, frequency, and duration of the vibration protocol, with attention to minimizing any potential interference with wound healing and graft closure.
authors.affiliation: School of Medicine, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Joel
authors.initials: J
authors.lastname: Edionwe
authors.affiliation: School of Medicine, University of Texas Medical Branch, Galveston, TX, United States.
authors.forename: Cameron
authors.initials: C
authors.lastname: Hess
authors.affiliation: Department of Educational Sciences, University of Oviedo, Oviedo, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Fernandez-Rio
authors.affiliation: Department of Surgery, University of Texas Medical Branch , Galveston, TX, United States; Shriners Hospitals for Children(®)-Galveston , Galveston, TX, United States.
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
authors.affiliation: Department of Surgery, University of Texas Medical Branch , Galveston, TX, United States; Shriners Hospitals for Children(®)-Galveston , Galveston, TX, United States.
authors.forename: Clark R
authors.initials: CR
authors.lastname: Andersen
authors.affiliation: Shriners Hospitals for Children(®)-Galveston , Galveston, TX, United States.
authors.forename: Gordon L
authors.initials: GL
authors.lastname: Klein
authors.affiliation: Department of Surgery, University of Texas Medical Branch , Galveston, TX, United States; Shriners Hospitals for Children(®)-Galveston , Galveston, TX, United States. Electronic address: oesuman@utmb.edu.
authors.forename: Oscar E
authors.initials: OE
authors.lastname: Suman
authors.affiliation: Department of Clinical Health and Applied Sciences, University of Houston-Clear Lake, Houston, TX, United States.
authors.forename: William E
authors.initials: WE
authors.lastname: Amonette
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001830:Body Surface Area; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000517:prevention & control*; D002056:Burns / Q000534:rehabilitation*; D002648:Child; D003131:Combined Modality Therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength; D026741:Physical Therapy Modalities; D014732:Vibration / Q000627:therapeutic use*
keywords: Bone; Bone content; Bone density; Exercise; Whole-body vibration