TY - JOUR

T1 - Effect of whole-body vibration exercise in preventing falls and fractures

T2 - a systematic review and meta-analysis

AU - Jepsen, Ditte Beck

AU - Thomsen, Katja

AU - Hansen, Stinus

AU - Jørgensen, Niklas Rye

AU - Masud, Tahir

AU - Ryg, Jesper

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017

Y1 - 2017

N2 - OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age.DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions.DATA SOURCES: The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA).RESULTS: 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA.CONCLUSIONS: WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls.PROSPERO REGISTRATION NUMBER: CRD42016036320; Pre-results.

AB - OBJECTIVE: To investigate the effect of whole-body vibration exercise (WBV) on fracture risk in adults ≥50 years of age.DESIGN: A systematic review and meta-analysis calculating relative risk ratios, fall rate ratio and absolute weighted mean difference using random effects models. Heterogeneity was estimated using I2statistics, and the Cochrane Collaboration's risk of bias tool and the GRADE approach were used to evaluate quality of evidence and summarise conclusions.DATA SOURCES: The databases PubMed, Embase and the Cochrane Central Register from inception to April 2016 and reference lists of retrieved publications.ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials examining the effect of WBV on fracture risk in adults ≥50 years of age. The primary outcomes were fractures, fall rates and the proportion of participants who fell. Secondary outcomes were bone mineral density (BMD), bone microarchitecture, bone turnover markers and calcaneal broadband attenuation (BUA).RESULTS: 15 papers (14 trials) met the inclusion criteria. Only one study had fracture data reporting a non-significant fracture reduction (risk ratio (RR)=0.47, 95% CI 0.14 to 1.57, P=0.22) (moderate quality of evidence). Four studies (n=746) showed that WBV reduced the rate of falls with a rate ratio of 0.67 (95% CI 0.50 to 0.89, P=0.0006; I2=19%) (moderate quality of evidence). Furthermore, data from three studies (n=805) found a trend towards falls reduction (RR=0.76, 95% CI 0.48 to 1.20, P=0.24; I2=24%) (low quality of evidence). Finally, moderate to low quality of evidence showed no overall effect on BMD and only sparse data were available regarding microarchitecture parameters, bone turnover markers and BUA.CONCLUSIONS: WBV reduces fall rate but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies. This meta-analysis suggests that WBV may prevent fractures by reducing falls.PROSPERO REGISTRATION NUMBER: CRD42016036320; Pre-results.

U2 - 10.1136/bmjopen-2017-018342

DO - 10.1136/bmjopen-2017-018342

M3 - Journal article

C2 - 29289937

VL - 7

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 12

M1 - e018342

ER -