Wolfgang Högler1,2, Janis Scott1, Nick Bishop3, Paul Arundel3, Peter Nightingale4, M Zulf Mughal5, Raja Padidela5, Nick Shaw1,2, Nicola Crabtree1. 1. Department of Endocrinology & Diabetes, Birmingham Children's Hospital, Birmingham B4 6NH, United Kingdom. 2. Institute of Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, United Kingdom. 3. Academic Unit of Child Health, Sheffield Children's Hospital, Sheffield S10 2TH, United Kingdom. 4. Wellcome Trust Clinical Research Facility, Queen Elizabeth Hospital, Birmingham B15 2TH, United Kingdom. 5. Department of Endocrinology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
Abstract
Context: Osteogenesis imperfecta (OI) is associated with reduced muscle size, dynamic muscle function, and mobility. Objective: To assess the effect of whole body vibration (WBV) on bone density and geometry, muscle size and function, mobility, and balance in children with OI. Design: Randomized controlled pilot trial. Setting: Tertiary pediatric research center. Participants: Twenty-four children (5 to 16 years) with OI types 1, 4, and limited mobility [Child Health Assessment Questionnaire (CHAQ) score ≥0.13] recruited in sex- and pubertal stage-matched pairs. Incident fractures in two boys (WBV arm) led to exclusion of two prepubertal pairs. Intervention: Five months of WBV training (3 × 3 minutes twice daily) or regular care. Main Outcome Measures: Bone and muscle variables measured by dual-energy X-ray absorptiometry (spine, hip, total body) and peripheral quantitative computed tomography (tibia). Mobility assessed by 6-minute walk tests and CHAQ; dynamic muscle function by mechanography. Results: All participants had reduced walking distances and muscle function (P < 0.001). Body mass index z score was associated with higher CHAQ scores (ρ + 0.552; P = 0.005) and lower walking and two-leg jumping performance (ρ - 0.405 to -0.654, P < 0.05). The WBV and control groups did not differ in the 5-month changes in bone. Total lean mass increased more in the WBV group [+1119 g (+224 to +1744)] compared with controls [+635 g (-951 to +1006)], P = 0.01, without improving mobility, muscle function, or balance. Conclusions: The increase in lean mass without changes in muscle function or bone mass suggests reduced biomechanical responsiveness of the muscle-bone unit in children with OI.
RCT Entities:
Context:Osteogenesis imperfecta (OI) is associated with reduced muscle size, dynamic muscle function, and mobility. Objective: To assess the effect of whole body vibration (WBV) on bone density and geometry, muscle size and function, mobility, and balance in children with OI. Design: Randomized controlled pilot trial. Setting: Tertiary pediatric research center. Participants: Twenty-four children (5 to 16 years) with OI types 1, 4, and limited mobility [Child Health Assessment Questionnaire (CHAQ) score ≥ 0.13] recruited in sex- and pubertal stage-matched pairs. Incident fractures in two boys (WBV arm) led to exclusion of two prepubertal pairs. Intervention: Five months of WBV training (3 × 3 minutes twice daily) or regular care. Main Outcome Measures: Bone and muscle variables measured by dual-energy X-ray absorptiometry (spine, hip, total body) and peripheral quantitative computed tomography (tibia). Mobility assessed by 6-minute walk tests and CHAQ; dynamic muscle function by mechanography. Results: All participants had reduced walking distances and muscle function (P < 0.001). Body mass index z score was associated with higher CHAQ scores (ρ + 0.552; P = 0.005) and lower walking and two-leg jumping performance (ρ - 0.405 to -0.654, P < 0.05). The WBV and control groups did not differ in the 5-month changes in bone. Total lean mass increased more in the WBV group [+1119 g (+224 to +1744)] compared with controls [+635 g (-951 to +1006)], P = 0.01, without improving mobility, muscle function, or balance. Conclusions: The increase in lean mass without changes in muscle function or bone mass suggests reduced biomechanical responsiveness of the muscle-bone unit in children with OI.
Authors: M B Saquetto; F F Pereira; R S Queiroz; C M da Silva; C S Conceição; M Gomes Neto Journal: Osteoporos Int Date: 2018-01-12 Impact factor: 4.507