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Among patients who will be admitted to the investigators' clinic for outpatients and whose bone densitometric measurement will be made with a prediagnosis postmenopausal osteoporosis (PMO), a total of 80 volunteers [40 having postmenopausal osteoporosis (T score ≤ -2.5) and 40 controls (T score >-1)] are planned to be included in this study.
After bone mineral density (BMD) and bone mineral content (BMC) is measured in all cases, whole body vibration will be applied in PMO groups and controls. Alpha motor neuron excitability (H/M ratio, muscle background electrical activity, recruitment) will be evaluated by electromyography at pre-treatment, post-treatment, and during treatment in patients with PMO and then their data will be compared with the controls' data.
Exercise will be applied by whole-body vibration (WBV) device. Cases will stand on vibration plate. Three intervals of WBV will be applied. Each interval will consist of 60 s of WBV followed by 60 s of rest. During first interval, H/M ratio measurements were made; during second interval, muscle background electrical activity measurements were done; during the last interval, motor recruitment measurements were done. WBV will be applied one session only.
Lumbar and bilateral hip BMD and BMC will be evaluated by bone densitometer. Based on WHO criteria, Osteopenia is defined as -1 ≥ T score > -2.5; osteoporosis is defined as -2.5 ≥ T score; normal is defined as T score > -1.
Motor unit potentials at rest (muscle background electrical activity), motor recruitment, Hoffman reflex, M response will be measured by electromyography at right and left m.gastrocnemius and m.soleus. Medtronic Keypoint Portable 2 channel electromyography device will be used.
It is usually reported that there is a parallelism between changes in the bone structure and function and the muscle structure and function. Sarcopenia is frequently observed in osteoporotic patients. Bone formation increases or bone resorption decreases with exercise.
To date, the effect of bone on the muscle activity is not investigated. One of the most important functions of bone bear mechanical loads include body weight. Bone must be strong enough to resist the mechanical loading. Mechanisms need to protect bone when bone is subject to excessive mechanical loading. These mechanisms may mainly focus on strengthening the bone and/or changing vectorial properties of mechanical loading applied bone.
The vectorial properties of mechanical loading applied bone may be controlled by muscle contractions. Bone contains wide mechanoreceptor net constructed by osteocytes. So,distribution of the mechanical loading on bone cross-sectional area is possible to perceive. It may be also possible that inappropriate distribution of mechanical loading on bone crosssectional area is optimized by muscle contractions. To get this regulation, there should be a mechanism that muscle activity is controlled by central nervous system based on mechanical loading distribution on bone cross-sectional area. We previously showed that bone can regulate muscle activity, based on its bone mineral density. According to this study result, it can be suggested there may exist a mechanism that bone sensing mechanical stimuli can send the signals to central nervous system and neuronally regulate muscle activity (bone myo-regulation reflex). (It is also well known that load-induced adaptive bone formation is neuronally regulated. Taken together, a general mechanism, bone reflex, may be defined that bone subjected to loading can neuronally regulate bone formation and muscle activity)
This study hypothesize that radius subjecting to mechanical loading may affect excitability of alpha motor neuron innervating muscle, based on its bone mineral density.
Allocation: Non-Randomized, Control: Active Control, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Basic Science
Whole body vibration
Vakif Gureba Training & Research Hospital
Not yet recruiting
Vakif Gureba Training and Research Hospital
Published on BioPortfolio: 2014-08-27T03:19:56-0400
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