Osteoporosis Clinical Trial
Official title:
Effect of Hip Bone Mineral Density / Content on Vibration-Induced Hip Adductors Muscle Electrical Activity in Postmenopausal Women
The aim of this study is to investigate effects of femur exposed to vibration on the rest
muscle electrical activity of hip adductors in cases with postmenopausal osteoporosis.
Among patients who will be admitted to the investigators clinic for out-patients and whose
bone densitometric measurement will be made with a prediagnosis postmenopausal osteoporosis,
a total of 80 voluntaries [40 having postmenopausal osteoporosis (femur neck or total hip T
score < -2.0) and 40 Controls (Hip and lumbar bone mineral density normal)] are planned to
include in this study.
After the left hip bone mineral density (BMD) and BMC is measured in all cases, whole body
vibration will be applied in PMO groups and Controls. The rest muscle electrical activity of
left hip muscles will be evaluated at pre-treatment, post-treatment and, during treatment in
patients with PMO and then their data will be compared with Controls data.
Plasma sclerostin level will be measured before and 10th minute after vibration.
Cases will stand on vibration plate. WBV will be applied at a frequency of 40 Hz and
amplitude of 2 mm for 30 + 30 seconds. WBV will be applied one session only. The left hip
BMD and BMC will be evaluated by bone densitometer (Norland).
The rest muscle electrical activity of hip adductor muscles at rest will be measured by
PowerLab (data acquisition system, ADInstruments, Australia) device.
This project is planed to be completed in 3 months.
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.
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. The investigators 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) Vibration has a strong osteogenic effect. Vibration-induced bone
formation is neuronally regulated. Vibration can also effectively enhance muscle strength
and power. Previous studies have shown that vibration increases muscle electromyographic
(EMG) activity. It has been showed that bone has an effect on the increase in muscle EMG
activity caused by vibration in healthy young adults in a study. In this study, it was
reported that vibrations-induced increases in muscle electrical activity of flexor carpi
radialis (FCR) was related to ultradistal radius bone mineral content (BMC) and the FCR
H-reflex was suppressed or depressed during vibration. This findings were reported to
support the assumption that the bone exposed to cyclic mechanical loading may neuronally
regulate muscle activity.
The aim of this study is to investigate effects of femur exposed to vibration on the rest
muscle electrical activity of hip adductors in cases with postmenopausal osteoporosis.
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Allocation: Non-Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Basic Science
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