Osteogenesis Imperfecta Clinical Trial
Official title:
Whole Body Vibration as an Osteogenic Treatment for Children With Osteogenesis Imperfecta With Limited Mobility: A Randomised Controlled Pilot Trial
Children with osteogenesis imperfecta (OI) have impaired bone strength, fractures, weak muscles and limited mobility. Mild to moderate forms of OI (type 1 and 4) may benefit from muscle training that leads to secondary improvement in bone strength (osteogenic treatment). Recent studies in children with cerebral palsy but also OI suggest that Whole Body Vibration Training (WBVT) improves mobility and also bone strength. No randomized controlled trials exist in OI children. This randomized controlled pilot study assesses the effect of 5 months WBVT (2 x 9min/day) on muscle function, mobility, bone structure and density. 24 children >5 years with OI type 1 and 4 with limited mobility (CHAQ Score ≥0.13) will be randomized into a WBVT group and a control group matched by gender and pubertal stage. Main outcome measure is the change in tibial volumetric BMD, secondary outcomes include a variety of bone, mobility and dynamic muscle function variables.
Osteogenesis imperfecta (OI) is a bone fragility disorder with impaired bone strength,
fractures, weak muscles and limited mobility. Mild to moderate forms of OI (type 1 and 4)
may not require bisphosphonate therapy but would benefit from muscle training that leads to
secondary improvement in bone strength (osteogenic treatment). The mechanostat theory states
that bone adapts its strength to mechanical forces mostly imposed by muscle. According to
this widely accepted theory, any treatment that strengthens muscle should also strengthen
bones. Whole body vibration therapy (WBVT) with side-alternating platforms (Galileo™) uses
the body's neuromotor reflex system to train muscles. Recent studies in children with
cerebral palsy but also OI suggest that WBVT improves mobility and also bone strength. No
randomized controlled trials exist in OI children.
This randomized controlled study assesses the effect of 5 months whole body vibration
training (2 x 9min/day) on muscle strength, motor function, bone structure and density. 24
children >5 years with OI type 1 and 4 with limited mobility (CHAQ Score ≥0.13) will be
randomized into a WBVT group and a control group matched by gender and pubertal stage.
Children with OI will be recruited from specialist clinics in Birmingham, Manchester and
Sheffield, as well as via advertisement on the Brittle Bone Society's homepage. Patients
will be equipped with side-alternating vibration platforms for home use and train with
increasing intensity. Outcome measures are tested pre- and post 5-months intervention.
Dynamic muscle function is measured by mechanography (jumping force plates) and mobility by
CHAQ questionnaire and a six-minute walk test. Changes in bone structure and density are
assessed by DXA and peripheral QCT of the tibia.
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