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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT05281120
Other study ID # 02C701
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date November 2006
Est. completion date November 2007

Study information

Verified date March 2022
Source Istituto Auxologico Italiano
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Duchenne muscular dystrophy (DMD) is a X-linked recessive disorder due to a mutation of the dystrophin gene (Xp21). Dystrophin is a sarcolemmal protein of skeletal and cardiac muscle, and its absence causes progressive muscle degeneration and substitution with fat and connective tissue. The progressive muscle degeneration leads to loss of autonomous walking before the age of 15 years and death for cardiac and/or respiratory failure. There are no specific treatment for DMD, and the standard of care is now based on long-term corticosteroid (CS) use. The studies on bone mass in DMD are very few, but they agree in reporting the presence of a reduced bone mass and an increased rate of fractures probably due to long-term steroid therapy and disuse-osteopenia. The aim of this study, involving 20 ambulant DMD boys (age 7-10 years) has been the evaluation of the effects of low-level mechanical vibrations on bone in a group of ambulant DMD children for 1 year, with RDA-adjusted dietary calcium intake and 25OH vitamin D supplementation.


Description:

All children were instructed to have a daily intake of calcium equal to the 100% of the RDA and were supplemented with calcifediol (0.7 mcg/kg/die). The 20 boys were randomly assigned to two groups: group 1 (mechanical intervention group) = a mechanical device (a small platform designed to induce vertical, sinusoidal acceleration) was installed in the home of each boy of group 1. group 2 (placebo control group) = a placebo device was installed in the home of each boy of group 2 All boys were instructed to stand on the platform for 10 minutes each day for 12 months. Compliance was followed and stimulated through weekly telephone contacts with parents and children.


Recruitment information / eligibility

Status Completed
Enrollment 20
Est. completion date November 2007
Est. primary completion date May 2007
Accepts healthy volunteers No
Gender Male
Age group 7 Years to 10 Years
Eligibility Inclusion Criteria: - Diagnosis of DMD - Ability to stand up and walk (some balance assistance allowed, but full weight-bearing necessary) - All the children must already be on glucocorticoid therapy for at least 6 months before the start of the study. Exclusion Criteria: - Presence of other diseases interfering with bone density and bone turnover - The inability to regularly use the vibratory platform.

Study Design


Intervention

Device:
Low-level mechanical vibrations WITH vertical sinusoidal acceleration
Small platform designed to induce vertical, sinusoidal acceleration.
Low-level mechanical vibrations WITHOUT vertical sinusoidal acceleration
Small platform designed to NOT induce vertical, sinusoidal acceleration

Locations

Country Name City State
n/a

Sponsors (1)

Lead Sponsor Collaborator
Istituto Auxologico Italiano

References & Publications (25)

Aparicio LF, Jurkovic M, DeLullo J. Decreased bone density in ambulatory patients with duchenne muscular dystrophy. J Pediatr Orthop. 2002 Mar-Apr;22(2):179-81. — View Citation

Baylink DJ. Glucocorticoid-induced osteoporosis. N Engl J Med. 1983 Aug 4;309(5):306-8. — View Citation

Bianchi ML, Mazzanti A, Galbiati E, Saraifoger S, Dubini A, Cornelio F, Morandi L. Bone mineral density and bone metabolism in Duchenne muscular dystrophy. Osteoporos Int. 2003 Sep;14(9):761-7. Epub 2003 Jul 29. — View Citation

Biggar WD, Gingras M, Fehlings DL, Harris VA, Steele CA. Deflazacort treatment of Duchenne muscular dystrophy. J Pediatr. 2001 Jan;138(1):45-50. — View Citation

Bonifati MD, Ruzza G, Bonometto P, Berardinelli A, Gorni K, Orcesi S, Lanzi G, Angelini C. A multicenter, double-blind, randomized trial of deflazacort versus prednisone in Duchenne muscular dystrophy. Muscle Nerve. 2000 Sep;23(9):1344-7. — View Citation

Chesney RW, Mazess RB, Rose P, Jax DK. Effect of prednisone on growth and bone mineral content in childhood glomerular disease. Am J Dis Child. 1978 Aug;132(8):768-72. — View Citation

Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med. 1993 Jun;94(6):646-50. Review. — View Citation

Courteix D, Lespessailles E, Peres SL, Obert P, Germain P, Benhamou CL. Effect of physical training on bone mineral density in prepubertal girls: a comparative study between impact-loading and non-impact-loading sports. Osteoporos Int. 1998;8(2):152-8. — View Citation

Gilsanz V, Wren TA, Sanchez M, Dorey F, Judex S, Rubin C. Low-level, high-frequency mechanical signals enhance musculoskeletal development of young women with low BMD. J Bone Miner Res. 2006 Sep;21(9):1464-74. — View Citation

Jones G, Ponsonby AL, Smith BJ, Carmichael A. Asthma, inhaled corticosteroid use, and bone mass in prepubertal children. J Asthma. 2000;37(7):603-11. — View Citation

Khan MA. Corticosteroid therapy in Duchenne muscular dystrophy. J Neurol Sci. 1993 Dec 1;120(1):8-14. Review. — View Citation

Larson CM, Henderson RC. Bone mineral density and fractures in boys with Duchenne muscular dystrophy. J Pediatr Orthop. 2000 Jan-Feb;20(1):71-4. — View Citation

McDonald DG, Kinali M, Gallagher AC, Mercuri E, Muntoni F, Roper H, Jardine P, Jones DH, Pike MG. Fracture prevalence in Duchenne muscular dystrophy. Dev Med Child Neurol. 2002 Oct;44(10):695-8. — View Citation

Mendell JR, Moxley RT, Griggs RC, Brooke MH, Fenichel GM, Miller JP, King W, Signore L, Pandya S, Florence J, et al. Randomized, double-blind six-month trial of prednisone in Duchenne's muscular dystrophy. N Engl J Med. 1989 Jun 15;320(24):1592-7. — View Citation

Merlini L, Mazzone ES, Solari A, Morandi L. Reliability of hand-held dynamometry in spinal muscular atrophy. Muscle Nerve. 2002 Jul;26(1):64-70. — View Citation

Naganathan V, Jones G, Nash P, Nicholson G, Eisman J, Sambrook PN. Vertebral fracture risk with long-term corticosteroid therapy: prevalence and relation to age, bone density, and corticosteroid use. Arch Intern Med. 2000 Oct 23;160(19):2917-22. — View Citation

Palmieri GM, Bertorini TE, Griffin JW, Igarashi M, Karas JG. Assessment of whole body composition with dual energy x-ray absorptiometry in Duchenne muscular dystrophy: correlation of lean body mass with muscle function. Muscle Nerve. 1996 Jun;19(6):777-9. — View Citation

Slemenda CW, Miller JZ, Hui SL, Reister TK, Johnston CC Jr. Role of physical activity in the development of skeletal mass in children. J Bone Miner Res. 1991 Nov;6(11):1227-33. — View Citation

Slemenda CW, Reister TK, Hui SL, Miller JZ, Christian JC, Johnston CC Jr. Influences on skeletal mineralization in children and adolescents: evidence for varying effects of sexual maturation and physical activity. J Pediatr. 1994 Aug;125(2):201-7. — View Citation

Talim B, Malaguti C, Gnudi S, Politano L, Merlini L. Vertebral compression in Duchenne muscular dystrophy following deflazacort. Neuromuscul Disord. 2002 Mar;12(3):294-5. — View Citation

Vestergaard P, Glerup H, Steffensen BF, Rejnmark L, Rahbek J, Moseklide L. Fracture risk in patients with muscular dystrophy and spinal muscular atrophy. J Rehabil Med. 2001 Jul;33(4):150-5. — View Citation

Ward K, Alsop C, Caulton J, Rubin C, Adams J, Mughal Z. Low magnitude mechanical loading is osteogenic in children with disabling conditions. J Bone Miner Res. 2004 Mar;19(3):360-9. Epub 2004 Jan 27. — View Citation

Welten DC, Kemper HC, Post GB, Van Mechelen W, Twisk J, Lips P, Teule GJ. Weight-bearing activity during youth is a more important factor for peak bone mass than calcium intake. J Bone Miner Res. 1994 Jul;9(7):1089-96. — View Citation

Whalen RT, Carter DR, Steele CR. Influence of physical activity on the regulation of bone density. J Biomech. 1988;21(10):825-37. — View Citation

Xie L, Jacobson JM, Choi ES, Busa B, Donahue LR, Miller LM, Rubin CT, Judex S. Low-level mechanical vibrations can influence bone resorption and bone formation in the growing skeleton. Bone. 2006 Nov;39(5):1059-1066. doi: 10.1016/j.bone.2006.05.012. Epub 2006 Jul 7. — View Citation

* Note: There are 25 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Change in bone mineral density at lumbar spine. Bone mineral density evaluated by DXA. Bone mineral apparent density calculated to correct for bone size (growing subjects). Z-score calculated.
Measurements: baseline and 12 months.
baseline and 12th month
Secondary Calcium changes in serum calcium (mg/dL) baseline and 12th month
Secondary Phosphate changes in serum phosphate (mg/dL) baseline and 12th month
Secondary Magnesium changes in serum magnesium (mg/dL) baseline and 12th month
Secondary Creatinine changes in serum creatinine (mg/dL) baseline and 12th month
Secondary Bone Alkaline Phosphatase changes in serum bone alkaline phosphatase (µg/L) baseline and 12th month
Secondary Osteocalcin changes in serum osteocalcin (µg/L) baseline and 12th month
Secondary Parathyroid Hormone changes in serum parathyroid hormone (ng/L) baseline and 12th month
Secondary 25-OH vitamin D changes in serum 25-OH vitamin D (µg/L) baseline and 12th month
Secondary 1,25(OH)2 vitamin D changes in serum 1,25(OH)2 vitamin D (ng/L) baseline and 12th month
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