The combined effect of parathyroid hormone (1\u201334) and whole-body vibration exercise on physical performance in OSteoporotic women (PaVOS study): a secondary analysis from a randomised controlled trial

Ditte Beck Jepsen,Stinus Hansen,Anders Holsgaard-Larsen,Niklas Rye Jørgensen,Jesper Ryg,Tahir Masud

doi:10.1186/s13102-020-00204-w

Abstract

BackgroundThe aim of this study was to investigate the effect on physical performance of combining whole-body vibration exercise (WBV) with parathyroid hormone 1–34 (teriparatide) compared to teriparatide alone.MethodsA secondary analysis from a RCT where postmenopausal women with severe osteoporosis were randomised to WBV plus teriparatide (intervention) or teriparatide alone (control). WBV was applied three times/week (6x1min WBV:1 min rest, (peak acceleration 3.6 g)) for twelve months. Both groups received teriparatide 20 μg s.c./day. The primary endpoint (bone mineral density) is reported elsewhere. Physical performance measures (Short Physical Performance Battery (SPPB), Timed-Up-and-Go (TUG), leg extension power, and grip strength) were obtained at baseline, three-, six-, and twelve months, lean mass at baseline and twelve months. Data were analysed with mixed linear regression model or robust cluster regression in an intention to treat analysis.ResultsThirty-five women aged (mean ± SD) 69 ± 7) years were recruited of which thirty-two (91%) completed the twelve months follow-up (WBV + teriparatide = 15, teriparatide = 17). SPPB score (mean ± SD) improved significantly at three months in the WBV + teriparatide group from 9.13 ± 2.03 to 10.35 ± 1.69 (p = 0.014) with a statistical trend towards a between-group change in favor of the WBV + teriparatide group (0.86 [95%CI(− 0.05,1.77), p = 0.065]). Both groups improved in leg extension power during the study period whereas no changes were seen in TUG, grip strength, or lean mass in either group. No statistical significant between-group differences were observed.ConclusionWBV may improve some short-term aspects of physical performance in severely osteoporotic postmenopausal women who are receiving teriparatide treatment.Trial RegistrationClinicalTrials.gov, ID:NCT02563353

Highlights

The aim of this study was to investigate the effect on physical performance of combining wholebody vibration exercise (WBV) with parathyroid hormone 1–34 compared to teriparatide alone
We have previously shown that combining pharmacological treatment for osteoporosis in the form of teriparatide with WBV as an exercise increased bone mineral density (BMD) of lumbar spine by an additional 2.95% [16]
The WBV + teriparatide group improved significantly in Short Physical Performance Battery (SPPB) at 3 months compared to baseline from 9.13 ± 1.96 to 10.35 ± 1.69 (p = 0.014) (Table 2), whereas no significant change was seen in the teriparatide group (10.16 ± 1.82 vs 10.17 ± 2.00)

Summary

Introduction

The aim of this study was to investigate the effect on physical performance of combining wholebody vibration exercise (WBV) with parathyroid hormone 1–34 (teriparatide) compared to teriparatide alone. Whole-body vibration exercise (WBV) has emerged as an alternative training intervention that is well tolerated in women with osteoporosis and even in older adults with a high risk of falls [10, 11]. WBV has the capacity to improve muscle strength of the lower extremities and body balance in older adults, both important factors in decreasing the risk of falls [12,13,14]. A previous study has shown a positive effect of combining osteoporotic treatment i.e. alendronate and exercise, where alendronate increased bone mass, exercise improved the participants’ muscular performance and dynamic balance, potentially decreasing the risk of fractures [15]

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