Hat die Aktivierung der Muskulatur durch Ganzkörpervibration einen Effekt auf die Knochendichte von postmenopausalen Frauen? Eine systematische Literaturübersicht

Zusammenfassung

Hintergrund: Ganzkörpervibrationstraining (GKV) stimuliert durch mechanische Schwingungen die Muskulatur. Dies führt zu einer erhöhten muskulären Aktivität und zu Verformung am Knochen, was zu einer Remodullierung der Knochen und Erhöhung der Dichte führt. Das Ziel dieser systematischen Literaturübersicht war, ob eine Muskelaktivierung bzw. Muskelkräftigung hervorgerufen durch GKV einen Effekt auf die Knochendichte von postmenopausalen Frauen hat.

Methoden: Diese systematische Literaturübersichtsarbeit wurde nach den Vorgaben des PRISMA-Statements für Metaanalysen und systematische Übersichtsarbeiten durchgeführt. Die Literatur wurde in verschiedenen elektronischen Datenbanken (PubMed, Cinahl) und Google Scholar gesucht. Die Suche, nach geeigneter Literatur, fand zwischen Juni 2012 und August 2013 statt. Die Qualität der Arbeiten wurden mittels dem „Cochrane-Risk-of-Bias-Instrument“ von zwei unabhängigen Personen (LC, SR) beurteilt.

Ergebnisse: Es wurden 246 Studien gesichtet. In die Analyse wurden 3 Studien mit vertikaler und 2 Studien mit seitenalternierender GKV eingeschlossen, mit insgesamt 368 Probanden mit einer Streuung von 60,7 – 79,6 Jahren. Von diesen trainierten 132 auf vertikal vibrierenden (VGKV) und 67 auf seitenalterierenden (SGKV) vibrierenden Platten. Die eingeschlossenen Studien wiesen ein mittleres bis hohes Risiko für Verzerrung auf. Die Behandlungsparameter waren sehr heterogen. Die Frequenzen wurden für VKGV zwischen 12,0 – 40,0 Hz und für SGKV mit 12,5 Hz gewählt und mit einer breit gestreuten Amplitude zwischen 1,7 und 12,0 mm bei einer vertikalen Beschleunigung von 0,1 – 10,0 g.

Schlussfolgerung: Diese systematische Literaturstudie zeigte signifikante Einflüsse nach VGKV mit Frequenzen von 30,0 – 40,0 Hz (3x/Woche, jeweils 15 Minuten Trainingszeit) auf die isometrische Maxmalkraft (IMK) von 15,1 – 16,5 % und der dynamischen Maximalkraft (DMK) von 7,9 – 16,5 % sowie der SKGV mit einer Frequenz von 12,5 Hz (3x/Woche, jeweils 15 Minuten Trainingszeit) auf die IMK von 26,6 %. Daraus resultierte eine Zunahme der Knochendichte in der LWS von 0,5 – 0,7 % und der Hüfte von 0,8 – 0,9 % bei postmenopausalen Frauen. Diese klinisch signifikanten Resultate müssen zukünftig mittels qualitativ hochwertig randomisiert-kontrollierten Studien bestätigt und nach dem CONSORT Statement rapportiert werden.

Abstract

Background: Whole body vibration training (WBV) stimulates muscles by mechanical vibrations. The resulting muscle activity and bone deformation may provoke an increase in bone density. The aim of this systematic review was to evaluate whether muscle activation and muscle strengthening caused by vibration training has an effect on bone density in postmenopausal women.

Methods: This systematic review was conducted according to the guidelines of the PRISMA statement for meta-analyses and systematic reviews. The literature search was conducted in several electronic databases (PubMed und CINAHL) and Google Scholar. The literature search was conducted between June 2012 and August 2013. The methodological quality of the included studies was assessed using the Cochrane risk of bias tool by two independent persons.

Results: A total of 246 studies was found. In this present analysis three studies with vertical and two studies with side-alternating WBV were included, totalling 368 participants with an age range between 60.7 and 79.6 years. From those 132 participants trained on vertically while 67 participants trained on side-alternating WBV engines. The included study shows a moderate to high risk of bias. The selected frequencies ranged from 12.0 Hz to 40.0 Hz for vertical WBV and 12.5 Hz for side-alternating WBV. The amplitude ranged between 1.7 and 12.0 mm with an acceleration from 0.1 to 10.0 g.

Conclusion: This systematic review showed significant influences on the isometric maximal voluntary contraction (IMVC) between 15.1 and 16.5 % and on dynamic maximal strength (DMS) between 7.9 to 16.5 % after vertically WBV (frequencies: 30.0 to 40.0 Hz; 3 sessions per week; 15 minutes per session) and on IMV with 26.6 % (frequency: 12.5 Hz; 3 sessions per week; 15 minutes per session). This increased muscle activity resulted in an improved bone density in the lumbar spine between 0.5 % to 0.7 % and the hip between 0.8 % to 0.9 % in postmenopausal women. These clinically significant findings should be confirmed by a large high-quality randomised controlled trial and reported following the CONSORT Statement guidelines.

Schlüsselwörter

isometrische Maximalkraft - dynamische Maximalkraft - Muskel-Knochen-Einheit - Muskelfunktion

Key words

isometric maximal voluntary contraction - dynamic strength - muscle-bone complex - muscle function

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