Efeito dos exercícios de vibração de corpo inteira na densidade mineral ósseas em mulheres pós menopausadas: revisão sistemática com metanálise

Abstract

Introduction: The Whole-body vibration exercise (WBVE) is realized by individual contact with the base of a vibrating platform, that generates mechanical vibrations that are transmitted to the entire body of the individual. Until this moment remains uncertain which are the best parameters, such as Frequency, amplitude, magnificence and position of the body capable of potentialize the increase of the bone mineral density (BMD) by WBVE. Objective: The aim was to update a previous systematic review with meta-analysis to observe the effects of WBVE on BMD in postmenopausal women. Methods: For meta-analysis, the weighted mean difference between WBVE and control groups, or WBVE and conventional exercise, was used for the area of bone mineral density (aBMD) of the lumbar spine, femoral neck, total hip, trochanter, intertrochanter, and Ward's area; or volumetric trabecular bone mineral density (vtBMD) of the radius and tibia. Methodological quality was assessed using the PEDro scale and the quality evidence using the GRADE system. Results: In total, 23 studies were included in the systematic review and 20 in the metaanalysis. Thirteen studies showed high methodological quality. WBVE compared with control groups showed significant effects on aBMD in the primary analysis (lumbar spine and trochanter), on the sensitivity (lumbar spine), with side-alternating vibration (lumbar spine and trochanter), with synchronous vibration (lumbar spine), on the low frequency and high magnitude (lumbar spine and trochanter), on the high frequency and low magnitude (lumbar spine), on the high frequency and high magnitude (lumbar spine, trochanter, and Ward’s area), on the high cumulative dose and low magnitude (lumbar spine), on the low cumulative dose and high magnitude (lumbar spine and trochanter), and on positioning with semi-flexed knees (trochanter). Conclusions: Of these results, only high frequency associated with low magnitude and high cumulative dose with low magnitude showed high-quality evidence. At this time, considering the high quality of evidence, it is possible to recommend WBV using high frequency (≈ 30 Hz), low magnitude (≈ 0.3 g), and high cumulative dose (≈ 7000 min) to improve lumbar spine aBMD in postmenopausal women. Other parameters, although promising, need to be better investigated, considering, when applicable, the safety of the participants, especially in vibrations with higher magnitudes (≥ 1 g).