Mechanical treatment shows promise in thalassemia

By Laura Cowen

Vibration therapy may be an effective nonpharmacologic intervention to increase bone mass in patients with thalassemia, US researchers report.

The pilot study, conducted among nine adults (age >18 years) and nine adolescents (age 10-18 years), showed that standing on a vibrating platform (30 Hz, 0.3g) for 20 minutes per day for 6 months increased whole-body bone mineral content (BMC) by a significant 2.6% compared with baseline.

Areal bone mineral density (aBMD) and BMC/height, both measured by dual-energy X-ray absorptiometry, increased by a significant 1.3% and 2.6%, respectively, during the intervention period, and remained elevated at 12 months.

Furthermore, the rate of change in hip BMD during the 6-month intervention in adults was significantly greater than the change observed in the year before study entry (2.2 vs -2.7%).

"Though these data are preliminary, they suggest promise of a non-invasive intervention in a group of patients who have a significant risk of osteoporosis morbidity," remark Ellen Fung (Children's Hospital and Research Center, Oakland, California) and co-authors in the American Journal of Hematology.

Fung and team explain that patients with thalassemia have low bone mass, which can lead to fracture and decreased quality of life.

Patients are commonly treated for hypogondism through hormonal supplementation and encouraged to take calcium and vitamin D, but the majority continue to lose bone, as much as 1% to 2% per year, as they age.

Mechanical stimulation through whole-body vibration has been shown to promote bone formation in previous studies, the researchers therefore tested its efficacy in thalassemia.

The increases in aBMD and BMC were accompanied by significant increases in levels of the bone formation marker osteocalcin and decreases in the bone resorption marker serum collagen type 1 cross-linked C-telopeptide.

Of note, although aBMD and BMC increased during the intervention period among adolescents, the increase was no greater than that recorded in the 6 months prior to the intervention. This was possibly because adolescents were captured during a period of rapid growth and pubertal development, limiting the ability to observe change, Fung et al remark.

They conclude: "Future research is needed to confirm these findings in a larger sample for longer duration."

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