***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background The issue of osteoporosis-induced fractures has attracted the world ’s attention . Postmenopausal women are particularly at risk for this type of fracture . The nonmedicinal intervention for postmenopausal women is mainly exercise . Whole body vibration ( WBV ) is a simple and convenient exercise . There have been some studies investigating the effect of WBV on osteoporosis ; however , the intervention models and results are different . This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density ( BMD ) of the lumbar spine in postmenopausal women . Methods This study r and omized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial . The WBV group received an intervention of high-frequency ( 30 Hz ) and high-magnitude ( 3.2 g ) WBV in a natural full-st and ing posture for 5 minutes , three times per week , at a sports center . Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention . Results Six months later , the BMD of the WBV group had significantly increased by 2.032 % ( P=0.047 ) , while that of the control group had decreased by 0.046 % ( P=0.188 ) . The comparison between the two groups showed that the BMD of the WBV group had increased significantly ( P=0.016 ) . Conclusion This study found that 6 months of high-frequency and high-magnitude WBV yielded significant benefits to the BMD of the lumbar spine in postmenopausal women , and could therefore be provided as an alternative exercise BACKGROUND Although data from studies in animals demonstrated beneficial effects of whole-body vibration ( WBV ) therapy on bone , clinical trials in postmenopausal women showed conflicting results . OBJECTIVE To determine whether WBV improves bone density and structure . DESIGN A 12-month , single-center , superiority , r and omized , controlled trial with 3 parallel groups . ( Clinical Trials.gov registration number : NCT00420940 ) SETTING Toronto General Hospital , Ontario , Canada . PARTICIPANTS 202 healthy postmenopausal women with bone mineral density ( BMD ) T-scores between -1.0 and -2.5 who were not receiving prescription bone medications . INTERVENTION Participants were r and omly assigned to 1 of 3 groups ( 1:1:1 ratio ) by using a block-r and omization scheme and sealed envelopes . They were asked to st and on a low-magnitude ( 0.3 g ) 90-Hz or 30-Hz WBV platform for 20 minutes daily or to serve as control participants ; all participants received calcium and vitamin D. MEASUREMENTS Bone outcome assessors , who were blinded to group assignment , determined trabecular volumetric BMD and other measurements of the distal tibia and distal radius with high-resolution peripheral quantitative computed tomography and areal BMD with dual-energy x-ray absorptiometry at baseline and at 12 months . RESULTS 12 months of WBV therapy had no significant effect on any bone outcomes compared with no WBV therapy . For the primary outcome of tibial trabecular volumetric BMD , mean change from baseline was 0.4 mg/cm(3 ) ( 95 % CI , -0.4 to 1.2 mg/cm(3 ) ) in the 90-Hz WBV group , -0.1 mg/cm(3 ) ( CI , -1.0 to 0.8 mg/cm(3 ) ) in the 30-Hz WBV group , and -0.2 mg/cm(3 ) ( CI , -1.1 to 0.6 mg/cm(3 ) ) in the control group ( P = 0.55 ) . Changes in areal BMD at the femoral neck , total hip , and lumbar spine were also similar among the groups . Overall , low-magnitude WBV at both 90 and 30 Hz was well-tolerated . LIMITATIONS Adherence to WBV ranged from 65 % to 79 % . Double-blinding was not possible . CONCLUSION Whole-body vibration therapy at 0.3 g and 90 or 30 Hz for 12 months did not alter BMD or bone structure in postmenopausal women who received calcium and vitamin D supplementation This perspective provides an overview of the r and omized controlled trials , systematic review s , and evidence -based clinical practice guidelines in physical therapy . Data from the Physiotherapy Evidence Data base ( PEDro ) are used to describe key events in the history of physical therapy research and the growth of evidence of effects of interventions used in the various subdisciplines of physical therapy . The 11,494 records that were identified reveal a rich history of physical therapy research dating back to the first trial in 1929 . Most of the r and omized controlled trials , systematic review s , and evidence -based clinical practice guidelines in physical therapy have been published since the year 2000 . This rapid growth presents a challenge for physical therapists who want to keep up to date in clinical practice OBJECTIVE To test whether training on a high-frequency ( 28Hz ) vibrating platform improves muscle power and bone characteristics in postmenopausal women . DESIGN R and omized controlled trial with 6-month follow-up . SETTING Outpatient clinic in a general hospital in Italy . PARTICIPANTS Twenty-nine postmenopausal women ( intervention group , n=14 ; matched controls , n=15 ) . INTERVENTION Participants stood on a ground-based oscillating platform for three 2-minute sessions for a total of 6 minutes per training session , twice weekly for 6 months . The controls did not receive any training . Both groups were evaluated at baseline and after 6 months . MAIN OUTCOME MEASURES Muscle power , calculated from ground reaction forces produced by l and ing after jumping as high as possible on a forceplate , cortical bone density , and biomarkers of bone turnover . RESULTS Over 6 months , muscle power improved by about 5 % in women who received the intervention , and it remained unchanged in controls ( P=.004 ) . Muscle force remained stable in both the intervention and control groups . No significant changes were observed in bone characteristics . CONCLUSION Reflex muscular contractions induced by vibration training improve muscle power in postmenopausal women Background Whole-body vibration ( WBV ) is a new type of exercise that has been increasingly tested for the ability to prevent  bone fractures and osteoporosis in frail people . There are two currently marketed vibrating plates : a ) the whole plate oscillates up and down ; b ) reciprocating vertical displacements on the left and right side of a fulcrum , increasing the lateral accelerations . A few studies have shown recently the effectiveness of the up- and -down plate for increasing Bone Mineral Density ( BMD ) and balance ; but the effectiveness of the reciprocating plate technique remains mainly unknown . The aim was to compare the effects of WBV using a reciprocating platform at frequencies lower than 20 Hz and a walking-based exercise programme on BMD and balance in post-menopausal women .  Methods Twenty-eight physically untrained post-menopausal women were assigned at r and om to a WBV group or a Walking group . Both experimental programmes consisted of 3 sessions per week for 8 months . Each vibratory session included 6 bouts of 1 min ( 12.6 Hz in frequency and 3 cm in amplitude with 60 ° of knee flexion ) with 1 min rest between bouts . Each walking session was 55 minutes of walking and 5 minutes of stretching . Hip and lumbar BMD ( g·cm-2 ) were measured using dual-energy X-ray absorptiometry and balance was assessed by the blind flamingo test . ANOVA for repeated measurements was adjusted by baseline data , weight and age . Results After 8 months , BMD at the femoral neck in the WBV group was increased by 4.3 % ( P = 0.011 ) compared to the Walking group . In contrast , the BMD at the lumbar spine was unaltered in both groups . Balance was improved in the WBV group ( 29 % ) but not in the Walking group . Conclusion The 8-month course of vibratory exercise using a reciprocating plate is feasible and is more effective than walking to improve two major determinants of bone fractures : hip BMD and balance Background and aims : Exercise may enhance the effect of alendronate on bone mineral density ( BMD ) and reduce chronic back pain in elderly women with osteoporosis . The aim of this study was to determine whether whole-body vibration exercise would enhance the effect of alendronate on lumbar BMD and bone turnover , and reduce chronic back pain in post-menopausal women with osteoporosis . Methods : Fifty post-menopausal women with osteoporosis , 55–88 years of age , were r and omly divided into two groups of 25 patients each : one taking alendronate ( 5 mg daily , ALN ) and one taking alendronate plus exercise ( ALN+EX ) . Exercise consisted of whole-body vibration using a Galileo machine ( Novotec , Pforzheim , Germany ) , at an intensity of 20 Hz , frequency once a week , and duration of exercise 4 minutes . The study lasted 12 months . Lumbar BMD was measured by dual energy X-ray absorptiometry ( Hologic QDR 1500W ) . Urinary cross-linked N-terminal telopeptides of type I collagen ( NTX ) and serum alkaline phos-phatase ( ALP ) levels were measured by enzyme-linked immunosorbent assay and st and ard laboratory techniques , respectively . Chronic back pain was evaluated by face scale score at baseline and every 6 months . Results : There were no significant differences in baseline characteristics , including age , body mass index , years since menopause , lumbar BMD , urinary NTX and serum ALP levels , or face scale score between the two groups . The increase in lumbar BMD and the reduction in urinary NTX and serum ALP levels were similar in the ALN and ALN+EX groups . However , the reduction in chronic back pain was greater in the ALN+EX group than in the ALN group . Conclusions : The results of this study suggest that whole-body vibration exercise using a Galileo machine appears to be useful in reducing chronic back pain , probably by relaxing the back muscles in post-menopausal osteoporotic women treated with alendronate Beck BR , Norling TL : The effect of 8 mos of twice-weekly low- or higher intensity whole body vibration on risk factors for postmenopausal hip fracture . Objective : Whole body vibration is a potential therapy for age-related loss of musculoskeletal competence . Vibration has improved bone in animal models , but evidence in humans is limited . Relative efficacy of low- vs. high-intensity whole body vibration is also unknown . Our goal was to observe the effect of brief low- and higher intensity whole body vibration on risk factors for hip fracture in postmenopausal women . Design : We used an 8-mo r and omized controlled trial design to examine the influence of twice-weekly low-intensity whole body vibration ( 15 mins , 30 Hz , 0.3 g ) or higher intensity whole body vibration ( 2 × 3 mins , 12.5 Hz , 1 g ) on anthropometrics , bone ( whole body , hip , spine , forearm , and heel ) , muscle ( wall squat and chair rise ) , and balance ( t and em walk and single leg stance ) . Physical activity , daily calcium , and compliance were recorded . Effects were examined by repeated- measures analysis of covariance , controlling for age , height , weight , calcium , physical activity , compliance , and baseline values . Results : Forty-seven women ( 71.5 ± 9.0 yrs ) completed the trial . There were no between-group differences in any measure at 8 mos , but within-group effects were evident . Controls lost bone at the trochanter ( −6 % , P = 0.03 ) and lumbar spine ( −6.6 % , P = 0.02 ) , whereas whole body vibration groups did not . Whole body vibration subjects improved wall squat ( up to 120 % , P = 0.004 ) and chair rise performance ( up to 10.5 % , P = 0.05 ) . Conclusions : Eight mos of twice-weekly whole body vibration may reduce bone loss at the hip and spine and improve lower limb muscle function . These changes may translate to a decreased risk of falls and hip fracture The purpose of this study was to examine the effect of whole-body vibration ( WBV ) on calcaneal quantitative ultrasound ( QUS ) measurements ; which has rarely been examined . We conducted a single-centre , 12-month , r and omized controlled trial . 202 postmenopausal women with BMD T score between −1.0 and −2.5 , not receiving bone medications , were asked to st and on a 0.3 g WBV platform oscillating at either 90- or 30-Hz for 20 consecutive minutes daily , or to serve as controls . Calcium and vitamin D was provided to all participants . Calcaneal broadb and attenuation ( BUA ) , speed of sound , and QUS index were obtained as pre-specified secondary endpoints at baseline and 12 months by using a Hologic Sahara Clinical Bone Sonometer . 12-months of WBV did not improve QUS parameters in any of our analyses . While most of our analyses showed no statistical differences between the WBV groups and the control group , mean calcaneal BUA decreased in the 90-Hz ( −0.4 [ 95 % CI −1 
    Output:
    
Summary This systematic review and meta- analysis of r and omized controlled trials ( RCTs ) identified significant effects of whole body vibration ( WBV ) on bone mineral density ( BMD ) of the lumbar spine ( in the sensitivity analysis and seven subgroup analyses ) , femoral neck ( in one subgroup analysis ) , and trochanter ( four subgroup analyses ) in postmenopausal women , but not other measurements of BMD .
Conclusions Despite WBV presenting potential to act as a coadjuvant in the prevention or treatment of osteoporosis , especially for aBMD of the lumbar spine , the ideal intervention is not yet clear .