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Osteoporosis treatment

Bone stability

The objective of osteoporosis treatment is to build – or at least maintain - bone stability. Having measured the bone mineral density, a treatment programme will aim to improve the T-scores with the goal being to get you out of the osteoporotic zone. Measuring at intervals, normally at the first yearly anniversary since treatment started and then annually from then on, shows the effectiveness of the treatment. The two most important parts of osteoporosis treatment are a diet sufficient in calcium and vitamin D and regular physical exercise. Medication can be prescribed but without a diet rich in vitamins and minerals and appropriate physical exercise, its effect is limited.

Wolff’s Law

Wolff's Law was developed by a Berlin physician, Julius Wolff, during the 19th Century following a series of observations and measurements of bones. Wolff’s Law is today one of the fundamental rules of orthopaedic work: it applies in particular to osteoporosis treatment. The main concept of Wolff’s Law is that bone actively adapts to loads and relative forces. In simple terms, if bones are subjected to loads and stress, the body reacts by building up more bone to withstand the force being applied. Both external and internal bone tissue reacts in this way. As bone increases in strength and builds itself up when subjected to loads the reverse is also true: bone decreases in strength and breaks down if it’s not used or subjected to loads.

The effect of applying or removing load to bone

When applying increased load to a bone it will adapt and remodel itself over time to become stronger, to handle the increased force. The reverse is also true that if the loading on a bone decreases the bone will remodel itself to become weaker and less dense as there is not enough stimulus to be strong.

 

How loads improve osteoporosis scores

osteoporose therapie knochen trabekel

The stronger and more stable, the more secure and durable

Bone mineral density is key to the stability of bones. The stronger and more stable the bones, the more secure and durable they are. Our bones naturally adapt to withstand loads and will tolerate regular demands on them. This is already proven by Wolff’s Law where bone actively adapts to loads and relative forces. It follows, therefore, that if you want strong bones, you have to subject them to loads. This may sound strange to someone with osteoporosis as the bones are weak and people fear they will break. But Wolff’s Law applies to people with osteoporosis: by carefully managing the load – such as with Low Intensity Vibration treatment – the effects will be felt and no damage will occur.

The less you load bone, the more it breaks down.

Looking at Wolff’s Law the other way around explains how when a bone is subject to little or no loads, the body perceives it as not used or needed. And it is broken down.

This principle plays a big role in osteoporosis. If you don’t load the bones or exercise for fear of fracture, the problem intensifies. Physical exercise is needed to train muscles and apply loads to build up the bones.

Treatment with peak dynamic forces

Bones react particularly well to special dynamic peak forces – whereby you alternate loading with relief/rest. Key to this is frequent repetition of alternating loading with relief.  Thus short bursts of loading can be highly effective.

Space medicine has known since the end of the last century the importance of loads on astronauts’ bones. In the weightless environment of space, an astronaut can exercise as much as they want but if there are no loads on his bones, they degenerate. Low Intensity Vibration (LIV) training was shown to keep an astronaut’s bones healthy. The logic from this was then applied to using LIV in osteoporosis treatment to activate the bone structure with gentle vibrations to stimulate a response.

Improving osteoporosis scores

Bones react particularly well to specific loading forces. If the objective is to improve the bone mineral density score (T-score), there are several ways to succeed. Medication can sometimes limit the reduction in breakdown of bone substance while physical exercise will help build up bones. For optimum success, targeting bones with a precise and specific load will help them build up safely and quickly.

It’s important to note that bone reacts less to movement and more to loads. Thus applying a precise load – through Low Intensity Vibration training – can be more effective than physical exercise where there is more movement combined with the load.

Precise force works best

When it comes to loading bone, a precise force targeted specifically is most effective. The magnitude of the force must be specifically adjusted to the bones and the load must be repeated frequently and regularly. This process is known as peak dynamic stimuli and is the best way to promote the build-up of bone. Doing any more than 10 minutes per day of Low Intensity Vibration treatment won’t build more bone more quickly. The 10 minutes is a precise time calculated to take the precise vibration and frequency (rate) to give optimum results » increased bone mineral density

Bones and structure

Bone consists of various types of tissue with different consistencies. Long, tubular bones (such as the upper part of your thigh – see figure above) consist of a strong, dense structure of tissue fibres known as cortical or compact bone. Inside the bone case is sponge-like trabecular bone with fine trabeculae. This is the area that is mainly affected by osteoporosis. Both the outer case and inner structure of bone tissue adapt constantly to mechanical loads as shown in Wolff’s Law.

Microarchitecture of bone

osteoporose therapie und aufbau knochendichte

Osteoporosis – treatment and training

One question that people affected by osteoporosis ask again and again is how you can picture the build-up of bone. The dynamic force stimuli which are adjusted to the bone are important. The correct magnitude and frequent repetition of the treatment are crucial.

Prof. Dr. Clinton Rubin was able to show how bone build-up and therefore increasing bone mineral density and cross-linking in the internal structure develops in a very impressive visual way in a comparative study (see figure below).

Increasing bone mineral density

osteoporose therapie und zunahme knochendichte

The inner part of long bones has relatively low mass compared to the whole bone, but a very large surface area. This inner-structure, with its many fine trabeculae, contributes extensively to facilitating bone metabolism and the production of various cell types which are then readily available for the body to use. It takes just a small load at optimum frequency to facilitate the formation of high-quality bone substances and new trabeculae with more intensive cross-linking. These combined create a more stable structure with greater strength and elasticity.

Professor Kemmler and Dr von Stengel, both from the Osteoporosis Research Centre at the University of Nuremberg-Erlangen, wrote in their article entitled “Whole-body Vibration Training” (Mobile Life, 3-2015): “A study by Professor Rubin from America, in which vibration training … led to an increase in bone mineral density in the thigh by 34% and an increase in fracture strength by 27%, led the way.” This refers to our medical director, Professor Rubin and his use of Low Intensity Vibration treatment. It is one of the many research papers that support the results achievable by application of LIV technology.

Example: % increase in bone mineral density by year

osteoporose therapie und zunahme knochendichte in prozent

Loading alone won’t work as well

There is more to the treatment of osteoporosis than just physical exercise and effective loading of bones. For example, a healthy diet that supplies the body with the vitamins (especially vitamin D) and minerals (especially calcium) is needed to help the bones build up. Medication (usually bisphosphonates) intended to slow down the degeneration of bone substance can be added as part of the treatment however they unfortunately can have detrimental side effects.

The medical profession agrees that subjecting bones to loads is vital and must always form part of the treatment: note the word ‘must’ is used, not ‘should’.

Low Intensity Vibration is an effective treatment

Low Intensity Vibration (LIV) is a very gentle yet very effective treatment system which supports bone build-up in a targeted manner. Its peak dynamic forces stimulate a reaction and activity within the bone-building cells (osteoblasts). The reaction and activity are closely related to the body’s own activity of type 2A muscle fibres which work to promote healthy bones and muscles making LIV treatment a natural and effective osteoporosis treatment.

Activation of stem cells

A primary action of the signals between the muscle tissue and bone is the stimulation of Mesenchymal Stem Cells (MSCs). These stem cells have the ability to become either bone, cartilage or fat cells.  People who are young, active and with a healthy muscle mass, create signals that are strong enough to stimulate the MSCs into bone production.  However, people who are older, inactive or have poor muscle mass, produce slower signals which result in the MSCs producing fat cells rather than bone cells. The LIV created by Marodyne mimics the faster signals and replicates the behaviour of a healthy muscle mass to stop the MSCs producing fat cells and resume the production of bone.  In this way, Marodyne halts the decline of bone mass and starts rebuilding a healthy musculoskeletal system.

Helping yourself

LIV treatment can certainly boost osteoporosis treatment but taking physical exercise and eating well will further enhance its effect. Simply using the Marodyne device for 10 minutes a day will certainly help but to enjoy the full benefits of this osteoporosis treatment, you should also look at other aspects of your lifestyle.

» Training

Osteoporosis

Osteoporose-Therapie und Trabekel

The fine internal bone structure is especially at risk: the loss of substance reduces density and strength and increases the risk of fractures » more

Increasing bone mineral density

Osteoporose-Therapie Werte verbessern

What does the build-up of bones look like as the result of the treatment? An example: increase in a bone’s internal (trabecular) structure » more

Improved results

knochendichte werte verbessern

In the event of osteoporosis, a key aim is to increase bone mineral density in three critical areas: in the thigh bone, hips and vertebrae » more