Impact of whole-body vibration exercise on physical performance and bone turnover in patients with monoclonal gammopathy of undetermined significance

Lothar Seefried; Franca Genest; Johanna Strömsdörfer; Bernhard Engelmann; Constantin Lapa; Franz Jakob; Freerk T Baumann; Billy Sperlich; Franziska Jundt

doi:10.1016/j.jbo.2020.100323

Impact of whole-body vibration exercise on physical performance and bone turnover in patients with monoclonal gammopathy of undetermined significance

J Bone Oncol. 2020 Sep 28:25:100323. doi: 10.1016/j.jbo.2020.100323. eCollection 2020 Dec.

Authors

Affiliations

¹ Orthopedic Department, University of Würzburg, Würzburg, Germany.
² Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany.
³ Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
⁴ Orthopedic Center for Musculoskeletal Research, Experimental and Clinical Osteology, Würzburg, Germany.
⁵ Department 1 of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany.
⁶ Integrative and Experimental Training Science, Department of Sport Science, University of Würzburg, Würzburg, Germany.
⁷ Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany.

Abstract

Objective: Monoclonal Gammopathy of Undetermined Significance (MGUS) is a risk factor for reduced physical performance, osteoporosis, and fractures due to compromised musculoskeletal metabolism. In this condition it is unknown whether whole-body vibration (WBV) exercise favorably alters physical performance and bone metabolism.

Methods: To evaluate the effect of three-months WBV exercise (30 min; 2x/week) including an optional three-month extension on physical performance, bone metabolism and bone mineral density. Endpoints included functional assessments, bone turnover markers and bone mineral density assessed by peripheral quantitative computed tomography of the tibia.

Results: Fifteen MGUS patients (median age 62.0, nine female) completed the first three months of which ten completed the three-month extension. Measures of physical functioning including chair rise test, timed up and go and 6-minute walk test improved (p = 0.007; p = 0.009; p = 0.005) after three and six months of WBV exercise. Total tibial bone mineral density remained unaltered (p > 0.05). WBV exercise tended to increase levels of sclerostin (p = 0.093) with a transient increase in osteoclast resorption markers (N-terminal telopeptide of collagen type 1, tartrate resistant acid phosphatase 5b) after three months while Dickkopf-1 (p = 0.093), procollagen I N-terminal propeptide (p = 0.074) and total alkaline phosphatase (p = 0.016) appeared to decline. No exercise-related adverse events were reported.

Conclusion: WBV exercise in MGUS patients improves indicators of physical performance. Observed trends in bone turnover markers and changes in distal tibial bone mineral density may indicate a regulatory effect of WBV exercise on bone metabolism and warrants further evaluation by large scale studies.

Keywords: Bone turnover; Dickkopf-1; Monoclonal gammopathy of undetermined significance; Physical performance; Quantitative computed tomography; Whole-body vibration.