Low-Magnitude, High-Frequency Mechanical Stimulation May Improve Bone Mineral Density in Young Childhood Cancer Survivors


Key Points

  • Stimulation increased the whole-body bone mineral density score in childhood cancer survivors with low bone mineral density.
  • Patients completing a higher percentage of sessions had a greater increase in tibial trabecular bone.

In a small trial reported in JAMA Oncology, Mogil et al found that low-magnitude, high-frequency mechanical stimulation improved the whole-body bone mineral density score in childhood cancer survivors with low bone mineral density.

Study Details

In the double-blind trial, 65 survivors of childhood cancer aged 7 to 17 years treated at St. Jude Children’s Research Hospital were randomized with stratification for sex and Tanner stage to use of a low-magnitude, high-frequency mechanical stimulation device (0.3 g; 32–37 Hz) for two daily 10-minute sessions 7 days per week for 1 year (n = 32) or a placebo device (n = 33); devices were used at home.

Patients had to be in remission and at least 5 years from diagnosis and had to have whole-body or lumbar spine bone mineral density z scores of −1.0 or lower. All patients were prescribed daily vitamin D and calcium.  For the intervention vs control groups, the mean age was 13.6 years in both, 56% and 52% were male, and 84% and 79% were white.

Bone and Marker Outcomes

In total, 48 patients completed the trial, including 22 in the intervention group and 26 in the placebo group. Median adherence to the study regimen was 70.1% vs 63.7%. Mean whole-body bone mineral density z score on dual x-ray absorptiometry increased by 0.25 (standard deviation [SD] = 0.78) in the intervention group and decreased by 0.19 (SD = 0.79) in the placebo group (P = .05).

Circulating levels of the bone formation biomarker osteocalcin at 12 months correlated with change in total-body bone mineral density (r = 0.35, P = .02). Among intervention patients completing ≥ 70% of sessions, tibial trabecular bone increased by a mean of 11.2% vs a decrease of 1.3% among those completing < 70% of sessions (P = .02). Circulating levels of the bone turnover marker RANKL increased by 0.06 pmol/L in the intervention group vs a decrease of 0.04 pmol/L in the placebo group (P = .04).

The investigators concluded: “Pediatric cancer survivors with low bone mineral density may benefit from low-magnitude, high-frequency mechanical stimulation as a novel and safe intervention to optimize peak bone mass during youth, alone or in conjunction with other therapies.”

The study was supported by Gabrielle’s Angel Foundation, the National Institutes of Health, and the American Lebanese Syrian Associated Charities.

Kirsten K. Ness, PhD, of St. Jude Children’s Research Hospital, is the corresponding author of the JAMA Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.