Swedish Agency for Health Technology Assessment and Assessment of Social Services
Whole-body vibration therapy for people who have an increased susceptibility to bone fractures, or osteoporosis
Bone fragility, or osteoporosis, is common in in the elderly, particularly among post-menopausal women. Whole-body vibration therapy (WBV) involves the patient standing on a vibrating platform. The therapy can be delivered one to several times a week, often over a longer time period. It has been suggested that WBV might build and strengthen bones in a manner much like other forms of physical training. Other potential effects of WBV include increased muscle strength, balance and mobility, which would be expected to reduce the risk of falls, and ultimately fractures, for this population.
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Question
What are the systematic reviews that examine the effects of whole-body vibration therapy for people with osteoporosis or elderly people with an increased susceptibility to fractures?
Identified literature
| Included studies | Population/Intervention | Outcome |
| Jepsen et al (2017) [1] | ||
| 14 RCTs | Population: 1 839 adults ≥50 years Mean age 74 years 90% women 82% living independently Intervention (studies): Sinusoidal WBV while standing on a platform Type of vibrations: side-alternating (5) vertical (9) Frequency: 12.5 to 40 Hz Magnitude: ≥1 g (11), <1x g (2) PPD: 0.7 to 4.2 mm Exposure: 1 to 7 sessions/week, 75 sec to 20 min exposure per session Control (studies): Continued daily activities (7), exercise or wellness therapy (3), sham (2), no treatment (2) Trial length: 6 weeks to 24 months |
Effects (studies): Falls (6) Fractures (1) Bone parameters (as secondary outcomes, 8) Adverse effects: Not addressed |
| Authors' conclusions: WBV reduces fall rates but seems to have no overall effect on BMD or microarchitecture. The impact of WBV on fractures requires further larger adequately powered studies.” |
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| Oliveira et al (2016) [2] | ||
| 17 RCTs | Population: 1 833 postmenopausal women, excluding secondary OP Mean ages 53 to 82.3 years 100% women Intervention (studies): Sinusoidal WBV training standing on a platform, concurrent lower limb exercise (6) Type of vibrations: Synchronous (8), side-alternating (8), not reported (2) Frequency 12 to 90 Hz Magnitude 0.1 to 10.9 x g PPD: 0.7 to 12 mm Exposure: 1 to 7 sessions per week, 1 to 30 min exposure per session, cumulative dose 208 to 78000 min Co-intervention (studies): Calcium (6), Alendronate (1) Control (studies): No activity (12), sham vibrations (1), walking (1), light exercise and relaxation (2) no control (1) Trial length: Minimum 6 months, range 6 to 18 months |
Effects (studies): BMD (17) at lumbar spine (10 studies), total hip (6), femoral neck (5), trochanter (3), ward’s area (2), radius (3), tibia (4) Adverse effects: 6 studies reported that no adverse effects were recorded. 7 studies reported transient minor adverse effects including pain in back or legs, dizziness, increased hypertension, itching legs, transient numbness in legs. 4 studies did not address adverse effects. |
| Authors' conclusions: “Our primary analysis found no significant effects associated with the WBV compared to control groups, either for the aBMD of the lumber spine, total hip, femoral neck, trochanter, and ward’s area, or for the vBMDt of the radius and tibia. However, when studies with low methodological quality were withdrawn there was significant difference in the aBMD of the lumbar spine in favour of the vibration, with an effect size of 0.004 g/cm2.” |
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| Lam et al (2012) [3] | ||
| 13 RCTs | Population: 949 older adults without primary diagnosis Mean ages 64.3 to 81.9 76.3% women 2 studies conducted in nursing homes (n=66) Intervention: WBV, concurrent lower limb exercise (6) Type of vibrations: synchronous (9), side-alternating (5), not reported (1) Frequency: 10 to 54 Hz Acceleration: 0.1 to 10.9 x g Amplitude=0.05 to 5 mm Exposure: 1 to 5 sessions per week, 1 to 27 pulses per session, pulse length 15 sec to 3 min Co-interventions: None reported Control (studies): Continued daily activities (1), balanced physical therapy (1), sham (3), no treatment (6), balanced vitamin D and calcium (1), unbalanced exercise (1) Trial length: 6 weeks to 18 months |
Effects (studies): Balance (10) Functional mobility (8 total, 7 with TUG) Fall risk (as secondary outcome, 2) Adverse effects: 3 studies reported that no adverse effects were recorded. 5 studies reported transient minor adverse effects: knee pain, erythema, oedema, itching legs, headache, groin pain, minor tingling in legs, muscle soreness. 5 studies did not address adverse effects. |
| Authors' conclusion: “WBV may be effective in improving relatively basic balance ability and mobility among older adults, particularly frailer ones. More good quality WBV trials are required.” |
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| Pollock et al (2012) [4] | ||
| 28 articles1: 22 RCTs 4 NRCTs 1 cross-over study 1 uncontrolled study |
Population: Participants over age 50 without know comorbidities other than OP (approx. 1 571 participants)2 Mean ages 57.3 to 81.9 years 100% women in 16 articles 3 studies conducted in nursing homes (n=179) Intervention (articles): Repeated exposure to WBV, concurrent lower limb exercise (15) Vibrations delivered while seated (1), or standing (27) Vibration orientation: rotational (14) or vertical (14) Frequency: 10 to 54 Hz Acceleration 0.02 to 5.09 x g PPD= 0.05 to 8 mm Exposure: 1 to 5 sessions per week, session length 3 to 40 min total, 1 pulse per session lasting 3 to 10 min, or 3 to 6 pulses lasting 45 to 80 sec Co-interventions: beyond exercise not discussed Control: Half of the studies did not have an appropriate control group (WBV was notthe only difference); subgroup analyses on studies with balanced exposures in both groups (well-controlled) Trial length: 6 to 52 weeks |
Effects (well-controlled studies/articles): BMD (5) at lumbar spine (3), hip/femoral neck (3), and trochanter (1) Strength (4) Power (2) Balance (6) Functional mobility (4) Adverse effects: 9 studies reported that no adverse effects were recorded. 13 studies reported transient minor adverse effects: knee pain, erythema, oedema, itching legs, headache, muscle soreness. 6 studies did not address adverse effects. |
| Authors' conclusions: There is some evidence supporting (the use of WBV) to improve strength, power, balance, mobility and bone strength, but these findings should be interpreted with caution, due to the fact that in a number of papers the effects of WBV cannot be separated from those of the additional exercises performed.” |
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| Lau et al (2011) [5] | ||
| 13 RCTs (18 articles) | Population: 896 adults over 50 years without primary diagnosis Mean ages 57.3 to 81.9 78% women 1 study conducted in nursing home (n=24), 1 in mixed settings (n=39). Intervention (studies): WBV, delivered while sitting (1) or while standing on a platform (12), concurrent lower limb exercise (6) Vibration orientation not reported Frequency 10 to 54 Hz Amplitude 0.05 to 8 mm Acceleration 0.05 to 32.2 x g Exposure: 1 to 7 sessions per week, 1 to 27 pulses per session lasting 30 sec to 10 min each Co-interventions (studies): Alendronate (1), exercise (4) Control (studies): No treatment (5), sham (2), unbalanced exercise (1), balanced exercise (4), balanced treatment with alendronate (1) Trial length: 6 weeks to 18 months |
Effects (studies): BMD at lumbar spine (5), total hip (2), femoral neck (2), peripheral sites (2) Leg strength (11) measured as isometric knee extension strength (3), dynamic knee extension strength (3), isometric leg extension (2), jumping height (3), and with the sit-to-stand test (3) Adverse effects: 3 studies reported that no adverse effects were recorded. 5 studies reported transient minor adverse effects: muscle soreness, fatigue erythema, oedema, itching legs, headache, groin pain, minor tingling in legs, and knee pain that correlated with pre-existing knee conditions. 5 studies did not address adverse effects. |
| Authors' conclusions: “Whole body vibration is beneficial for enhancing leg muscle strength among older adults. However, the review suggests that WBV has no overall treatment effect on BMD in older women. No randomized trial has examined the effects of WBV on bone mineral density in older men.” |
||
| 1. Some of the trials are reported in multiple articles according to some of the other review authors. While the authors do indicate which articles come from the same research group, they do not clearly indicate which articles stem from a single study. The authors appear to have avoided referring repeatedly to a single study in when synthesizing the results. 2. Participants per study was estimated based on judgements made by the other review authors. SR = Systematic review; RCT = Randomised controlled trial; NRCT = Non-randomised controlled trial; MA = Meta-analysis; BMD = Bone mineral density; aBMD = areal bone mineral denisty; vBMDt = trabecular volumetric bone mineral density; WBV = Whole-body vibration; TUG = Timed-up-and-go test; OP = Osteoporosis; PPD = Point to point displacement, measurement of vibration amplitude |
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References
- Jepsen, DB, Thomsen, K, Hansen, S, Jorgensen, NR, Masud, T, Ryg, J. Effect of whole-body vibration exercise in preventing falls and fractures: a systematic review and meta-analysis. BMJ Open. 2017; 7(12):e018342.
- Oliveira, LC, Oliveira, RG, Pires-Oliveira, DAA. Effects of whole body vibration on bone mineral density in postmenopausal women: a systematic review and meta-analysis. Osteoporosis International. 2016; 27(10):2913-33.
- Lam, FM, Lau, RW, Chung, RC, Pang, MY. The effect of whole body vibration on balance, mobility and falls in older adults: a systematic review and meta-analysis. Maturitas. 2012; 72(3):206-13.
- Pollock, RD, Martin, FC, Newham, DJ. The effect of whole body vibration on older people: a systematic review. Physical Therapy Reviews. 2012; 17(2):110-23.
- Lau, RW, Liao, LR, Yu, F, Teo, T, Chung, RC, Pang, MY. The effects of whole body vibration therapy on bone mineral density and leg muscle strength in older adults: a systematic review and meta-analysis. Clin Rehabil. 2011; 25(11):975-88.
Literature search
| The search result, usually found at the end of the documentation, forms the list of abstracts.; (MeSH) = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; (MeSH:NoExp) = Does not include terms found below this term in the MeSH hierarchy; (MAJR) = MeSH Major Topic; (TIAB) = Title or abstract; (TI) = Title; (AU) = Author; (OT) = Other term; (TW) = Text Word; Systematic(SB) = Filter for retrieving systematic reviews; * = Truncation | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | "Osteoporosis"(Mesh) or "Osteoporotic Fractures"(Mesh) or "Bone Density"(Mesh) or "Hip Fractures"(Mesh) or "Spinal Fractures"(Mesh) or "Accidental Falls"(Mesh) | 125278 |
| 2. | bone densit*(Title) or bone densit*(Other Term) or bone mineral densit*(Title) or bone mineral densit*(Other Term) or bone loss*(Title) or bone loss*(Other Term) or decalcification(Title) or decalcification(Other Term) or fall(Title) or fall(Other Term) or falls(Title) or falls(Other Term) or falling(Title) or falling (Other Term) or "accidental fall*"(Title) or "accidental fall*"(Other Term) or "fragility fracture*"(Title) or "fragility fracture*"(Other Term) or "hip fracture*"(Title) or "hip fracture*"(Other Term) or "femoral neck fracture*"(Title) or "femoral neck fracture*"(Other Term) "trochanteric fracture*"(Title) or "trochanteric fracture*"(Other Term) or "intertrochanteric fracture*"(Title) or "intertrochanteric fracture*"(Other Term) or "subtrochanteric fracture*"(Title) or "subtrochanteric fracture*"(Other Term) or "osseous densit*"(Title) or "osseous densit*"(Other Term) or osteoporo*(Title) or osteoporo*(Other term) or osteopenia*(Title) or osteopenia*(Other Term) or spine fracture*(Title) or spine fracture*(Other Term) or spinal fracture*(Title) or spinal fracture*(Other Term) or "slip and fall"(Other Term) or "slip and fall"(Title) or "fall and slip"(Title) or "fall and slip"(Other Term) or vertebra fracture*(Title) or vertebral fracture*(Title) or vertebra fracture*(Other Term) or vertebral fracture*(Other Term) | 79038 |
| 3. | 1 OR 2 | 148366 |
| 4. | ((bone densit*(Title/Abstract) or bone mineral densit*(Title/Abstract) or bone loss*(Title/Abstract) or decalcification(Title/Abstract) or fall(Title/Abstract) or falls(Title/Abstract) or falling(Title/Abstract) or "accidental fall*"(Title/Abstract) or "fragility fracture*"(Title/Abstract) or "hip fracture*"(Title/Abstract) or "femoral neck fracture*"(Title/Abstract) or "trochanteric fracture*"(Title/Abstract) or "intertrochanteric fracture*"(Title/Abstract) or "subtrochanteric fracture*"(Title/Abstract) or "osseous densit*"(Title/Abstract) or osteoporo*(Title/Abstract) or osteopenia*(Title/Abstract) or spine fracture*(Title/Abstract) or spinal fracture*(Title/Abstract) or "slip and fall"(Title/Abstract) or "fall and slip"(Title/Abstract) or vertebra fracture*(Title/Abstract) or vertebral fracture*(Title/Abstract))) NOT medline(sb)) | 32176 |
| 5. | 3 OR 4 | 169242 |
| Study types: Systematic review | ||
| 6. | systematic(sb) | 353687 |
| Limits | ||
| 7. | ((animals (MeSH) NOT humans (MeSH)) OR (rat(Title/Abstract) OR rats(Title/Abstract) OR mouse (Title/Abstract) OR mice (Title/Abstract) OR murine (Title/Abstract) OR rodent (Title/Abstract) OR rodents (Title/Abstract) OR hamster (Title/Abstract) OR hamsters (Title/Abstract) OR pig (Title/Abstract) OR pigs (Title/Abstract) OR pORcine (Title/Abstract) OR rabbit (Title/Abstract) OR rabbits (Title/Abstract) OR animal (Title/Abstract) OR animals (Title/Abstract) OR canine (Title/Abstract) OR canines (Title/Abstract) OR dog (Title/Abstract) OR dogs (Title/Abstract) OR cats (Title/Abstract) OR cow (Title/Abstract) OR bovine (Title/Abstract) OR sheep(Title/Abstract) OR ovine(Title/Abstract) OR monkey(Title/Abstract) OR monkeys(Title/Abstract))) | 5573846 |
| 8. | Filters activated: Danish, English, Norwegian, Swedish | |
| Combined sets | ||
| 9. | 5 AND 6 | 5302 |
| 10. | 9 NOT 7 | 5165 |
| 11. | 10 AND 8 | 4756 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; [MeSH] = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; [MeSH:NoExp] = Does not include terms found below this term in the MeSH hierarchy; [MAJR] = MeSH Major Topic; [TIAB] = Title or abstract; [TI] = Title; [AU] = Author; [OT] = Other term; [TW] = Text Word; Systematic[SB] = Filter for retrieving systematic reviews (updated after first search date); * = Truncation | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | "Osteoporosis"[Mesh] or "Osteoporotic Fractures"[Mesh] or "Bone Density"[Mesh] or "Hip Fractures"[Mesh] or "Spinal Fractures"[Mesh] or "Accidental Falls"[Mesh] | 132731 |
| 2. | bone densit*[Title] or bone densit*[Other Term] or bone mineral densit*[Title] or bone mineral densit*[Other Term] or bone loss*[Title] or bone loss*[Other Term] or decalcification[Title] or decalcification[Other Term] or fall[Title] or fall[Other Term] or falls[Title] or falls[Other Term] or falling[Title] or falling [Other Term] or accidental fall*[Title] or accidental fall*[Other Term] or fragility fracture*[Title] or fragility fracture*[Other Term] or hip fracture*[Title] or hip fracture*[Other Term] or femoral neck fracture*[Title] or femoral neck fracture*[Other Term] OR trochanteric fracture*[Title] or trochanteric fracture*[Other Term] or intertrochanteric fracture*[Title] or intertrochanteric fracture*[Other Term] or subtrochanteric fracture*[Title] or subtrochanteric fracture*[Other Term] or osseous densit*[Title] or osseous densit*[Other Term] or osteoporo*[Title] or osteoporo*[Other term] or osteopenia*[Title] or osteopenia*[Other Term] or spine fracture*[Title] or spine fracture*[Other Term] or spinal fracture*[Title] or spinal fracture*[Other Term] or "slip and fall"[Other Term] or "slip and fall"[Title] or "fall and slip"[Title] or "fall and slip"[Other Term] or vertebra fracture*[Title] or vertebral fracture*[Title] or vertebra fracture*[Other Term] or vertebral fracture*[Other Term] | 92318 |
| 3. | ((bone densit*[Title/Abstract] or bone mineral densit*[Title/Abstract] or bone loss*[Title/Abstract] or decalcification[Title/Abstract] or fall[Title/Abstract] or falls[Title/Abstract] or falling[Title/Abstract] or accidental fall*[Title/Abstract] or fragility fracture*[Title/Abstract] or hip fracture*[Title/Abstract] or femoral neck fracture*[Title/Abstract] or trochanteric fracture*[Title/Abstract] or intertrochanteric fracture*[Title/Abstract] or subtrochanteric fracture*[Title/Abstract] or osseous densit*[Title/Abstract] or osteoporo*[Title/Abstract] or osteopenia*[Title/Abstract] or spine fracture*[Title/Abstract] or spinal fracture*[Title/Abstract] or "slip and fall"[Title/Abstract] or "fall and slip"[Title/Abstract] or vertebra fracture*[Title/Abstract] or vertebral fracture*[Title/Abstract])) NOT medline[sb]) | 36999 |
| 4. | 1 OR 2 OR 3 | 183039 |
| Combined sets, limited to systematic reviews, humans, languages | ||
| 5. | 4 AND systematic[SB] | 2181 |
| 6. | 5 NOT ((animals[MeSH] NOT humans[MeSH]) | 2171 |
| 7. | 6 AND (english[la] OR swedish[la] OR danish[la] OR norweigan[la]) | 2131 |
| 8. | 7 AND Filters activated: Publication date from 2018/02/01 | 483 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; /de = Term from the EMTREE controlled vocabulary; /exp = Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti:ab = Title or abstract; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | 'osteoporosis'/exp/mj or 'fragility fracture'/exp/mj or 'bone density'/exp/mj or 'hip fracture'/exp/mj or 'spine fracture'/exp/mj or 'falling'/exp/mj | 119443 |
| 2. | ('bone densit*' or 'bone mineral densit*' or 'bone loss*' or decalcification or fall or falls or falling or 'accidental fall*' or 'fragility fracture*' or 'hip fracture*' or 'femoral neck fracture*' or 'trochanteric fracture*' or 'intertrochanteric fracture*' or 'subtrochanteric fracture*' or 'osseous densit*' or osteoporo* or osteopenia* or 'spine fracture*' or 'spinal fracture*' or 'slip and fall' or 'fall and slip' or 'vertebra fracture*' or 'vertebral fracture*'):ti,kw | 121513 |
| 3. | 1 OR 2 | 159136 |
| Systematic review | ||
| 4. | 'systematic review'/exp OR 'meta analysis'/de OR (systematic* NEXT/3 (review* OR overview)):kw,ti,ab OR (systematic* NEXT/3 bibliographic*):kw,ti,ab OR (systematic* NEXT/3 literature):kw,ti,ab OR (meta-analy* or metaanaly*):kw,ti,ab | 320096 |
| Limits | ||
| 5. | (('animal'/exp OR 'nonhuman'/exp) NOT 'human'/exp) | 6328563 |
| 6. | (danish)/lim OR (english)/lim OR (norwegian)/lim OR (swedish)/lim | 27541421 |
| Combined sets | ||
| 7. | 3 AND 4 | 3873 |
| 8. | 7 NOT 5 | 3849 |
| 9. | 8 AND 6 | 3568 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; /de = Term from the EMTREE controlled vocabulary; /exp= Includes terms found below this term in the EMTREE hierarchy; /mj = Major Topic; :ab = Abstract; :au = Author; :ti = Article Title; :ti:ab = Title or abstract; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | 'osteoporosis'/exp/mj or 'fragility fracture'/exp/mj or 'bone density'/exp/mj or 'hip fracture'/exp/mj or 'spine fracture'/exp/mj or 'falling'/exp/mj | 127,089 |
| 2. | ('bone densit*' or 'bone mineral densit*' or 'bone loss*' or decalcification or fall or falls or falling or 'accidental fall*' or 'fragility fracture*' or 'hip fracture*' or 'femoral neck fracture*' or 'trochanteric fracture*' or 'intertrochanteric fracture*' or 'subtrochanteric fracture*' or 'osseous densit*' or osteoporo* or osteopenia* or 'spine fracture*' or 'spinal fracture*' or 'slip and fall' or 'fall and slip' or 'vertebra fracture*' or 'vertebral fracture*'):ti,kw | 134,720 |
| 3. | 1 OR 2 | 171,362 |
| Combined sets: limited to systematic review, humans, languages | ||
| 4. | 3 AND ('systematic review'/exp OR 'meta analysis'/de OR (systematic* NEXT/3 (review* OR overview)):kw,ti,ab OR (systematic* NEXT/3 bibliographic*):kw,ti,ab OR (systematic* NEXT/3 literature):kw,ti,ab OR (meta-analy* or metaanaly*):kw,ti,ab) | 4,527 |
| 5. | 4 NOT (('animal'/exp OR 'nonhuman'/exp) NOT 'human'/exp) | 4,499 |
| 6. | 5 AND ([danish]/lim OR [english]/lim OR [norwegian]/lim OR [swedish]/lim) | 4,119 |
| 7. | 5 AND [1-2-2018]/sd | 837 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; (mh) = Term from the Medline controlled vocabulary, including term explosion (terms found below this term in the MeSH hierarchy); (mh ^) = Term from the Medline controlled vocabulary, without term explosion; :ti, ab, kw = Title or abstract or keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | (mh "Osteoporosis") or (mh "Osteoporotic Fractures") or (mh "Bone Density") or (mh "Hip Fractures") or (mh "Spinal Fractures") or (mh "Accidental Falls") | 8740 |
| 2. | ("bone densit*" or "bone mineral densit*" or "bone loss*" or decalcification or fall or falls or falling or "accidental fall*" or "fragility fracture*" or "hip fracture*" or "femoral neck fracture*" or "trochanteric fracture*" or "intertrochanteric fracture*" or "subtrochanteric fracture*" or "osseous densit*" or osteoporo* or osteopenia* or "spine fracture*" or "spinal fracture*" or "slip and fall" or "fall and slip" or "vertebral fracture*" or "vertebral fracture*"):ti,kw | 17233 |
| 3. | 1 OR 2 | 17490 |
| CDSR/118 DARE/762 Central/ 16034 CRM/33 HTA/246 EED/297 |
||
| The search result, usually found at the end of the documentation, forms the list of abstracts.; :au = Author; MeSH = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; this term only = Does not include terms found below this term in the MeSH hierarchy; :ti = title; :ab = abstract; :kw = keyword; * = Truncation; “ “ = Citation Marks; searches for an exact phrase; CDSR = Cochrane Database of Systematic Review; CENTRAL = Cochrane Central Register of Controlled Trials, “trials”; CRM = Method Studies; DARE = Database Abstracts of Reviews of Effects, “other reviews”; EED = Economic Evaluations; HTA = Health Technology Assessments | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | [mh "Osteoporosis"] or [mh "Osteoporotic Fractures"] or [mh "Bone Density"] or [mh "Hip Fractures"] or [mh "Spinal Fractures"] or [mh "Accidental Falls"] | 8795 |
| 2. | ("bone density" or "bone mineral density" or "bone loss" or decalcification or fall or falls or falling or "accidental fall" or "accidental falls" OR "accidental falling" or "fragility fracture" or "fragility fractures" or "hip fracture" or "hip fractures" or "femoral neck fracture" or "femoral neck fractures" or "trochanteric fracture" OR "trochanteric fractures" or "intertrochanteric fracture" or "intertrochanteric fractures" or "subtrochanteric fracture" or "subtrochanteric fractures" or "osseous density" or osteoporo* or osteopenia* or "spine fracture" or "spine fractures" or "spinal fracture" or "spinal fractures" or "slip and fall" or "fall and slip" or "vertebral fracture" or "vertebral fractures"):ti,kw | 21226 |
| 3. | 1 OR 2 | 21230 |
| CDSR/101 | ||
| Limits: with Cochrane Library publication date from Feb 2018 to Apr 2019 | CDSR/8 | |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; .ab. = Abstract; .ab,ti. = Abstract or title; .af. = All fields; Exp = Term from the Medline controlled vocabulary, including terms found below this term in the MeSH hierarchy; .sh. = Term from the Medline controlled vocabulary; .ti. = Title; / = Term from the Medline controlled vocabulary, but does not include terms found below this term in the MeSH hierarchy; * = Focus (if found in front of a MeSH-term); * or $ = Truncation (if found at the end of a free text term); .mp = text, heading word, subject area node, title | ||
| Search terms | Items found | |
| Population: Osteoporosis | ||
| 1. | exp Osteoporosis/ or Osteoporotic Fractures/ or Bone Density/ or exp Hip Fractures/ or exp Spinal Fractures/ or exp Accidental Falls/ | 132668 |
| 2. | ("bone densit*" or "bone mineral densit*" or "bone loss*" or decalcification or fall or falls or falling or "accidental fall*" or "fragility fracture*" or "hip fracture*" or "femoral neck fracture*" or "trochanteric fracture*" or "intertrochanteric fracture*" or "subtrochanteric fracture*" or "osseous densit*" or osteoporo* or osteopenia* or "spine fracture*" or "spinal fracture*" or "slip and fall" or "fall and slip" or "vertebra fracture*" or "vertebral fracture*").ti,kw. | 90585 |
| 3. | 1 OR 2 | 157898 |
| Combined sets, limited to systematic reviews, languages | ||
| 4. | 3 AND systematic review[SB] | 5150 |
| 5. | 3 AND meta-analysis/ | 1457 |
| 6. | 4 OR 5 | 5154 |
| 7. | 6 limited to (danish or english or norwegian or swedish) | 4739 |
| 8. | 7 limited to (yr="2018 -Current") | 429 |
| The search result, usually found at the end of the documentation, forms the list of abstracts.; AB = Abstract; AU = Author; DE = Term from the thesaurus; MM = Major Concept; TI = Title; TX = All Text. Performs a keyword search of all the database's searchable fields; ZC = Methodology Index; * = Truncation; “ “ = Citation Marks; searches for an exact phrase | ||
| Search terms | Items found | |
| Population: osteoporosis | ||
| 1. | (MH "Osteoporosis") OR (MH "Osteoporotic Fractures") OR (MH "Bone Density") OR (MH "Hip Fractures+") OR (MH "Spinal Fractures+") OR (MH "Accidental Falls") | 56,822 |
| 2. | TI ("bone densit*" or "bone mineral densit*" or "bone loss" or decalcification or fall or falls or falling or "fragility fracture*" or "hip fracture*" or "femoral neck fracture*" or "trochanteric fracture*" or "intertrochanteric fracture*" or "subtrochanteric fracture*" or "osseous densit*" or osteoporo* or osteopenia* or "spine fracture*" or "spinal fracture*" or "slip and fall" or "fall and slip" or "vertebra fracture*" or "vertebral fracture*") | 36,907 |
| 3. | 1 OR 2 | 65,739 |
| Study type: systematic review | ||
| 4. | MH "Systematic Review" OR ZT "systematic review" OR MH "Meta Analysis" OR ZT "meta analysis" | 108,478 |
| 5. | (TI (systematic* n3 review*)) or (AB (systematic* n3 review*)) or (TI (systematic* n3 bibliographic*)) or (AB (systematic* n3 bibliographic*)) or (TI (systematic* n3 literature)) or (AB (systematic* n3 literature)) or (TI (comprehensive* n3 literature)) or (AB (comprehensive* n3 literature)) or (TI (comprehensive* n3 bibliographic*)) or (AB (comprehensive* n3 bibliographic*)) or (TI (integrative n3 review)) or (AB (integrative n3 review)) or (JN "Cochrane Database of Systematic Reviews") or (TI (information n2 synthesis)) or (TI (data n2 synthesis)) or (AB (information n2 synthesis)) or (AB (data n2 synthesis)) or (TI (data n2 extract*)) or (AB (data n2 extract*)) or (TI (medline or pubmed or psyclit or cinahl or (psycinfo not "psycinfo database") or "web of science" or scopus or embase)) or (AB (medline or pubmed or psyclit or cinahl or (psycinfo not "psycinfo database") or "web of science" or scopus or embase)) or (TI (meta-analy* or metaanaly*)) or (AB (meta-analy* or metaanaly*)) | |
| 6. | 4 OR 5 | |
| Combined sets & limits | ||
| 7. | 3 AND 6 | 2,743 |
| 8. | 7 AND Limiters - Language: Danish, English, Norwegian, Swedish | 2,670 |
| 9. | 8 AND Limiters - Published Date: 20180101-20191231 | 351 |
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