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"Vibration therapy has been shown to increase bone mass in animals, astro-nauts and postmen-opausal women. We're hoping it can have the same ben-eficial effects in thalassemia patients as well."
New Treatment Gives Good Vibrations
CHORI Scientist Receives Cooley's Anemia Foundation Grant

CHORI clinical scientist Ellen Fung, PhD, has just been awarded a competitive Cooley's Anemia Foundation grant award to conduct a pilot feasibility study in thalassemia patients.

The only translational research proposal to receive funding, Dr. Fung's study will evaluate how well thalassemia patients accept and use vibration therapy in their homes for the treatment of osteoporosis. Osteoporosis, having weak or brittle bones, is a significant problem among patients with thalassemia.

A serious blood disorder in which the ability of hemoglobin to transport oxygen throughout the body is impaired, thalassemia has a variety of associated complications, including osteoporosis, with about 70 percent of thalassemia patients suffering from reduced bone density.

"The main reasons thalassemia patients are at risk for osteoporosis is that their bone marrow has to work overtime to make more red blood cells than normal, because these blood cells break down so quickly," says Dr. Fung. "The bone marrow inside the bone expands as a result, which makes the outside shell of your bone thinner than in a healthy non-thalassemic individual. Also, many patients with thalassemia don't have enough estrogen or testosterone (called hypogonadism), and that adversely effects your bone density, too."

But what does having weaker bones mean? It simply means having an increased risk of fracture. For older adults, fracturing dramatically increases the risk of morbidity and mortality. In kids and teens with thalassemia, osteoporosis can have a significant impact on their quality of life. As Dr. Fung explains, when you get a fracture at a young age, you have a greater likelihood of fracturing again.
"When you're fifteen and you suffer from a spine fracture because you fall a little too hard, the kind of break that normally happens when you're 80 years old, it really has an impact."
"These kids are less independent, they may have bone pain, and they are limited in the types of activites they can do," says Dr. Fung.

The best way to treat osteoporosis at any age is by prevention, but the normal recommendations for prevention - weight-bearing physical activity and supplementation - are harder to achieve in thalassmia patients with low bone mass.

"Most of these kids with thalassemia are already trying to follow the recommendations, but it's not enough. They don't have a lot of circulating hemoglobin, when means they have very little energy. Going out and jogging around the block isn't appealing or sometimes even possible," explains Dr. Fung. "They also may need more calcium and vitamin D compared to healthy adolescents, so even regular supplements aren't enough."

Which is where the low hertz frequency machine for vibration therapy comes in – a new technology that looks just like a typical bathroom scale and weighs about 20 pounds. First developed for astronauts with low bone mass after returning from space, the vibration machine provides a mechanical stimulus to the skeleton just like any weight-bearing exercise regimen.

“You just stand on the scale for about 10 minutes a day and it provides minimal vibration all through the skeleton that you can hardly feel,” says Dr. Fung. “The machine calibrates to the size of the patient. Depending on how much they weigh, it increases or decreases to provide same amount of vibration to each patient.”

During the 6-month pilot study, Dr. Fung will be measuring short term indicators of bone density in 20 thalassemia patients who use the vibration therapy each day. Dr. Fung doesn’t expect to see huge gains in bone density over such a short period of time, but what she does hope to find is that patients with thalassemia find it easy to comply with the regimen and accept it for daily use.

“If we can determine that patients like it and find it easy to use, then we can apply for a larger grant over a longer period of time, and hopefully determine that we can increase bone density in thalassemia patients just as easily as with other groups,” says Dr. Fung.

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Tuesday, May 17, 2011 8:19 AM

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