"Good Vibrations" Studies Osteoporosis in Thalassemia
August 5, 2009 – Many patients with thalassemia develop bone mass issues, usually referred to as osteoporosis or osteopenia. One of this year’s CAF-funded medical research grants is looking at a special therapy to help address this problem.
|This is the first in a series of articles which will provide detailed information about the grants and fellowships awarded by CAF for the 2009-2010 award period. For a list of all of this year’s awardees, please click here.|
In recent years, CAF has initiated a category of translational research grants in addition to its decades-long program of medical research fellowships. Ellen Fung, PhD RD of Children’s Hospital & Research Center in Oakland, received a translational research grant for her project entitled “Good Vibrations: A pilot study of vibration therapy to improve bone health in patients with thalassemia induced osteoporosis.”
Dr. Fung describes her project in her abstract as follows:
Osteoporosis, or weak bones, affects patients with all types of thalassemia syndromes at all ages. It has been estimated that nearly 70% of adults with thalassemia have osteopenia or osteoporosis, which can lead to fracture, bone pain and decreased quality of life. The most effective way to treat osteoporosis is through prevention, by building strong, dense bones in childhood and adolescence. It has been shown in healthy individuals that cardiovascular, weight bearing physical activity strengthens bone by increasing mineralization as well as bone size. However, adherence to regular exercise can be difficult for patients with thalassemia due to low hemoglobin and energy levels or pre-existing heart disease. Recent advances in the field have shown that low magnitude mechanical stimulation or “vibration therapy” can also strengthen bone. This simple therapy can be conducted in the home and does not increase strain on the heart. The primary aim of this proposal is a pilot and feasibility trial to evaluate “vibration therapy” as an anabolic stimulus to bone in a small group of patients with thalassemia. The crossover intervention design will consist of 15 to 20 minute daily sessions in the home, standing on an active vibration platform or placebo. The study will examine bone density, size and strength by peripheral quantitative computed tomography and dual energy xray absorptiometry instrumentation. Factors which may respond more quickly to the intervention (markers of bone turnover) and those which may modify the effect of the intervention (growth hormone, vitamin D and sex hormone levels) will be measured at intervals throughout the study.
Dr. Fung has advanced training in nutrition and a long-standing interest in the impact of nutrition on children with chronic disease. Particular areas of concentration have included the assessment of energy expenditure, dietary intake, growth and body composition, bone density and trace mineral metabolism (zinc, iron, copper) in a variety of chronic pediatric disorders including cerebral palsy, cystic fibrosis, vitamin D deficiency rickets, sickle cell anemia and thalassemia. Her most recent NIH-funded project is a placebo controlled clinical trial to test the effect of zinc supplementation on bone health in patients with thalassemia. The Cooley’s Anemia Foundation-funded project, “Good Vibrations”, is a natural progression of the work she has been doing to improve overall bone health in patients with thalassemia.
Dr. Fung is an Assistant Clinical Research Scientist at the Children’s Hospital & Research Center in Oakland, CA. She also has Adjunct Associate positions at the University of California Davis, Nutrition department and the University of Pennsylvania School of Nursing. She previously held the Helen M. Shearer Endowed Term Professor of Nutrition at the University of Pennsylvania (1998-2000) and was a Dannon Nutrition Leadership Institute recipient in 1999. She has published over 40 peer-reviewed articles and book chapters and is an Editor of the first textbook related to the assessment of pediatric bone health, Bone Densitometry in Growing Patients: Guidelines for Clinical Practice , Humana Press, 2007.