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Here, we applied this technology to a cohort of postmenopausal women with varying bone mineral density (BMD) T-scores at the total hip (\u22120.524\u2009\u00b1\u20090.843) and spine (\u22120.795\u2009\u00b1\u20091.03) to examine the response to intervention after 1\u2009year of daily treatment with 10\u2009minutes of vibration therapy in a randomized double-blinded trial. The device operates either in an active mode (30\u2009Hz and 0.3\u2009g) or placebo. Primary endpoints were changes in bone stiffness at the distal tibia and marrow adiposity of the vertebrae, based on 3 Tesla high-resolution MRI and spectroscopic imaging, respectively. Secondary outcome variables included distal tibial trabecular microstructural parameters and vertebral deformity determined by MRI, volumetric and areal bone densities derived using peripheral quantitative computed tomography (pQCT) of the tibia, and dual-energy X-ray absorptiometry (DXA)-based BMD of the hip and spine. Device adherence was 83% in the active group (n = 42) and 86% in the placebo group (n = 38) and did not differ between groups (p = .7). The mean 12-month changes in tibial stiffness in the treatment group and placebo group were +1.31\u2009\u00b1\u20096.05% and \u22122.55\u2009\u00b1\u20093.90%, respectively (group difference 3.86%, p = .0096). In the active group, marrow fat fraction significantly decreased after 12\u2009months of intervention (p = .0003), whereas no significant change was observed in the placebo group (p = .7; group difference \u22121.59%, p = .029). Mean differences of the changes in trabecular bone volume fraction (p = .048) and erosion index (p = .044) were also significant, as was pQCT-derived trabecular volumetric BMD (vBMD; p = .016) at the tibia. The data are commensurate with the hypothesis that vibration therapy is protective against loss in mechanical strength and, further, that the intervention minimizes the shift from the osteoblastic to the adipocytic lineage of mesenchymal stem cells. \u00a9 2020 American Society for Bone and Mineral Research (ASBMR).<\/jats:p>","DOI":"10.1002\/jbmr.4229","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T21:20:37Z","timestamp":1607894437000},"page":"673-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Effect of Low-Intensity Vibration on Bone Strength, Microstructure, and Adiposity in Pre-Osteoporotic Postmenopausal Women: A Randomized Placebo-Controlled Trial"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9247-833X","authenticated-orcid":false,"given":"Chamith S","family":"Rajapakse","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa J","family":"Johncola","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra S","family":"Batzdorf","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon C","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Al Mukaddam","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Pennsylvania Philadelphia PA USA"},{"name":"Department of Orthopaedic Surgery University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Sexton","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justine","family":"Shults","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Epidemiology, and Informatics University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary B","family":"Leonard","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Stanford University School of Medicine Stanford CA USA"},{"name":"Department of Pediatrics, Children's Hospital of Philadelphia University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J","family":"Snyder","sequence":"additional","affiliation":[{"name":"Department of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix W","family":"Wehrli","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,12,13]]},"reference":[{"issue":"3","key":"2024012713495329900_jbmr4229-bib-0001","doi-asserted-by":"crossref","first-page":"197","DOI":"10.7326\/0003-4819-148-3-200802050-00198","article-title":"Systematic review: comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis","volume":"148","author":"MacLean","year":"2008","journal-title":"Ann Intern 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