Whole-body vibration training and bone mineral density in older adults: an updated systematic review and meta-analysis

To evaluate the effects of whole-body vibration training on bone mineral density at different sites in the elderly population via meta-analysis. We systematically searched CNKI, VIP, Wanfang, China Biomedical Literature Database, PubMed, Cochrane Library, Embase, and Web of Science from inception to April 20, 2025, for randomized controlled trials comparing whole-body vibration training with conventional exercise on bone mineral density in elderly individuals. Methodological quality was assessed using the TESTEX (Tool for the Assessment of Study Quality and Reporting in Exercise) checklist, while risk of bias was evaluated with the Cochrane RoB 2.0 tool. Data were analyzed using Review Manager 5.4 for meta-analysis and heterogeneity assessment, Stata MP 18 for Egger’s test, and the GRADE framework for evidence quality evaluation. Fourteen studies involving 1,447 participants were included, with TESTEX = 9.5 (good quality) and risk of bias (21% low risk, and 79% some concerns). Results indicated that whole-body vibration training significantly increased bone mineral density in the Ward's triangle region (WMD=0.04, P < 0.00001) and greater trochanter region (WMD = 0.03, P = 0.0002) in the elderly. It also showed improvement effects on the femoral neck region (WMD = 0.01, P = 0.01) and lumbar spine L2‒L4 region (WMD = 0.04, P = 0.003). However, no significant effects were observed in the lumbar spine L1‒L4 region (WMD=0.00, P=0.79) or total hip region (WMD=0.01, P=0.56). Whole-body vibration training significantly increased bone mineral density in Ward's triangle and greater trochanter regions in elderly subjects, with smaller improvements in the femoral neck region. The L2‒L4 lumbar spine segment may substantially increase, whereas the L1‒L4 lumbar spine segment and total hip region have negligible effect. CRD420251038478.