This study aims to explore the effects of Whole-Body Vibration (WBV) exercises and relaxation techniques on adolescent female athletes who are experiencing Female Athlete Triad Syndrome - a condition that may include low bone density, irregular menstrual cycles, and low energy availability.
Participants will take part in a structured program combining vibration training and relaxation sessions over several weeks. The goal is to determine whether this combination can improve bone health, menstrual regularity, physical performance, and overall well-being in young female athletes.
Low energy availability (with or without disordered eating)
Menstrual dysfunction (oligomenorrhea)
Low bone mineral density or a history of stress fractures
Recent fractures or unhealed stress fractures within the last 6 months.
Presence of serious medical conditions that contraindicate WBV or exercise participation, such as: Uncontrolled cardiovascular disease, Uncontrolled hypertension, Neurological disorders, Severe vestibular disorders, Active cancer, Bleeding/clotting disorders.
Severe eating disorder requiring inpatient medical or psychiatric treatment.
Current use of medications that significantly affect bone or hormonal status
Parallel
whole body vibration device
DeviceParticipants in study group will receive a combination of Whole-Body Vibration (WBV) training and relaxation techniques during the same intervention period. Each session will include approximately 15-20 minutes of WBV exercises performed on a vibration platform under physiotherapist supervision, followed by 20-30 minutes of guided relaxation training involving deep breathing, progressive muscle relaxation, and mindfulness-based relaxation. The sessions will be conducted three times per week for 8 weeks. In control group participant will receive relaxation techniques the program will include a combination of guided breathing exercises, progressive muscle relaxation, and mindfulness-based relaxation.Each session will last about 20-30 minutes, conducted three times per week for 8 weeks, supervised by a physiotherapist or psychologist trained in relaxation therapy.
relaxation training
Other interventionfor both groups (A\&B) will receive relaxation Techniques Training The program may include: 1. Diaphragmatic (Deep) Breathing Focus on slow, controlled breathing from the diaphragm Typically: 4-6 breaths per minute 2. Progressive Muscle Relaxation (PMR) Tensing and relaxing different muscle groups Increases body awareness and reduces physical tension 3. Autogenic Training Uses visualizations and self-suggestions to induce relaxation (e.g., "My arms feel heavy and warm") Enhances self-regulation and calmness 4. Mindfulness Meditation Focuses on present-moment awareness Helps reduce intrusive thoughts, improve attention and emotional regulation
hormonal regularity
hormonal regularity via Estrogen serum analysis It involves measuring the levels of estrogens (primarily estradiol) in the blood to evaluate reproductive health, menstrual cycle function, fertility, menopause status, or hormonal disorders.
bone mineral density
bone mineral density via DEXA. that used to diagnose osteoporosis, assess fracture risk, and monitor changes in bone over time. The gold standard for assessing BMD is the DEXA scan (also known as DXA, or Dual-Energy X-ray Absorptiometry).
psychological well-being
psychological well-being via Hamilton Anxiety Rating Scale (HAM-A) (Hamilton, 1959) This scale measures the anxiety symptoms severity. It has 14 items and series of symptoms define every item. 5 point Likert scale is used to rate each item i.e. (1) never, (2) rarely, (3) sometimes, (4) very often, (5) always. Mild anxiety is indicated by lowest score and the highest scores indicate severe anxiety.
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