In this study, we aimed to assess the safety and efficacy of physical exercise, with or without whole-body vibration (WBV), in patients with aromatase inhibitor-induced musculoskeletal symptoms (AIMSS). Eligible patients were adults (>= 18 years) with a history of breast cancer and current AIMSS. Enrolled patients (n = 22) were randomly assigned 1:1 to receive physical exercise combined with WBV or sham WBV for 4 weeks. The primary endpoint was pain intensity measured by numerical pain rating scale (NPRS). The secondary endpoints were muscle strength, physical function, physical performance, and quality of life. The WBV group (mean age 51.73 +/- 10.73 years; body mass index (BMI) 25.56 +/- 5.17 kg/m2) showed a statistically significant pain reduction (NPRS 6.82 +/- 1.17 versus 5.73 +/- 1.01; p = 0.031), whereas patients in the sham WBV group (mean age 58.55 +/- 9.71 years; BMI 27.31 +/- 3.84 kg/m2), did not reach statistical significance (NPRS 6.91 +/- 2.02 versus 5.91 +/- 2.51; p = 0.07). Concurrently, muscle strength, physical performance, and quality of life significantly improved in both groups, without significant differences between groups. No dropouts and no side effects were recorded. Both patients and the physical therapist reported a high level of satisfaction with the intervention. Our findings suggest that physical exercise and WBV combination might be a safe therapeutic option for improving the rehabilitative management of patients with AIMSS.

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