Whole body vibration training with quadriceps strengthening exercise may improve knee OA

Study Type: Randomized Trial
OE Level of Evidence: 2
Journal Level of Evidence: N/A
Synopsis
39 patients with medial compartment knee OA were randomized to either whole-body vibration training in combination with quadriceps strengthening exercise (WBVT+QSE) or quadriceps strengthening exercise alone (QSE-only). The objective of the study was to determine whether combination therapy provides superior results compared to monotherapy over a 3-month treatment period. Findings indicated that Please login to view the rest of this report. Please login to view the rest of this report.
Funding: Not Reported
Conflicts: None disclosed
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Why was this study needed now?
Knee osteoarthritis (OA) is a common musculoskeletal disorder that results in degradation of articular cartilage and inflammation of the knee joint. The strengthening of the quadriceps muscles has been shown to be an effective component of a successful multimodal management strategy for patients with this condition. Whole-body vibration training (WBVT) has been reported be an effective method to improve muscle strength, power, joint movement, balance, and flexibility by placing the patient on a platform that vibrates via ultrasound. The addition of WBVT to quadriceps strengthening exercises has been suggested to provide an additive effect in relieving and improving knee OA symptoms, therefore, the present study was warranted to evaluate the beneficial outcomes of this combined intervention.
What was the principal research question?
In the treatment of knee osteoarthritis, does the addition of whole-body vibration training to quadriceps strengthening exercises lead to greater improvements in pain, stiffness, and physical function compared to quadriceps strengthening exercises alone when assessed over a 16-week follow-up post protocol initiation?
Population: 39 primary symptomatic knee OA patients, between 40 and 80 years of age, were included in this study. Eligible patients had medial compartment knee OA as determined by radiographs, pain over the medial knee region, a Kellgren and Lawrence score of at least 2, and greater medial tibiofemoral joint narrowing and osteophyte grade than lateral tibiofemoral joint narrowing and osteophyte grade respectively. (36 completed)
Intervention: Whole body vibration training + quadriceps strengthening exercise (WBVT+QSE) group: a vibration device (My7 model Personal Plate, Power Plate; USA) was administered at a frequency of 35 Hz and an amplitude of 4 to 6mm displacement for 30 minutes daily, with alternating vibration and rest periods of 60 second intervals, 5 days per week, for a total of 12 weeks. Patients were in a standing position on the vibrating plate with knees flexed to about 30 degrees. Patients in this group also participated in quadriceps strengthening exercises as outlined below. (n=19; Mean age: 61.6 +/- 7.1; 9M/10F)
Comparison: Quadriceps strengthening only (QSE-only) group: four consecutive quadriceps strengthening exercise sessions were implemented. Exercises included static inner quadriceps contraction, quadriceps over fulcrum resistance, knee extension using a band while sitting, and squats using an exercise ball. (n=20; Mean age: 61.5 +/- 7.3; 7M/13F)
Outcomes: Pain was assessed using the visual analog scale (VAS). Pain, stiffness, and function were measured by the Western and McMaster Universities Osteoarthritis Index (WOMAC). The timed up and go (TUG) test was used to measure balance and mobility, and the 6-minute walk distance (6MWD) test was administered to assess functional performance. Three-dimensional (3D) gait analysis was done to assess spatiotemporal (double limb support, single limb support, walking speed, cadence, stride length) and kinetic (knee varus moment, knee valgus moment, knee power generation, ankle power generation) gait parameters.
Methods: RCT; single-center, assessor-blinded
Time: Outcomes were assessed at 12 and 16 weeks follow-up
What were the important findings?
What should I remember most?
How will this affect the care of my patients?
The authors responsible for this critical appraisal and ACE Report indicate no potential conflicts of interest relating to the content in the original publication.