The Effects of Whole-body Vibration Therapy on Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Author: Chenguang Qiu, Elvis Chun Sing Chui, Simon Kwoon Ho Chow, Wing-Hoi Cheung, Ronald Man Yeung Wong1
1 Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Hong Kong SAR.
Conference/Journal: J Rehabil Med
Date published: 2022 Feb 17
Other: Special Notes: doi: 10.2340/jrm.v54.2032. , Word Count: 355

Knee osteoarthritis is a leading cause of disability and medical costs. The effect of whole-body vibration is still controversial in knee osteoarthritis. The aim of this study was to assess the effects and safety of whole-body vibration on pain, stiffness, physical function, and muscle strength in patients with knee osteoarthritis.

Pubmed, Scopus, Web of Science, Physiotherapy Evidence Database (PEDro) and EMBASE databases were searched (date last accessed on April 1, 2021) using the keywords "vibration" and "knee osteoarthritis", to identify all randomized controlled trials related to WBV and knee osteoarthritis. Outcomes related to pain, stiffness, physical function, muscle strength, adverse events were included. The risk of bias and quality were assessed by the Cochrane collaboration tool and PEDro scale. Systematic review and meta-analysis were performed. Subgroup analysis was performed for low- and high-frequency interventions.

Fourteen randomized controlled trials involving 559 patients with knee osteoarthritis met the inclusion criteria. 9 studies were good quality trials (PEDro score = 6-8), 5 studies were fair quality trials (PEDro score = 4-5). 10 studies were included in the meta-analysis. One study showed negative effects of WBV on knee osteoarthritis. The duration of WBV treatment ranged from 4 to 24 weeks. Meta-analysis revealed that WBV with strengthening exercises has a significant treatment effect in pain score (SMD=0.46 points, 95% CI=0.20-0.71, p=0.0004), The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC-function) (SMD=0.51 points, 95% CI= 0.27-0.75, p<0.0001), timed up and go (TUG) test (SMD=0.82 points, 95% CI=0.46-1.18, p<0.00001), extensor isokinetic peak torque (SMD=0.65 points, 95% CI=0.00-1.29, p=0.05), peak power (SMD=0.68 points, 95% CI=0.26-1.10, p=0.001), and extensor isometric strength (SMD=0.44 points, 95% CI=0.13-0.75, p=0.006). Both low-frequency (10-30 Hz) and high-frequency (30-40 Hz) WBV were associated with significant changes in pain, physical function, and knee extensor strength (p<0.05). WBV was not associated with significant changes in stiffness, balance ability, quality of life, and knee flexor strength. No adverse events were reported.

Meta-analysis showed that low-frequency and high-frequency whole-body vibration had additional positive effects compared to strengthening exercises alone on pain, knee extensor muscle strength, and physical function in individuals with knee OA. whole-body vibration with strengthening exercises can be incorporated into treatment protocols.

PMID: 35174868 DOI: 10.2340/jrm.v54.2032