Effects of Whole-Body Vibration Therapy on Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Bibliographic record
Abstract
Introduction: Knee osteoarthritis is a leading cause of disability and medical costs. The effect of whole-body vibration in knee osteoarthritis is controversial. 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.Methods: PubMed, Scopus, Web of Science, Physiotherapy Evidence Database (PEDro) and EMBASE databases were searched (date last accessed 1 April 2021) using the key words “vibration” and “knee osteoarthritis”, to identify all randomized controlled trials related to whole-body vibration 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. A systematic review and meta-analysis were performed. Subgroup analysis was performed for low- and high-frequency interventions.Results: A total of 14 randomized controlled trials involving 559 patients with knee osteoarthritis met the inclusion criteria. Nine studies were good-quality trials (PEDro score=6–8), and 5 studies were fairquality trials (PEDro score=4–5). Ten studies were included in the meta-analysis. One study showed negative effects of whole-body vibration on knee osteoarthritis. The duration of whole-body vibration ranged from 4 to 24 weeks. Meta-analysis revealed that whole-body vibration with strengthening exercises has a significant treatment effect on pain score (standardized mean difference (SMD) = 0.46 points, 95% confidence interval (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 highfrequency (30–40 Hz) whole-body vibration 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.Conclusion: Meta-analysis showed that low-frequency and high-frequency whole-body vibration had additional positive effects compared with 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. LAY ABSTRACTKnee osteoarthritis is a leading cause of disability and medical costs. Osteoarthritis leads to pain, stiffness, swelling and loss of function, resulting in poor quality of life. Whole-body vibration is a non-invasive treatment that has been proposed to improve muscle strength and physical performance. This analysis of 14 randomized controlled trials showed that, compared with exercise alone, wholebody vibration with exercise had positive effects on pain, physical function, and knee extensor muscle strength in patients with knee osteoarthritis. Based on these findings, we recommend whole-body vibration used together with strengthening exercises for knee osteoarthritis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.022 | 0.047 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.027 | 0.041 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".