Effects of Vibration Exercise on Knee Pain and Function

February 19, 2009 · 9 Comments

Knee pain and impairment are common conditions that present to a Chiropractic office. Treatment programs range from passive modalities for pain control, low tech rehabilitation, to a full blown comprehensive rehabilitation program. However, vibration exercise platforms are continuing to increase in popularity in offices, providing the doctor with a safe and quick rehabilitation program in a small square footage of area. A couple of new studies have been published in the past several months that take a look at vibration effects on knee pain and impairment. Not only are the results positive, but the implications for practice is significant. Let’s take a look at the most recent study:

Trans T, et al. Effect of whole body vibration exercise on muscle strength and proprioception in females with knee osteoarthritis, The Knee (2009)

This study compared the effects of vibration on knee strength and proprioception to a control group. Results indicated significant increases in knee muscle strength and proprioception with the vibration group. What was interesting was comparing two different types of platforms: one was a balance board with vibration effects, while the other was a flat platform. There was more proprioceptive improvements in the group with balance board vibration. However, there was greater strength increases in the flat platform vibration group. The study is significant because its one of the first few studies to actually take a look at effects on osteoarthritis. The only thing the study did not show was any changes in self reported disease status measurements.

The results of this study point to several key points that need to be considered when looking at implementing a vibration platform in your practice. The strength gains in this study are similar to strength gains seen in other vibration studies so we know that there is an effective increase in strength. The exciting part is that the setting parameters used were relatively low. In a practical setting, we are able to progress the patient to higher parameter levels. Keep in mind that vibration exercise is a high intensity form of exercise, while maintaining minimal load on the body. Utilizing weight exercises at this high intensity is sometimes not possible in light of stresses and shearing forces on the joints. I would expect to see more significant strength gains if the parameters were based on individual progression. However, this is usually not possible in a research study.

This study used vibration exercise 2 times per week for approximately 10 minutes. This is significant for a chiropractic practice that may not have a lot of time to provide a comprehensive rehabilitation program. However, it would have been interesting to see the results from increasing the frequency to 3 times per week, which is sometimes the right amount of dose for any strength training program.

This study didn’t find any changes in self reported disease status measurements, although there were several other studies that have ( Bruyere et al., Cheung et al., Roelants M et al. ). Again, one needs to consider that the progression was consistent and not individualized to each person’s presentation. In addition to simple strength training exercises, I also incorporate muscle facilitation techniques that increase the contraction of the Vastus Medialis. This allows for faster stabilization of the knee joint musculature.

No matter how you cut it, new research into arthritis and vibration exercise are showing positive results. Considering this is an exercise modality that takes up very little space and can be done in a relatively short period of time with minimal loads and stresses on your patient, a Chiropractic practice is now equipped with a unique new exercise modality that can benefit a diverse range of the patient population.

Bruyere O, et al. Controlled whole body vibration to decrease fall risk and improve health-related quality of life of nursing home residents. Arch Phys Med Rehabil 2005; 86(2): 303-7.

Cheung WH, et al. High – frequency whole body vibration improves balancing ability in elderly women. Arch Phys Med Rehabil 2007; 88(7): 852 – 7.

Roelants M, Declecluse C, Verschueren SM. Whole-body-vibration training increases knee-extension strength and speed of movement in older women. J Am Geriatr Soc 2004; 52 (6): 901 – 8.

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9 responses so far ↓

  •   Chiropractor Back Blog » » Effects of Vibration Exercise on Knee Pain and Function … // Mar 1st 2009 at 8:54 pm

    [...] planetc1.com-news posted a noteworthy aricle today onHere’s a small snippetKnee pain and impairment are common conditions that present to a Chiropractic office. Treatment programs range from passive modalities for pain control, low tech rehabilitation, to a full blown comprehensive rehabilitation program. … [...]

  •   Chiropractor Back Blog » Effects of Vibration Exercise on Knee Pain and Function // Mar 2nd 2009 at 7:51 am

    [...] Matthew Loop DC posted a noteworthy aricle today onHere’s a small snippetThis is significant for a chiropractic practice that may not have a lot of time to provide a comprehensive rehabilitation program. However, it would have been interesting to see the results from increasing the frequency to 3 times per … [...]

  •   Jessica // Mar 24th 2009 at 5:55 pm

    I was wondering if I could do vibration therapy with a tore MCL and ACL. My Orthopedic Surgeon is hoping my MCL will heal on its own (I see him again in 2 more months) If it does then they will repair my ACL. Thank-you

  •   Dr. Jasper Sidhu // Mar 24th 2009 at 6:05 pm

    Hi Jessica

    Your question brings up many variables that must be looked at before making a decision to use vibration exercise for your MCL and ACL. In order to assess the efficacy of using vibration exercise, one has to know whether there is pain upon movement, if there is swelling present and if any form of exercise if painful. Also, we need to understand what your goals of vibration exercise will be. Vibration exercise will not heal your MCL. What it can do is provide you with an effective strengthening program prior to surgery, which may lead to better outcomes after surgery. If you do decide to pursue with vibration exercise, always make sure you pay attention to any increasing symptoms such as pain or swelling. If this does not happen, then vibration exercise can be effective in getting you prepared for your surgery. I hope this answers your question, but make sure you discuss this with the health professional that is helping you with your rehabilitation.

  •   Jessica // Mar 24th 2009 at 8:00 pm

    Thank-you for you quick response! I plan on using it to strengthen my leg before and after surgery. I am hoping it will speed up my recovery time. It has been 5 weeks since my skiing accident, my swelling has gone down a tremendous amount but I still have some swelling. I wear a DonJoy, see a Chiropractor and still workout with my PT, 2 to 3x a week (only rehab work on bad knee). I Just want to get back to running! Thanks again.

  •   mandi // Apr 14th 2009 at 12:55 pm

    hello, i work for a chiroprctor, and we are considering using vibration therapy. we currntly comine discforce deconmpression with several other therapies such as rebounding, hydrotherapy massage, and so on… my question to you is, I see information reguarding the effect this therapy has on your knees, what bout the hip? is it just as beneficial?

  •   Dr. Jasper Sidhu // Apr 15th 2009 at 5:05 pm

    Hi Mandi,

    vibration exercise is good for all body parts because at the end of the day, it’s an effective exercise device. In order to target the hip, it’s really about utilizing various positions on the platform to target the hip.

    For the hip, it depends on what you are trying to achieve. If it’s strengthening, then various strengthening exercises can be incorporated. We have also developed some protocols on mobilizing the hip joint in addition to stretching out some of the muscles around the area.

    The benefits with vibration is that its’ much easier and faster to perform. For a lot of patients that may be limited in their ability to perform some of these exercises, utilizing the vibration platform may be more appropriate. If you have any more specific questions about how it can be used within the practice, you can email me at jsidhu@wavexercise.com and I will be happy to answer any other questions you may have.

  •   Dr. Brian Pierce // Aug 13th 2009 at 6:28 am

    I have begun to utlize WBV in my office as a form of neuromuscular reeducation, as well as a introduction back into exercise. I am interested on articles relating to treating spinal cord injuries. Assessment outcomes, etc. Can you give me some direction?

  •   Dr. Jasper Sidhu // Oct 3rd 2009 at 2:29 pm

    Hi Dr. Pierce

    I apologize for not getting back to you sooner regarding spinal cord injury and vibration. Please see the following points regarding this:

    Our company has been dealing with several hospitals, therapists and research universities regarding spinal cord injury and assessing such outcomes as bone density, decrease spasticity, central effects of vibration, etc.

    I have a therapists in Michigan that will be starting a center of excellence for vibratoin training and spinal cord injury and will soon be providing educational seminars on this topic. If you want his contact information, just let me know. We believe that developing these type of centers and disseminating the right information through experience and research is the way to go. Apart from that, most of what you will find out there is the experience of other therapists and doctors that have used vibration in their practices.

    I will also provide you the following references for recent articles on spinal cord injury and vibration. Hope this also helps. It’s an exciting field in treating patients that may not engage in conventional exercise or those that need an early adoption of exercise:

    Whole-body vibration improves walking function in individuals with spinal cord injury: a pilot study.

    Ness LL, Field-Fote EC.

    Gait Posture. 2009 Nov;30(4):436-40. Epub 2009 Aug 3.

    Increases in muscle activity produced by vibration of the thigh muscles during locomotion in chronic human spinal cord injury.

    Cotey D, Hornby TG, Gordon KE, Schmit BD.

    Exp Brain Res. 2009 Jul;196(3):361-74. Epub 2009 May 29.

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