3 weeks of vibration therapy reduces pain and increases mobility in people with knee osteoarthritis

Knee degeneration is a common orthopaedic condition that affects millions of people worldwide. Although these degenerations are often associated with ageing, they can also occur in younger people for a variety of reasons. In this article, we will discuss the causes, symptoms and available treatments for knee degeneration.

Causes of knee osteoarthritis

The causes of knee osteoarthritis are very varied. They can be caused by one factor or many at once. The process of ageing is one of the main causes of knee degeneration. As the body ages, the articular cartilage that protects the bones from wear and tear can wear down and reduce its elasticity. Another cause is excess weight. Overweight and obesity are key risk factors for knee degeneration. The extra strain on the knee joints can lead to accelerated wear and tear of the articular cartilage. In younger people, injuries are often the cause of knee degeneration. This indicates sports injuries, car accidents or other injuries to the knee joints can damage the articular cartilage and lead to degeneration. A tendency to knee degeneration can be hereditary. If there is a family history of the condition, there is a higher risk of it occurring in offspring.

Symptoms of knee osteoarthritis

Symptoms of knee degeneration can vary depending on the severity of the condition. Here are some of the most common symptoms:

• Pain: Pain in the knee area is one of the most troublesome symptoms of arthritis. It can be moderate to severe and can occur both during physical activity and at rest.
• Stiffness: People with knee osteoarthritis often experience joint stiffness, especially after prolonged periods of rest.
• Reduced mobility: Reduced ability to bend and straighten the knee joints is another characteristic symptom of arthritis.
• Crackling or popping in the joint: Sounds such as crackling or popping in the knee joint can accompany movement and are often a sign of damage to the articular cartilage.

Treatment methods for knee osteoarthritis

Treatment of knee osteoarthritis depends on the severity of the condition and the individual patient’s needs. Here are some commonly used treatment methods:

• Physical therapy: Physical therapy therapies including vibration therapy can help to strengthen the muscles around the knee joint and improve range of motion, which can provide relief from arthritis.
• Pain medications: Painkillers, such as non-steroidal anti-inflammatory drugs (NSAIDs), can help relieve pain and inflammation.
• Steroid injections: steroid injections into the knee joint can help reduce inflammation and pain.
• Supplements and diet: Certain supplements, such as glucosamine and chondroitin, can support joint health. A healthy diet and maintaining a healthy weight also play an important role.
• Surgery: In cases of advanced knee degeneration, surgery such as arthroscopy, knee replacement or osteotomy may be required.

Osteoarthritis

Osteoarthritis (OA) is one of the most commonly recorded diseases in clinical practice. Vibration therapy has been proposed for the treatment of osteoarthritis of the knee. The aim of this study was to determine the effect of variable-frequency, low-amplitude vibration on pain sensation and mobility in patients suffering from knee osteoarthritis.

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Study population

A total of 32 people participated in the study, divided into two groups. The sample size was determined by performing an a priori power analysis. Sixteen patients were included in the treatment group. The control group also comprised 16 subjects. The age of the subjects included in the study ranged from 42 to 79 years (mean 64.28 years), their mean body weight was 82.18 kg and their body height was 1.62 m. Patients included in the study were diagnosed with advanced knee osteoarthritis grade II based on the Kellgren-Lawrence scale. The progression of degenerative changes was assessed by a specialist in orthopaedics and musculoskeletal traumatology. The knee joint, which was characterised by a higher degree of degenerative changes, was considered for analysis.

Study procedure

Thirty-two participants were allocated to two groups – Group 1 (oscillatory-cycloidal vibration therapy – WOC) and Group 2 – control (sham therapy). Participants were diagnosed with degenerative changes in the knee (grade II based on the Kellgren-Lawrence (KL) scale). Patients received 15 sessions of vibration therapy and sham therapy (placebo), respectively. Pain, range of motion and functional disability were assessed using the visual analogue scale (VAS), Laitinen questionnaire, goniometer (ROM – range of motion), stand up and walk test (TUG) and the knee injury and osteoarthritis outcome scale (KOOS). Measurements were taken at the start of the study, after the last session and four weeks after the last session (follow-up study). The T-test and the Whitney U-Mann test compare baseline characteristics. Wilcoxon’s test and ANOVA compared the mean values of VAS, Laitinen, ROM, TUG and KOOS. The significant P value was less than 0.05.

Use of vibration therapy in the study

Vibration therapy was performed using a Vitberg medical device (previous model of the Vitberg Recovery System series). The vibration frequency varied over time (5-50 Hz), low amplitude (0-0.2 mm) with an inter-peak acceleration of 1.38 g (g = gravitational acceleration). This type of vibrotherapy is referred to by the manufacturer as Oscillatory-Cycloidal Vibrotherapy. The subjects participated in a 3-week cycle of vibrotherapy or sham therapy, lasting approximately 60 minutes each, in a semi-recumbent position (2 treatments of 30 minutes each). The vibrotherapy treatments were performed in a number of 15, divided into 3 treatment series, for 3 weeks (5 treatments on 5 consecutive treatment days), once a day and included both knee joints. The sham therapy devices (placebo) had no function to generate measurable vibrations (acceleration a < 0.01 m/s2; frequency f < 0.01 Hz, amplitude A < 0.01 mm). Externally, the devices did not visually differ from the vibration therapy devices and emitted the same sound and light signals at the beginning and end of the therapy. The study was not blinded and the researchers were aware of which stages of the study were carried out on the vibration therapy devices and which on the sham devices.

Study results

After 3 weeks (15 sessions) of vibration therapy, there was a reduction in pain and improvement in mobility. There were more significant improvements in the vibration therapy group than in the control group in pain relief on the VAS scale (p < 0.001), Laitinen scale (p < 0.001), knee flexion (p < 0.001) and TUG (p < 0.001) at the last session. KOOS scores with pain index, symptoms, activities of daily living, sports and recreational functioning and knee-related quality of life improved more in the vibration therapy group than in the control group. Effects lasted up to four weeks in the vibration group. No adverse events were reported.

Comment

The data showed that the use of variable-frequency, low-amplitude vibration in patients with knee osteoarthritis is a safe and effective therapy. What is important to note: as little as 3 weeks of treatments resulted in relief for a minimum of 1 month! It is important to use vibrotherapy systematically to counteract degeneration. Knee degeneration is a condition that can significantly affect patients’ quality of life. It is important to recognise this condition early and treat it appropriately to minimise pain, restore mobility and prevent further progression of degeneration. Those suffering from pain or other knee-related symptoms should consult a doctor who can recommend appropriate therapy.

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