Effects of whole body vibration exercise on neuromuscular function for individuals with knee osteoarthritis: study protocol for a randomized controlled trial

Multimodal Magnetic Resonance Imaging to Diagnose Knee Osteoarthritis under Artificial Intelligence

This work aimed to investigate the application value of the multimodal magnetic resonance imaging (MRI) algorithm based on the low-rank decomposition denoising (LRDD) in the diagnosis of knee osteoarthritis (KOA), so as to offer a better examination method in the clinic. Seventy-eight patients with KOA were selected as the research objects, and they all underwent T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), fat suppression T2WI (SE-T2WI), and fat saturation T2WI (FS-T2WI). All obtained images were processed by using the I-LRDD algorithm. According to the degree of articular cartilage lesions under arthroscopy, the patients were divided into a group I, a group II, a group III, and a group IV. The sensitivity, specificity, accuracy, and consistency of KOA diagnosis of T1WI, T2WI, SE-T2WI, and FS-T2WI were analyzed by referring to the results of arthroscopy. The results showed that the peak signal-to-noise ratio (PSNR) and structural similarity index (SSIM) of the I-LRDD algorithm used in this work were higher than those of image block priori denoising (IBPD) and LRDD, and the time consumption was lower than that of IBDP and LRDD (p < 0.05). The sensitivity, specificity, accuracy, and consistency (Kappa value) of multimodal MRI in the diagnosis of KOA were 88.61%, 85.3%, 87.37%, and 0.73%, respectively, which were higher than those of T1WI, T2WI, SE-T2WI, and FS-T2WI. The sensitivity, specificity, accuracy, and consistency of multimodal MRI in diagnosing lesions in group IV were 95%, 96.10%, 95.88%, and 0.70%, respectively, which were much higher than those in groups I, II, and III (p < 0.05). In conclusion, the LRDD algorithm shows a good image processing efficacy, and the multimodal MRI showed a good diagnosis effect on KOA, which was worthy of promotion clinically.

The Application of Whole-Body Vibration Training in Knee Osteoarthritis

With the gradual increase of the aging population in Chinese society, the incidence of knee osteoarthritis showed an increasing trend. However, there are very few practical solutions for it. As a novel neuromuscular training technique, whole-body vibration training has become a candidate for treating knee osteoarthritis. In this review, we firstly elaborated on the mode of action and influence factors of the whole-body vibration training. Next, we summarized its effects in knee osteoarthritis, including improving knee function and some uncertain muscle function and proprioception effects. Next, we also summarized its possible mechanisms, including improving bone microstructure, delaying articular cartilage degeneration, modulating inflammatory cells and inflammatory factors. Then, we summarized the clinical effectiveness of whole-body vibration training by analyzing some clinical randomized controlled trials. Finally, based on the above summary, we analyzed and listed the limitations of whole-body vibration training in treating knee osteoarthritis and found the shortcomings in the existing studies. This review provides ideas for the future application of whole-body vibration training in the treatment of knee osteoarthritis.

Effect of Whole-Body Vibration Training on Muscle Activation for Individuals with Knee Osteoarthritis

Whole-body vibration (WBV) training may improve the strength of lower extremity muscles in patients with knee osteoarthritis (KOA), but the inconsistency in vibration parameters leads to differences in findings. This cross-sectional study is aimed at observing the effects of different vibration frequencies and knee flexion angles on the activation of lower extremity muscles in patients with KOA. Enrolled participants received WBV training at 0, 30, and 60° knee flexion angles with vibration frequencies of 0, 5, 10, and 20 Hz. Activation rates for vastus medialis, vastus lateralis, rectus femoris, biceps femoris, and semitendinosus in different combinations were collected through surface electromyography. The effects of frequency and angle on muscle activation rate were quantified by repeated measures ANOVA. Individual and synergistic effects of frequency and angle were also analysed. Twenty-six participants with KOA were included. Muscle activation increased with the vibration frequency in 0–20 Hz range and with knee flexion angle in 0–60° range. WBV training at 20 Hz was the most effective for knee muscle activation, and static squatting at 60° was the most suitable for WBV training. Therefore, WBV training can increase the activation rate of knee flexor and extensor muscles in patients with KOA, and the most efficient combination was 20 Hz vibration frequency and 60° knee flexion. When applying WBV to patients with KOA, individual differences and rehabilitation purposes should be considered in selecting vibration parameters and knee angle to effectively increase neuromuscular activity.

Acute Effects of Whole-Body Vibration Exercises at 2 Different Frequencies Versus an Aerobic Exercise on Some Cardiovascular, Neuromotor and Musculoskeletal Parameters in Adult Patients With Obesity

Whole-body vibration exercise (WBVE), a nonimpact, viable and safe type of exercise, has been reported to be useful in the physical rehabilitation of obesity. Aim of the study was to compare the acute effects of WBVE with a session of walking and running (AER) on cardiovascular, neuromotor and musculoskeletal parameters in obese subjects. Sixteen adult obese subjects performed 3 tests (WBVE at 30 and 45 Hz, AER) randomly in different days. An increase in heart rate was recorded after AER and 45 Hz WBVE (p < 0.001), while only AER increased systolic (p = 0.003) and diastolic blood pressure (p = 0.004) and ratings of perceived exertion (p < 0.001). All 3 exercises determined lactate increase [AER p < 0.001, 45 Hz (p = 0.04), 30 Hz (p = 0.03) WBVE] and sit-and-reach (AER p = 0.002, 45 and 30 Hz WBVE p < 0.001) and fingertip-to-floor improvements (AER p = 0.003, 30 and 45 Hz WBVE p < 0.001), while only 30 Hz WBVE determined improvement in stair climbing test (p < 0.05). Considering the lack of effects of 30 Hz WBVE on the cardiovascular system and fatigue and its positive effect on flexibility and muscle power, this procedure can be considered an appropriate exercise protocol for the obese population.

Whole-Body Vibration as Antihypertensive Non-Pharmacological Treatment in Hypertensive Individuals with Knee Osteoarthritis: Randomized Cross-Over Trial

(1) Background: Hypertension is a serious medical condition characterized by a persistent increase in blood pressure (BP), which is prevalent in individuals with knee osteoarthritis (KOA). Pharmacological interventions are normally used to treat both hypertension and KOA; however, a more sustainable form of treatment is desirable for these clinical conditions. Whole-body vibration (WBV) exercise has been proposed as a non-pharmacological therapy for reducing both BP and KOA symptomatology. This study aimed to evaluate the antihypertensive effect of WBV in hypertensive individuals with KOA. (2) Methods: Nineteen hypertensive individuals with KOA were randomly allocated to either a control (CG) (n = 9) or a WBV group (WBVG) (n = 10). Subjects in the WBVG were positioned sitting in a chair in front of a vibrating platform (VP) with the feet on the base (peak-to-peak displacement 2.5, 5.0 and 7.5 mm; frequencies 5 to 14 Hz). In the CG, subjects assumed the same position with the VP turned off. The protocols in the CG and WBVG were performed 2 days/week for a total of 5 weeks. (3) Results: No baseline differences (age, anthropometrics, BP parameters and medications) between the groups were found (p > 0.05). WBV exercise reduced systolic BP (SBP: 126.1 ± 2.7 versus 119.1 ± 3.2 mmHg; p = 0.001; post hoc: p = 0.02; F = 23.97) and mean BP (MBP: 82.6 ± 1.8 versus 78.7 ± 1.8, p = 0.001, post hoc: p = 0.02; F = 23.97), while no significant changes were found in diastolic BP (DBP: 68.5 ± 2.2 versus 64.4 ± 2.3; p = 0.11; F = 2.68). (4) Conclusions: WBV might be considered a sustainable therapy for exerting an antihypertensive effect in medicated hypertensive individuals with KOA. This decline in BP might translate to a reduction in pharmacological need, although further studies are necessary to understand the mechanisms underlying the described effect.

Effect of whole body vibration on HIF-2α expression in SD rats with early knee osteoarthritis

INTRODUCTION

To investigate the effect of different frequencies of whole body vibration (WBV) on articular cartilage of early knee osteoarthritis (OA) rats and determine whether WBV would influence the pathway of hypoxia-inducible factor-2α (HIF-2α) regulation-related genes after 8 weeks of treatment.

MATERIALS AND METHODS

Forty 8-week-old OA rats were divided into five groups: sham control (SC); high frequency 60 Hz (HV₁); high frequency 40 Hz (HV₂); middle frequency 20 Hz (MV) and low frequency 10 Hz (LV). WBV (0.3 g) treatment was given 40 min/day and 5 days/week. After 8 weeks, rats were killed and knees were harvested. OA grading score: Osteoarthritis Research Society International (OARSI), and the expression of related genes: interleukin-1β (IL-1β), HIF-2α, matrix metalloproteinases-13 (MMP-13), and collagen type II alpha 1 (COL2A1), at both mRNA and protein levels were analyzed.

RESULTS

After 8 weeks of WBV, our data showed that lower frequency (10 Hz) was more effective than the higher ones, yet they all suggested that WBV alleviates the erosion of knee articular cartilage in early OA. The expression of IL-1β, HIF-2α and MMP-13 decreased with frequency and reached the lowest level at 10 Hz, the expression of COL2A1 increased with frequency and reached the highest level at 10 Hz.

CONCLUSIONS

This study demonstrates that WBV could alleviate the degeneration of knee joints in an early OA rat model. WBV regulates related gene expression at both mRNA and protein levels. HIF-2α could be a therapeutic target. The effect of WBV is frequency dependent; the lower frequency shows better effects.

Effect of Whole-Body Vibration on the Functional Responses of the Patients with Knee Osteoarthritis by the Electromyographic Profile of the Vastus Lateralis Muscles during the Five-Repetition Chair Stand Test: A Randomized Crossover Trial

Knee osteoarthritis (KOA) can cause functional disability. Neuromuscular function is relevant in the development and progression of KOA. It can be evaluated by the analysis of the surface electromyography (sEMG), which has an important role in the understanding of KOA. Whole-body vibration (WBV) is an intervention suggested to treat KOA. The objective of this work was to verify the effectiveness of WBV on the functionality of lower limbs by the electromyographic profile of the vastus lateralis (VL) muscles during the five-repetition chair stand test (5CST) in patients with KOA. This was a two-period crossover trial study (8-week washout). Nineteen patients with KOA were allocated to the group submitted to WBV (WBVG), with peak-to-peak displacement of 2.5 to 7.5 mm, frequency from 5 to 14 Hz, and acceleration peak from 0.12 to 2.95 g, or to the control group (0 Hz) (2 days per week for 5 weeks). The 5CST and the sEMG of the VL during 5CST were evaluated before and after the interventions. Results: Significant differences in 5CST were evident only in WBVG (p = 0.018), showing a decrease of the execution time. The sEMG profile showed no significative difference. Therefore, only 10 sessions of WBV with comfortable posture can bring about improvement in functionality of KOA patients without alteration of the muscle excitation.

Pulsed Electromagnetic Field Versus Whole Body Vibration on Cartilage and Subchondral Trabecular Bone in Mice With Knee Osteoarthritis

Pulsed electromagnetic field (PEMF) and whole body vibration (WBV) interventions are expected to be important strategies for management of osteoarthritis (OA). The aim of the study was to investigate the comparative effectiveness of PEMF versus WBV on cartilage and subchondral trabecular bone in mice with knee OA (KOA) induced by surgical destabilization of the medial meniscus (DMM). Forty 12-week-old male C57/BL mice were randomly divided into four groups (n = 10): Control, OA, PEMF, and WBV. OA was induced (OA, PEMF, and WBV groups) by surgical DMM of right knee joint. Mice in PEMF group received 1 h/day PEMF exposure with 75 Hz, 1.6 mT for 4 weeks, and the WBV group was exposed to WBV for 20 min/day with 5 Hz, 4 mm, 0.3 g peak acceleration for 4 weeks. Micro-computed tomography (micro-CT), histology, and immunohistochemistry analyses were performed to evaluate the changes in cartilage and microstructure of trabecular bone. The bone volume fraction (BV/TV), trabecular thickness (Tb.Th), and trabecular number (Tb.N) increased, and bone surface/bone volume (BS/BV) decreased by micro-CT analysis in PEMF and WBV groups. The Osteoarthritis Research Society International (OARSI) scores in PEMF and WBV groups were significantly lower than in the OA group. Immunohistochemical results showed that PEMF and WBV promoted expressions of Aggrecan, and inhibited expressions of IL-1β, ADAMTS4, and MMP13. Superior results are seen in PEMF group compared with WBV group. Both PEMF and WBV were effective, could delay cartilage degeneration and preserve subchondral trabecular bone microarchitecture, and PEMF was found to be superior to WBV. Bioelectromagnetics. 2020;41:298-307 © 2020 Bioelectromagnetics Society.

Effect of the Combined Intervention with Passive Whole-Body Vibration and Auriculotherapy on the Quality of Life of Individuals with Knee Osteoarthritis Assessed by the WHOQOL-Bref: A Multi-Arm Clinical Trial

The aim of this study was to determine the effect on the quality of life of two non-pharmacological interventions isolated or in combination: (i) passive whole-body vibration exercise (WBVE), and (ii) auriculotherapy (AT). One hundred three participants with knee osteoarthritis (KOA) were allocated to: (a) a vibration group (WBVEG; n = 17) that performed WBVE (peak-to-peak displacement: 2.5 to 7.5 mm, frequency: 5 to 14 Hz, Peak acceleration: 0.12 to 2.95 g), two days/weekly for five weeks, (b) an AT group (ATG; n = 21), stimulation of three specific auriculotherapy points (Kidney, Knee and Shenmen) in each ear pavilion, (c) WBVE + AT (WBVE + AT; n = 20) and (d) respective control groups (WBVE_CG, n = 15; AT_CG, n = 12; WBVE + AT_CG, n = 18). The participants filled out the WHOQOL-bref Questionnaire before the first and after the last sessions. Statistical differences in the various domains of the WHOQOL-bref were not found. In conclusion, WBVE or AT alone or combined did not contribute in altering the quality of life of individuals exposed to these interventions.

Semi-Recumbent Vibration Exercise in Older Adults: A Pilot Study of Methodology, Feasibility, and Safety

Objectives:

Older adults with impaired physical function are at risk for further functional decline in part due to limited ability to engage in regular exercise. Effective approaches to exercise in this vulnerable population are needed to improve functional capacity and optimize independence.

Methods:

Thirty-two residential care apartment complex (RCAC) residents, age ≥70, with low short physical performance battery (SPPB) scores were recruited and randomly assigned to a crossover-design study exploring feasibility and safety of semi-recumbent vibration exercise in older adults living in one RCAC. The primary outcomes were retention and adherence rates and adverse events.

Results:

The retention rate was 78%. Adherence rate was 79.7% and 78.6% during the vibration and control training sessions, respectively. Thirty-eight adverse events (AEs) occurred. Mild muscle soreness and knee pain were the only AEs related to vibration exercise. No serious adverse events (SAEs) were study-related. Participants were able to increase training intensity and load and rated the training enjoyable.

Conclusion:

Semi-recumbent vibration exercise was feasible, well tolerated, and safe in RCAC residents with reduced physical function. Future studies need to examine the effect of this type of exercise on physical function, mobility, falls, and quality of life.

Exercise as a prescription for patients with various diseases

A growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy. Because each sport has its own set of characteristics and physiological complications that tend to occur during exercise training, the effects and underlying mechanisms of exercise remain unclear. Thus, the first step in probing the effects of exercise on different diseases is the selection of an optimal exercise protocol. This review summarizes the latest exercise prescription treatments for 26 different diseases: musculoskeletal system diseases (low back pain, tendon injury, osteoporosis, osteoarthritis, and hip fracture), metabolic system diseases (obesity, type 2 diabetes, type 1 diabetes, and nonalcoholic fatty liver disease), cardio-cerebral vascular system diseases (coronary artery disease, stroke, and chronic heart failure), nervous system diseases (Parkinson's disease, Huntington's disease, Alzheimer's disease, depression, and anxiety disorders), respiratory system diseases (chronic obstructive pulmonary disease, interstitial lung disease, and after lung transplantation), urinary system diseases (chronic kidney disease and after kidney transplantation), and cancers (breast cancer, colon cancer, prostate cancer, and lung cancer). Each exercise prescription is displayed in a corresponding table. The recommended type, intensity, and frequency of exercise prescriptions are summarized, and the effects of exercise therapy on the prevention and rehabilitation of different diseases are discussed.