Vibration improves gait biomechanics linked to posttraumatic knee osteoarthritis following anterior cruciate ligament injury

Abstract

Anterior cruciate ligament reconstruction (ACLR) incurs a high risk of posttraumatic knee osteoarthritis (PTOA). Aberrant gait biomechanics contribute to PTOA and are attributable in part to quadriceps dysfunction. Vibration improves quadriceps function following ACLR, but its effects on gait biomechanics are unknown. The purpose of this study was to evaluate the effects of whole-body vibration (WBV) and local muscle vibration (LMV) on gait biomechanics in individuals with ACLR. Seventy-five volunteers (time since ACLR 27 ± 16 months) were randomized to WBV, LMV, or Control interventions. Walking biomechanics were assessed prior to and following a single exposure to the interventions.Outcomes included pre-post change scores in the ACLR limb for the peak vertical ground reaction force (vGRF) and its loading rate, peak internal knee extension (KEM) and abduction moments, and peak knee flexion and varus angles. LMV produced a significant decrease in the vGRF loading rate (−3.6 BW/s) that was greater than the changes in the WBV (−0.3 BW/s) and Control (0.5 BW/s) groups. Additionally, WBV produced an increase in the peak KEM (0.27% BW × Ht) that was greater than the change in the Control group (−0.17% BW × Ht) but not the LMV group (0.01% BW × Ht). Lower KEM and greater loading rates have been linked to declines in joint health following ACLR.WBV acutely increased the peak KEM and LMV decreased loading rates. These data suggest that vibration has the potential to mitigate aberrant gait biomechanics, and may represent an effective approach for reducing PTOA risk following ACLR.

Acutely Normalizing Walking Speed Does Not Normalize Gait Biomechanics Post-Anterior Cruciate Ligament Reconstruction

“…It may be that other neuromuscular and compensatory mechanisms are driving aberrant gait biomechanics development following ACLR beyond what can be explained by adaptations in walking speed. For example, neural activation to the quadriceps following ACLR is known to be altered which may contribute to aberrant biomechanics (43,44), and interventions such as muscle vibration have shown to elicit some improvements in gait biomechanics (45). It may be that walking speed serves as a clinical screening tool to identify individuals who may demonstrate aberrant biomechanics rather than a primary target for biomechanical interventions as increasing beyond a MDD elicited little to no biomechanical changes in the slow self-selected speed group.…”

Arthrogenic Muscle Inhibition: Best Evidence, Mechanisms, and Theory for Treating the Unseen in Clinical Rehabilitation

“…Vibration therapy may reduce the effects of AMI by altering somatosensory input to articular and cutaneous mechanoreceptors. In the context of orthopedic injury, both whole-body and local muscle vibration have enhanced various aspects of muscle function among individuals with ACLR, [134][135][136][137][138] experimental effusion, 139 knee OA, [140][141][142][143][144] total knee arthroplasty, 145 knee pain, 146 and chronic ankle instability. 147 Vibration has been conventionally applied in short bouts (30-60 s) either indirectly via platform (whole-body) or directly to a muscle-tendon unit (local) during therapeutic exercise or a series of isometric squats with protocols ranging from 1 to 24 sessions over 8 to 12 weeks.…”

Nanoparticle-Based Drug Delivery System—A Target Strategy for Osteoarthritis Treatment

“…Studies have shown that quadriceps weakness after knee injury is one of the causes of PTOA [47]. When the quadriceps muscles are weak, as in the case of anterior cruciate ligament injury and reconstruction, they cannot fully absorb the impact energy [48]. This will put more load on the articular cartilage, which will eventually lead to joint degeneration.…”