Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Lam KY (1), Cheung TKR (1), Tam KL (1), Choi TL (1), Tsang HC (1), To YL (1)
Affiliation :
(1) Physiotherapy Department, North District Hospital
Introduction :
Quadriceps wasting and mobility impairment is commonly seen in patients with advanced knee osteoarthritis (OA). Prehabilitation training with muscle strengthening before knee arthroplasty can accelerate post-operative recovery and clinical outcomes. However, profound knee pain or joint discomfort may hinder patients’ performance during the resistive training. The use of whole-body vibration therapy may be an alternative as it bolsters the muscle strengthening effect by inducing the tonic vibration reflex while avoiding vigorous joint movement.
Objectives :
To investigate the additional effect of whole-body vibration therapy compared to traditional exercise training alone in the prehabilitation of knee arthroplasty for elderly with advanced knee OA.
Methodology :
This study was a prospective, open-label, randomized controlled trial with 2 parallel groups, including 1 control group and 1 experimental group. Patients referred for prehabilitation of knee arthroplasty from September to December 2023 were screened.
Participants were recruited based on the following inclusion criteria: (1) age 60 to 85 years old, (2) primary diagnosis of advanced knee osteoarthritis, (3) scheduled for knee arthroplasty within 2 months after recruitment, (4) able to provide signed informed consent. Patients were excluded if they had (1) known neoplasm, (2) chronic inflammatory joint disease, (3) severe neurological, cardiovascular or respiratory disease (4) impaired verbal communication (5) prior experience of vibration therapy.
12 prehabilitation exercise sessions were offered to each participant. In the control group, 40-minutes traditional exercises were performed including lower limb ergometer, leg press machine, mini-stepper workout and mini-squat exercise. For the experimental group, the mini-squat exercise was performed on the vibration platform. Isometric quadriceps muscle strength (kgf) and ultrasound-measured quadriceps thickness (cm) were measured in the initial and last sessions respectively.
Result & Outcome :
18 participants (Experimental group: 9; Control group: 9) were recruited. All measures were normally distributed as determined by the Shapiro-Wilks test. Statistical analysis was performed using ANOVA for repeated measures 2 (group) x 2 (time). The significance level was set at α< 0.05 for all comparisons.
Both isometric quadriceps strength and ultrasound-measured quadriceps thickness (α < 0.01) were improved in both groups upon completion of the prehabilitation although statistically significant between-group difference cannot be reached (α = 0.797). The isometric quadriceps strength improved by 23.5% in the experimental group whereas the percentage improvement is 17.9% in the control group. Moreover, ultrasound-measured quadriceps thickness increased by 19.9% in the experimental group and 13.0% in the control group.
To conclude, the addition of whole-body vibration therapy has shown equal benefits when compared to traditional exercise training alone. It can be used as an adjunct exercise for patients with severe joint pain before knee arthroplasty.
