Vibration therapy for knee replacement

There’s a lot of interest in vibration for those with hip and knee replacements. Initially, the consensus was that knee replacements were contraindications for vibration therapy. Over time, this changed, mostly due to the experience of physical therapists and other health professionals. In addition to some new research coming out for vibration therapy, there is starting to be a shift towards implementing vibration within a knee replacement rehabilitation program.

Vibration therapy increases knee strength after arthroplasty

A study was done at Brigham Young University on vibration strengthening compared to traditional strengthening during physical therapy for those with total knee arthroplasty. The study found that knee extensor strength improved 84.3% with vibration while the traditional resistance program increased by 77.3%. Timed Up and Go scores also improved 31 and 32 % with vibration and traditional exercise, respectively. No adverse effects were noted.

Study shows vibration therapy to be safe for knee replacement

The study used 8 subjects for each group. One of the most important findings apart from the strength gains and TUG results is the fact that there were no adverse effects noted. This is important because most physical therapists and health professionals may initially be we weary to place their more compromised patients on a vibration platform. Originally, the contraindications list dictated that people place those with knee replacements on after 1 year post surgery. However, this rarely takes into consideration the stage of healing, the ability of the patient to begin a strengthening program, and other ways to utilize vibration other than strengthening. We have seen therapists use vibration much earlier than the 1 year. However, applications are modified based on clinical presentation and treatment goals.

Vibration therapy is based on treatment goals

Therapists wonder when vibration therapy should be initiated. The real questions are ‘what are your treatment goals?’ ‘Is the patient ready for strength training?’ ‘Can we initiate other treatment techniques such as massage, strengthening of opposite extremities to initiate cross over effect’? Once a clinician understands what they are looking to achieve, the use of vibration exercise becomes much more effective. Calf massage and circulation can assist in keeping blood flow going once the patient has been cleared of any risks of thrombosis. Strengthening of the other leg can be easily begun at an earlier stage than traditional exercise. Placing the patient in a static posture is easier with vibration exercise in order to begin initiating involuntary muscle contractions. The cross over effect is well known and we’ve seen improved outcomes in patients that have begun their exercise program earlier on.

Vibration does increase muscle activation

The study pointed to the fact that it was unclear that vibration initiated muscle activation. Recent studies do indeed show greater muscle activation. However, adding muscle facilitation techniques like the ones we’ve been utilizing over the last 8 years are highly effective. Muscle facilitation is a technique used by therapists to help a patient recruit more muscle fibers. It’s no different with vibration. Utilizing these techniques can be very helpful in generating activation, particularly the gluteals and the vastus medialis. We hope to see further studies that look into this and compare to conventional training. This is only the beginning for studies like this. We expect to see more post surgical studies that truly lead to the justification of utilizing vibration therapy for knee arthroplasty.