Efeitos da terapia vibratória sistêmica na flexibilidade, no nível de dor e na capacidade funcional de idosas com osteoartrite de joelho

Abstract

Knee osteoarthritis (KOA) is one of the leading causes of chronic pain and functional disability worldwide and occurs predominantly in women and older adults. The main symptoms of KOA include pain, reduced flexibility, and edema. Physical exercises are one of the recommended treatments. However, the intensity of the pain can make it challenging to perform, which is why it is necessary to evaluate other exercise modalities. Systemic vibration therapy (SVT) generates whole-body vibration exercises due to the individual’s exposure to mechanical vibration produced on a vibrating platform (PV) in operation and is a treatment strategy for individuals with KOA. The sitting position, applied in the protocol adopted by this study, reduces the load on the knee joint, thus being able to stimulate the practice of physical exercise. This study aimed to analyze the effects of SVT on the level of pain, flexibility, and functional capacity of older women with KOA, in addition to performing a systematic review (SR) on the influence of physical exercises on the flexibility of older individuals with KOA. This study is a pre- and post-intervention with SVT analysis of a single group of fourteen women aged 60 years and over. The protocol lasted five weeks (twice a week). Participants sat on an ancillary chair with adjustable height positioned in front of the VP, bare feet resting on the base of an alternating-type VP, remaining for three minutes, with a one-minute interval, in each peak-to-peak displacement (2.5, 5.0, and 7.5 mm). The frequency varied from 5 to 14 Hz, and the peak acceleration from 0.12 to 2.95g. The Lequesne Algofunctional Index (Lequesne) and the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) were applied to assess functional capacity. The Numerical Rating Scale (NRS) was used to assess the level of pain intensity, and the anterior trunk flexion (ATF) test to assess flexibility before and after each session. Seven databases were consulted for the SR, which followed the Preferred Reporting Items for SR and Meta-Analysis (PRISMA) recommendations and was registered in the International Prospective Register of SR (PROSPERO). The pre-and post-intervention study showed a significant reduction in pain observed in the WOMAC (p= 0.00) and the self-reported pain while standing up (p= 0.01). Despite this significant cumulative reduction, the reduction observed before and immediately after each session was not statistically significant. The flexibility showed a significant improvement (p= 0.04), and no progressive reduction was observed across the sessions. Functional capacity improved by analyzing the WOMAC total score (p= 0.03), but no differences were observed in the Lequesne scores. The SR, which included ten articles, observed that flexibility improved in older KOA individuals after performing different physical exercise protocols. In conclusion, the results of this study suggest evidence in favor of the application of SVT for the KOA population. These findings corroborate the SR, which concluded that different modalities of physical exercise can be used as an intervention strategy in individuals with KOA