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.

ABSTRACT

OBJECTIVE: This study aimed to review and summarize the existing evidence on the effectiveness of vibration therapy (VT) in comparison with conventional rehabilitation in anterior cruciate ligament (ACL)-reconstructed patients considering muscle peak torque and postural control. METHODS: We searched available online databases for relevant studies published up to February 2020. All randomized clinical trials investigating the effect of VT on quadriceps peak torque, hamstring peak torque, and postural control (closed-eye and open-eye) were included. Overall, 13 clinical trials with a total sample size of 407 participants were included for the meta-analysis. We used the pooled mean difference with random effects model for meta-analyses. We assessed the heterogeneity of the studies using the I2 and Cochran's Q test. Meta-regression analysis was used to assess the source of heterogeneity. RESULTS: We found that VT significantly improved hamstring peak torque [weighted mean difference (WMD) 12.67, 95% CI 4.51-20.83] and quadriceps peak torque (WMD 0.11, 95% CI -0.06 to 0.29). However, subgroup analysis showed a significant increase in mentioned muscles' peak torque in studies employing interventions including both local muscle vibration (LMV) and vibration frequency higher than 100 Hz (WMD 20.84, 95% CI 11.75-29.93). With regard to postural control, we observed a significant improvement only in open-eye mediolateral postural control (WMD 0.26, 95% CI -1.26 to 1.77). CONCLUSION: This study suggests that VT, especially LMV type with vibration frequency higher than 100 Hz, can be effective in rehabilitation of ACL-reconstructed patients. Although improvement in the peak torque of hamstring and quadriceps muscles was seen, there was no significant improvement in postural control, especially closed-eye, in comparison with conventional rehabilitation. LEVEL OF EVIDENCE 1. HIGHLIGHTS Vibration therapy can increase hamstring peak torque in individuals with ACL reconstruction. Local muscle vibration type in comparison with whole-body vibration is recommended for ACL-reconstructed patients. Vibration frequency higher than 100 Hz is preferred in ACL-reconstructed rehabilitation.