***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract Salmon , JR , Roper , JA , and Tillman , MD . Does acute whole-body vibration training improve the physical performance of people with knee osteoarthritis ? J Strength Cond Res 26(11 ) : 2983–2989 , 2012—The purpose of this study was to determine the effects of a single session of whole-body vibration training ( WBVT ) on the physical performance of individuals with knee osteoarthritis ( OA ) in 3 tests design ed to simulate activities of daily living ( ADLs ) . Fifteen individuals with symptomatic knee OA completed the Timed-Up- and -Go Test , step test , 20-m walk test , and visual analog scale ( VAS ) recordings of knee pain intensity . A main effect was detected for time to complete the step test ( F[2,28 ] = 6.243 , p = 0.006 , ) . Post hoc analyses revealed that the time to complete the step test at 5 minutes after WBVT improved significantly ( p = 0.042 ) from that of the pretest . A moderate correlation ( r = 0.465 , p = 0.001 ) was found between the VAS scores and the time to complete the step test across all trials . A main effect was found for time to complete the walk test ( F[2,28 ] = 4.370 , p = 0.022 , ) . Post hoc analyses did not indicate significant improvements from pretest seen at 5 minutes after WBVT ( p = 0.110 ) and 1 hour after WBVT ( p = 0.224 ) . The WBVT was well tolerated in nearly all the participants , and we observed that an acute bout of WBVT was effective in improving the ability of individuals with knee OA  to perform a step test and 20-m walk test . Our findings suggest that WBVT may be an effective nonpharmacologic modality to treat some knee OA symptoms and improve ADLs Objective To investigate the effect on pain reduction and strengthening of the whole body vibration ( WBV ) in chronic knee osteoarthritis ( OA ) . Methods Patients were r and omly divided into two groups : the study group ( WBV with home based exercise ) and control group ( home based exercise only ) . They performed exercise and training for 8 weeks . Eleven patients in each group completed the study .  Pain intensity was measured with the Numeric Rating Scale ( NRS ) , functional scales were measured with Korean Western Ontario McMaster score ( KWOMAC ) and Lysholm Scoring Scale ( LSS ) , quadriceps strength was measured with isokinetic torque and isometric torque and dynamic balance was measured with the Biodex Stability System . These measurements were performed before training , at 1 month after training and at 2 months after training . Results NRS was significantly decreased in each group , and change of pain intensity was significantly larger in the study group than in the control group after treatment . Functional improvements in KWOMAC and LSS were found in both groups , but no significant differences between the groups after treatment . Dynamic balance , isokinetic strength of right quadriceps and isometric strengths of both quadriceps muscles improved in both groups , but no significant differences between the groups after treatment . Isokinetic strength of left quadriceps did not improve in both groups after treatment . Conclusion In chronic knee OA patients , WBV reduced pain intensity and increased strength of the right quadriceps and dynamic balance performance . In comparison with the home based exercise program , WBV was superior only in pain reduction and similarly effective in strengthening of the quadriceps muscle and balance improvement The aim of this study was to investigate the effect of adding whole-body vibration ( WBV ; frequency = 35 to 40 Hz ; amplitude = 4 mm ) to squat training on the T-cell proliferative response of elderly patients with osteoarthritis ( OA ) of the knee . This study was a r and omized controlled trial in which the selected variables were assessed before and after 12 weeks of training . Twenty-six subjects ( 72 ± 5 years of age ) were divided into three groups : 1 ) squat training with WBV ( WBV , N = 8) ; 2 ) squat training without WBV ( N = 10 ) , and 3 ) a control group ( N = 8) . Women who were ≥60 years of age and had been diagnosed with OA in at least one knee were eligible . The intervention consisted of 12 uninterrupted weeks of squatting exercise training performed 3 times/week . Peripheral blood mononuclear cells were obtained from peripheral blood collected before and after training . The proliferation of TCD4 + and TCD8 + cells was evaluated by flow cytometry measuring the carboxyfluorescein succinimidyl ester fluorescence decay before and after the intervention ( Δ ) . The proliferative response of TCD4 + cells ( P = 0.02 , effect size = 1.0 ) showed a significant decrease ( 23 % ) in the WBV group compared to the control group , while there was no difference between groups regarding the proliferative response of TCD8 + cells ( P = 0.12 , effect size = 2.23 ) . The data suggest that the addition of WBV to squat exercise training might modulate T-cell-mediated immunity , minimizing or slowing disease progression in elderly patients with OA of the knee Background Osteoarthritis ( OA ) is the most common degenerative arthropathy . Load-bearing joints such as knee and hip are more often affected than spine or h and s. The prevalence of gonarthrosis is generally higher than that of coxarthrosis . Because no cure for OA exists , the main emphasis of therapy is analgesic treatment through either mobility or medication . Non-pharmacologic treatment is the first step , followed by the addition of analgesic medication , and ultimately by surgery . The goal of non-pharmacologic and non-invasive therapy is to improve neuromuscular function , which in turn both prevents formation of and delays progression of OA . A modification of conventional physiotherapy , whole body vibration has been successfully employed for several years . Since its introduction , this therapy is in wide use at our facility not only for gonarthrosis , but also coxarthrosis and other diseases leading to muscular imbalance . Methods / Design This study is a r and omized , therapy-controlled trial in a primary care setting at a university hospital . Patients presenting to our outpatient clinic with initial symptoms of gonarthrosis will be assessed against inclusion and exclusion criteria . After patient consent , 6 weeks of treatment will ensue . During the six weeks of treatment , patients will receive one of two treatments , conventional physiotherapy or whole-body-vibration exercises of one hour three times a week . Follow-up examinations will be performed immediately after treatment and after another 6 and 20 weeks , for a total study duration of 6 months . 20 patients will be included in each therapy group . Outcome measurements will include objective analysis of motion and ambulation as well as examinations of balance and isokinetic force . The Western Ontario and McMaster Universities Arthritis Index and SF-12 scores , the patients ' overall status , and clinical examinations of the affected joint will be carried out . Discussion As new physiotherapy techniques develop for the treatment of OA , it is important to investigate the effectiveness of competing strategies . With this study , not only patient-based scores , but also objective assessment s will be used to quantify patient-derived benefits of therapy . Trial registration Deutsches Register Klinischer Studien ( DRKS ) DRKS00000415 Clinical trials.gov NCT01037972EudraCT 2009 - 017617 - In this study , we investigated a new method of training for maximal strength and flexibility , which included exertion with superimposed vibration ( vibratory stimulation , VS ) on target muscles . Twenty-eight male athletes were divided into three groups , and trained three times a week for 3 weeks in one of the following conditions : ( A ) conventional exercises for strength of the arms and VS stretching exercises for the legs ; ( B ) VS strength exercises for the arms and conventional stretching exercises for the legs ; ( C ) irrelevant training ( control group ) . The vibration was applied at 44 Hz while its amplitude was 3 mm . The effect of training was evaluated by means of isotonic maximal force , heel-to-heel length in the two-leg split across , and flex- and -reach test for body flexion . The VS strength training yielded an average increase in isotonic maximal strength of 49.8 % , compared with an average gain of 16 % with conventional training , while no gain was observed for the control group . The VS flexibility training result ed in an average gain in the legs split of 14.5 cm compared with 4.1 cm for the conventional training and 2 cm for the control groups , respectively . The ANOVA revealed significant pre-post training effects and an interaction between pre-post training and ' treatment ' effects ( P < 0.001 ) for the isotonic maximal force and both flexibility tests . It was concluded that superimposed vibrations applied for short periods allow for increased gains in maximal strength and flexibility BACKGROUND AND PURPOSE Assessment of the quality of r and omized controlled trials ( RCTs ) is common practice in systematic review s. However , the reliability of data obtained with most quality assessment scales has not been established . This report describes 2 studies design ed to investigate the reliability of data obtained with the Physiotherapy Evidence Data base ( PEDro ) scale developed to rate the quality of RCTs evaluating physical therapist interventions . METHOD In the first study , 11 raters independently rated 25 RCTs r and omly selected from the PEDro data base . In the second study , 2 raters rated 120 RCTs r and omly selected from the PEDro data base , and disagreements were resolved by a third rater ; this generated a set of individual rater and consensus ratings . The process was repeated by independent raters to create a second set of individual and consensus ratings . Reliability of ratings of PEDro scale items was calculated using multirater kappas , and reliability of the total ( summed ) score was calculated using intraclass correlation coefficients ( ICC [ 1,1 ] ) . RESULTS The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters . The ICC for the total score was.56 ( 95 % confidence interval=.47-.65 ) for ratings by individuals , and the ICC for consensus ratings was.68 ( 95 % confidence interval=.57-.76 ) . DISCUSSION AND CONCLUSION The reliability of ratings of PEDro scale items varied from " fair " to " substantial , " and the reliability of the total PEDro score was " fair " to " good . OBJECTIVES The study objectives were to evaluate the effects of adding whole-body vibration to squat training on functional performance and self-report of disease in elderly individuals with knee osteoarthritis ( OA ) . DESIGN This was a prospect i ve , r and omized trial in which selected variables were evaluated at three periods : 3 weeks prior to the training , immediately prior , and after the end of the training . SUBJECTS Twenty-three ( 23 ) elderly subjects were evaluated using four functional performance tests : Berg Balance Scale ( BBS ) , Timed Get Up and Go Test ( TGUG ) , Chair St and Test ( CST ) , and 6-Minute Walk Test ( 6MWT ) , and a self-report of the status of disease ( WOMAC ) . INTERVENTIONS The intervention lasted for 12 weeks , 3 times per week . The participants were r and omized into two groups : ( 1 ) squat training with whole-body vibration , and ( 2 ) squat training without vibration . RESULTS Although there was no statistical difference in functional performance and self-report of disease status between the groups , performance in all the functional tests and in all the domains of WOMAC improved in the vibration group compared to their initial status . In the exercise group , performance improved only two tests ( BBS and 6MWT ) , and there was a reduction in self-reported pain ( WOMAC ) compared to their initial status . CONCLUSIONS Although the addition of whole-body vibration to squat training failed to result in a significant improvement in functional performance and self-reported status of knee osteoarthritis in the elderly , the intragroup results suggest that whole-body vibration may represent a feasible and effective way of improving the functionality and self-perception of disease status in older adults with knee OA The purpose of this study was to assess the effect of whole body vibration ( WBV ) exercise on muscle strength and proprioception in female patients with osteoarthritis in the knee ( knee-OA ) . A single blinded , r and omised , controlled trial was performed in an outpatient clinic on 52 female patients diagnosed with knee-OA ( mean age 60.4 years+/-9.6 ) . They were r and omly assigned to one of 3 groups : 1 . WBV-exercise on a stable platform ( VibM ; n=17 ( mean age , 61.5+/-9.2 ) ) , WBV-exercise on a balance board ( VibF ; n=18 ( mean age , 58.7+/-11.0 ) ) , or control group ( Con ; n=18 ( mean age , 61.1+/-8.5 ) ) . The WBV groups trained twice a week for 8 weeks , with a progressively increasing intensity . The WBV groups performed unloaded static WBV exercise . The following were measured : knee muscle strength ( extension/flexion ) and proprioception ( threshold for detection of passive movement ( TDPM ) ) . Self-reported disease status was measured using WOMAC . It was found that muscle strength increased significantly ( p<0.001 ) in VibM compared to Con . Isometric knee-extension significantly increased ( p=0.021 ) in VibM compared to Con . TDPM was significantly improved ( p=0.033 ) in VibF compared 
    Output:
    
Whole body vibration was not associated with a signiﬁcant reduction in Western Ontario and McMaster Universities index pain and stiffness score .
Conclusion : Eight-week and 12-week whole body vibration is beneficial for improving physical functions in patients with knee osteoarthritis and could be included in rehabilitation programs