Whole-Body Vibration Impacts on the Degree of Toe Angle and Its Correlation to the Knee Osteoarthritis Index during Level Walking among Female University Students: A Randomized Controlled Trial

Abstract: Whole-body vibration (WBV) training is used for ankle rehabilitation as it stimulates muscle
spindles to excite tonic vibration reflexes, and improves muscle strength, power, joint proprioception,
balance, and flexibility. Thus, this study aims to determine the impact of whole-body vibration
on the degree of the toe angle and the correlation between the toe angle and knee osteoarthritis
index during level walking among female university students. A randomized controlled trial was
conducted with 42 participants divided into two groups. The control group performed only homebased exercise (HBE) after education, and the study group received WBV with HBE. The functional
status of participants to predict osteoarthritis was evaluated using the Western Ontario and McMaster
osteoarthritis index (WOMAC), where the toe angle degree and WOMAC index were assessed before
and six weeks after training. The results showed a significant improvement in the toe-in angle of
HBE + WBV compared to the HBE group (p = 0.02), and in HBE + WBV, an improvement of the
toe angle showed a 43% decrease in the WOMAC index (p = 0.001). In conclusion, WBV for the
ankle and foot training program positively affected the degree of the toe angle, that directly affected
the subtalar and ankle joint mechanics.