## 4 Discussion
Furthermore, a study with similar parameters in an acute protocol for KOA individuals used a frequency of 35 Hz and an amplitude of 4 to 6 mm [50]. Concerning acute vibration exposure, one study using LVT used a fixed frequency of 100 Hz, an amplitude from 0.2 to 0.5 mm, and an aPeak from 20.4 to 81.6 g [13]. The frequency used in the study is corroborated by [PERSON] et al., 2017, for recruitment of type Ia afferent fibers, being proportional from one-to-one to the range of 120 Hz [8]. Regarding functional capacity, the SVT studies [31; 34; 41] demonstrated an increase in the muscle strength in the lower limbs and increased functional mobility after exposure to cumulative MV (8 weeks). [PERSON] et al. [50] also demonstrated, in KOA individuals exposed to SVT (6 weeks), increases in muscle strength and power. Additionally, a 3-week SVT protocol applied to moderately active women led to improvements in knee extensor muscle strength and flexibility compared to both the control group and baseline values [51]. These findings can be justified by the activation of type II fibers that are activated by SVT [10]. Likewise, the LVT studies reported reductions in pain perception [14; 32; 33], increases in functional capacity [14; 32; 33], and improvements in the ROM [14] and in biomechanics of the gait [32]. The results in the literature corroborate the findings of the current systematic review, where one study demonstrated a reduction in the level of pain and an increase in range of movement after intervention with LVT [52]. These variations in the mechanical vibration's parameters and population characteristics across studies may help explain the heterogeneity observed in functional and symptomatic outcomes. Higher frequencies and amplitudes in SVT protocols appeared more often in studies reporting significant gains in muscle strength and functional mobility [35; 39; 40; 50; 51], while lower intensities were associated with subtler effects [41]. Similarly, differences in participants profiles, such as BMI and age ranges [31; 44; 45], may have influenced the response to vibration therapy, as metabolic and biomechanical constraints in older or obese individuals could attenuate improvements. The predominance of female participants also deserves consideration, as hormonal factors might modulate both pain perceptions and neuromuscular adaptation [44; 45]. Finally, differences in vibration devices and intervention durations [13; 14; 32; 33; 40] likely contributed to the variability in reported effects, emphasizing the need for standardization in future studiesand more precise stratification of outcomes by participant characteristics. However, few studies employed LVT protocols in this population, and further research is warranted. The present study has some limitations. The high heterogeneity in study design, mechanical vibration parameters (e.g., frequency, amplitude, duration), and outcome measures (e.g., TUG, WOMAC, ROM) limited the possibility of direct comparison between SVT and LVT. Although both approaches demonstrated functional improvements, the lack of standardized protocols and consistent outcome metrics make it difficult to determine the relative efficacy of one modality over the other. Despite promising preliminary evidence, the overall confidence in the findings is limited by the small number of high-quality randomized controlled trials and the moderate to high risk of bias in several studies. Therefore, the conclusions should be interpreted with caution, and future studies should aim to confirm these effects using a more rigorous methodological design. A quantitative synthesis (e.g., meta-analysis) was not feasible due to the substantial methodological heterogeneity across studies. However, future systematic reviews might consider extracting standardized mean differences for more commonly reported outcomes when data availability permits. This could facilitate the generation of forest plots and comparative effect size estimates between SVT and LVT.