People with knee osteoarthritis (OA) frequently complain of knee instability. This study will test whether certain exercises can improve knee stability, reduce pain, and improve physical function in people with knee OA. Study hypotheses: 1) Participants in the stability training group will demonstrate less pain and higher levels of physical function, based on self-report measures of pain and function (WOMAC, Lower Extremity Function Scale), and less time to complete the Get Up and Go test, a physical performance measure of function. 2) During walking and the step down task, participants in the stability training group will demonstrate greater knee motion during weight bearing, greater vertical ground reaction forces and loading rates, and reduced ratios of co-contraction between quadriceps/hamsting and tibialis anterior/gastrocnemius muscle pairs compared to the standard group. Participants in the stability group will also demonstrate greater step lengths, single limb support times, and average walking velocity compared to the standard group.
Traditional exercise therapy for knee OA primarily focuses on lower limb strength and joint motion deficits. Recent evidence has suggested that changes in lower limb biomechanical factors during weight bearing activities may have substantial impact on physical function and disease progression in individuals with knee OA. The effectiveness of exercise therapy programs might be improved by incorporating balance and agility training techniques (knee stability training). The aim of this trial is to test the effectiveness of supplementing traditional exercise therapy with knee stability training techniques tailored for individuals with knee OA. Participants will be randomly assigned to one of two groups. The first group will participate in a standard rehabilitation program of traditional exercise therapy for knee OA. The second group will participate in a standard rehabilitation program supplemented with a knee stability program. Study visits will occur at study entry, 2 months, 6 months, and 1 year. At each study visit, changes in pain, physical function, and biomechanical factors will be assessed. This study will last for one year.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
231
Exercises include stretching, strengthening, and aerobic exercise
The addition of agility and perturbation training techniques to the traditional exercise program
University of Pittsburgh, Department of Physical Therapy, School of Health and Rehabilitation Sciences
Pittsburgh, Pennsylvania, United States
Western Ontario and McMaster OA index (WOMAC)
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Lower Extremity Function Scale
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Get Up and Go test (a physical performance measure of function)
Time frame: Measured at baseline, 2 months, 6 months
Knee Outcome Survey - Activities of Daily Living Scale
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Cartilage morphology changes as measured by MRI
Time frame: Measured at baseline, 1 year
Physical Activity Scale for the Elderly
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Quadriceps strength and activation
Time frame: Measured at baseline, 2 months, 6 months
Radiographic severity of OA
Time frame: Measured at baseline, 1 year
Fear Avoidance questionnaire for the knee
Time frame: Measured at baseline, 2months, 6 months, 1 year
Beck Anxiety Index
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Center for Epidemiological Studies Depression Scale
Time frame: Measured at baseline, 2 months, 6 months, 1 year
Motion analysis variables (knee motion, vertical ground reaction force, loading rates, knee adduction/abduction moment, and lower extremity muscle co-contractions during walking and a step-down task)
Time frame: Measured at baseline, 2 months, 6 months
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.