Osteoarthritis (OA) of the knee is a disease characterized mainly by the wear and tear of the articular structures, which affects 6% to 13% of men and 7% to 19% of women, and their prevalence may be increased proportionally with increasing age. Signs and symptoms include pain, joint stiffness and loss of function. In this perspective, kinesio taping (KT) appears as an alternative therapeutic resource for the treatment of this type of patient. However, the current evidence on this technique is limited and conflicting, making its effects on the symptomatology of the disease still uncertain. Thus, the present study will evaluate the effects of KT application on muscle strength, pain, physical function, edema and quality of life of elderly women with knee OA. It will be a randomized, blind clinical trial in which 45 volunteers will be allocated to three groups: G1 (placebo group), G2 (control group) and G3 (intervention group). The G1 will be submitted to the placebo (no tension) application of KT on rectos femoris muscle and knee; the G2 will receive a protocol of a health education activity session lasting 60 minutes and finally the G3 will be submitted to the simultaneous application (with tension) of two KT techniques on rectos femoris muscle and knee. All groups will be evaluated before, immediately after and 72 hours after the application. To measure the variables, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Numerical Pain Rating Scale (NPRS), 6-minute walk test (6MWT), isometric dynamometer, perimetry and global rating of change. Statistical analysis will be done using SPSS® software (Statistical Package Social Science) version 20.0. The Kolmogorov-Smirnov and Levene tests will be applied to evaluate the normality and homogeneity of the data, respectively. Intra and intergroup comparisons will be evaluated using analysis of variance ANOVA of mixed model. In the presence of a significant F, the Benferroni pot-hoc test will be used to identify where the difference occurred. For all statistical analyzes, a significance level of 5% (p \<0.05) and 95% confidence interval (95% CI) will be adopted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
45
application of kinesio taping in the rectus femoris muscle and in the medial and lateral region of the knee
Faculdade de ciências da saúde do trairi - FACISA/UFRN
Santa Cruz, Brazil
Numerical Pain Rating Scale (NPRS)
The primary outcome will pain assessed by the NPRS, whereby participants were asked to choose a number between 0 (no pain) and 10 (worst pain possible). They will instructed to report the level of pain while sitting and rising from a chair.
Time frame: Time 0 - baseline
Numerical Pain Rating Scale (NPRS)
The pain of the volunteers will be indirectly measured by the Visual Analogue Scale (VAS), which varies from 0 to 10 (unbearable pain) (SCOTT and HUSKISSON, 1976) . The pain will be measured during the activity of climbing stairs. The patient will be directed to go up and down a staircase with two steps. Initially a volunteer will become familiarized. Volunteers will be guided to perform a normal collective activity (the way they are done in the day). In order to, a voluntary test measure will be used while using an VAS. In VAS, the lower the value, the less the pain sensation realatable by the patient and the higher the value, the greater the pain sensation.
Time frame: Time 1 - after 10min of the baseline
Numerical Pain Rating Scale (NPRS)
The primary outcome will pain assessed by the NPRS, whereby participants were asked to choose a number between 0 (no pain) and 10 (worst pain possible). They will instructed to report the level of pain while sitting and rising from a chair.
Time frame: Time 2 - after 72 hours of baseline
Perimetry
To perform perimetry, a tape measure will be used to measure the perimeter of the assessed limb. For this, the volunteer will be placed in dorsal decubitus with hip in neutral position, extended knees and relaxed quadriceps. In this position, the evaluator will measure the knee at three specific points: the fold of the popliteal fossa, 5 cm above and 5 cm below. Each level will be evaluated three times and the average of the measurements will be used for analysis.
Time frame: Time 0 - baseline
Perimetry
To perform perimetry, a tape measure will be used to measure the perimeter of the assessed limb. For this, the volunteer will be placed in dorsal decubitus with hip in neutral position, extended knees and relaxed quadriceps. In this position, the evaluator will measure the knee at three specific points: the fold of the popliteal fossa, 5 cm above and 5 cm below. Each level will be evaluated three times and the average of the measurements will be used for analysis.
Time frame: Time 2 - after 72 hours of baseline
Quadriceps muscle strength
The isometric strength of the femoral quadriceps will evaluated using a hand-held dynamometer (HHD; Nicholas Manual Muscle Tester, Lafayette Instrument Company, Lafayette, Indiana, USA). The participant will placed in the sitting position on a stretcher, with arms crossed over chest. An ankle stabilization belt will placed on the evaluated limb to maintain hip and knee flexion at 90°. The HHD will placed 2 cm proximal to the lateral malleolus midpoint, in the anterior region of the ankle (between the malleoli). Maximum isometric strength will then measured in 5-second knee extensions, with continuous verbal encouragement. Subjects perform one practice trial, rested for 30 s and then carried out the three measured trials, the strongest of which will use for data analysis. The results of all trials \[kg\] will transformed into Newtons (Strength\[N\] = strength \[kg\] x 9.81) and normalized by body mass (Normalized Strength \[N/kg\] = Strength \[N\] ÷ Body Mass\[kg\]).
Time frame: Time 0 - baseline
Quadriceps muscle strength
The isometric strength of the femoral quadriceps will evaluated using a hand-held dynamometer (HHD; Nicholas Manual Muscle Tester, Lafayette Instrument Company, Lafayette, Indiana, USA). The participant will placed in the sitting position on a stretcher, with arms crossed over chest. An ankle stabilization belt will placed on the evaluated limb to maintain hip and knee flexion at 90°. The HHD will placed 2 cm proximal to the lateral malleolus midpoint, in the anterior region of the ankle (between the malleoli). Maximum isometric strength will then measured in 5-second knee extensions, with continuous verbal encouragement. Subjects perform one practice trial, rested for 30 s and then carried out the three measured trials, the strongest of which will use for data analysis. The results of all trials \[kg\] will transformed into Newtons (Strength\[N\] = strength \[kg\] x 9.81) and normalized by body mass (Normalized Strength \[N/kg\] = Strength \[N\] ÷ Body Mass\[kg\]).
Time frame: Time 2 - after 72 hours of baseline
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a reliable and validated instrument for the Portuguese language that contains 24 questions divided into three categories: pain (5 questions), rigidity (2 questions) and self-reported physical function (17 questions). The items are evaluated by a Likert scale and each question receives a score ranging from 0 to 96, according to the patient's response. The higher the score obtained, the worse is the severity of the disease (BELLAMY et al., 1988).
Time frame: Time 0 - baseline
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a reliable and validated instrument for the Portuguese language that contains 24 questions divided into three categories: pain (5 questions), rigidity (2 questions) and self-reported physical function (17 questions). The items are evaluated by a Likert scale and each question receives a score ranging from 0 to 96, according to the patient's response. The higher the score obtained, the worse is the severity of the disease (BELLAMY et al., 1988).
Time frame: Time 2 - after 72 hours of baseline
6-minute walk (6MWT)
The six-minute walk test (6MWT) will follow the recommendations of the American Thoracic Society (2002). A distance of 30 meters will be demarcated by two cones (one in the initial mark and the other in the final mark). The volunteers will be instructed to walk the greatest number of times the distance marked for six minutes and, at the end of this time, the distance traveled will be measured, in this case, the greater the distance covered, the better the patient's function.
Time frame: Time 0 - baseline
6-minute walk (6MWT)
The six-minute walk test (6MWT) will follow the recommendations of the American Thoracic Society (2002). A distance of 30 meters will be demarcated by two cones (one in the initial mark and the other in the final mark). The volunteers will be instructed to walk the greatest number of times the distance marked for six minutes and, at the end of this time, the distance traveled will be measured, in this case, the greater the distance covered, the better the patient's function.
Time frame: Time 2 - after 72 hours of baseline
Global rating of change
This will assessed via the patient global impression of change. The measure is recommended by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials group and targets four different domains: pain, function, quality of life, and global condition, measured using a 7-point scale (from 'considerably improved' to 'considerably deteriorated').
Time frame: Time 2 - after 72 hours of baseline
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