Cross-Education From Unilateral Strength and Balance Training in Older Adults With Bilateral Knee Osteoarthritis

March 18, 2026 updated by: Lara Juriša, University of Zagreb

Cross-Education of Combined Unilateral Strength and Balance Training on Motor Function in Older Adults With Bilateral Knee Osteoarthritis

Kinesitherapy is one of the main tools in the rehabilitation of knee osteoarthritis, but is often limited due to pain, reduced functionality, and fear of falling in older adults. This study will, through three sub-studies, examine the effects of unilateral training programs on strength, movement control, balance, and pain in the contralateral leg, as well as on functionality, fall risk, and kinesiophobia in older adults with bilateral knee osteoarthritis through three sub-studies. A total of 45 participants (aged 60-80 years) with bilateral knee osteoarthritis will be randomly assigned to one of three groups: 1. combined unilateral strength and balance training; 2. unilateral balance training; 3. unilateral strength training. Strength will be measured with maximal voluntary contraction, balance using a single leg stance test on an unstable surface, movement control with an active joint position reproduction test, and functionality using the six-minute walk test and the Western Ontario and McMaster Osteoarthritis Index questionnaire. Pain will be assessed with the Visual Analog Scale and the Intermittent and Constant Osteoarthritis Pain questionnaire, fall risk with the Timed Up and Go test and the Falls Efficacy Scale-International questionnaire, and kinesiophobia using the TAMPA questionnaire. This study will expand knowledge on cross-transfer and its effects on symptoms in the rehabilitation of older adults with bilateral knee osteoarthritis.

This research is a part of a doctoral thesis conducted under the supervision of assoc. prof. Tatjana Trošt, PhD.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Not yet recruiting

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Estimated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
45

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

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Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.

Study Contact Backup

Study Locations

  • Croatia
      • Zagreb, Croatia, 10000
        • University of Zagreb Faculty of Kinesiology

Participation Criteria

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Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • age 60-80 years,
  • bilateral knee osteoarthritis of grade II-III according to the Kellgren-Lawrence classification

Exclusion Criteria:

  • acute lower extremity injuries in the past year,
  • taking nonsteroidal anti-inflammatory drugs within the past month,
  • involvement in physical therapy within the past 6 months,
  • undergoing intra-articular injections and/or knee surgery within the past year,
  • rheumatoid arthritis, septic arthritis, uncontrolled diabetes, other systemic inflammatory and autoimmune diseases, and severe cardiovascular, renal, and hepatic comorbidities

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Unilateral strength and balance training group
Other: 8-Week Unilateral Strength and Balance Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral exercises with the less affected leg, combining strength and balance training. Each session lasts 50 minutes, including warm-up, main exercises (15-20 min), and relaxation. The program consists of 24 sessions over 8 weeks.
Experimental: Unilateral balance training group
Other: 8-Week Unilateral Balance Training Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral balance exercises with the less affected leg. Each 50-minute session includes warm-up, 15-20 minutes of main balance exercises, and relaxation. The program lasts 8 weeks with 24 sessions.
Experimental: Unilateral strength training group
Other: 8-Week Unilateral Strength Training Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral strength exercises with the less affected leg. Each 50-minute session includes warm-up, 15-20 minutes of main strength exercises, and relaxation. The program lasts 8 weeks with 24 sessions.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Time Frame
Change from baseline in balance performance in older adults with bilateral knee osteoarthritis after 8 weeks of unilateral strength and/or balance training across all three intervention groups
Time Frame: From baseline (pre-intervention) to the end of the 8-week training program
From baseline (pre-intervention) to the end of the 8-week training program

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Zagreb

Collaborators

Collaborators

An organization other than the sponsor that provides support for a clinical study. This support may include activities related to funding, design, implementation, data analysis, or reporting.
University of Zagreb, The Faculty of Kinesiology

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
September 1, 2026

Primary Completion (Estimated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 1, 2027

Study Completion (Estimated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 1, 2027

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
March 18, 2026

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 18, 2026

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
March 24, 2026

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
March 24, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
March 18, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
May 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 13/2025

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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