Knee Malalignment and Thigh Muscle Strengthening in Individuals With Medial Knee Arthritis

December 21, 2006 updated by: University of Melbourne

The Effects of Knee Malalignment and Quadriceps Strengthening on the Adduction Moment in Individuals With Medial Knee Osteoarthritis

To investigate the effects of quadriceps strengthening on the adductor moment in individuals with medial knee OA and whether quadriceps strengthening has a different effect on the adductor moment in individuals with and without knee malalignment

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Although quadriceps strengthening is the cornerstone of physiotherapy management, recent evidence suggests that high quadriceps strength in patients with malaligned knees may increase OA progression.

This study investigates the effects of quadriceps strengthening on the adduction moment in patients with medial knee OA with and without malalignment. 107 participants with and without varus knee malalignment were recruited and randomised into an exercise or a control group. Participants in the exercise group were taught five quadriceps strengthening exercises by a project physiotherapist to be performed five days a week for twelve weeks at home. The exercises were:

  1. Quadriceps exercise over fulcrum using ankle weight
  2. Straight leg raise exercise using ankle weight
  3. Long arc knee extension exercise in sitting using ankle weight
  4. Knee extension exercise with isometric hold at 60° knee flexion using ankle weight
  5. Knee extension exercise with isometric hold at 60° knee flexion using an elastic band.

Each exercise was performed at 2x10 repetitions for the first 2 weeks and 3x10 repetitions thereafter.

Participants visited the physiotherapist 7 times at Week 1, 2, 3, 4, 5, 7 and 10. They were given the ankle weights and elastic band to bring home and instructed about the repetitions and weights to use by the physiotherapist, who also checked and progressed their exercises. The average duration of the physiotherapy sessions was 30 minutes. To monitor compliance, each participant was given an exercise instructions sheet and kept a training diary to record the exercises they had done.

The control group received no intervention.

Study Type

Interventional

Enrollment

107

Phase

  • Phase 2
  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Australia
    • Victoria
      • Melbourne, Victoria, Australia, 3040
        • The University of Melbourne

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Pain in the knee
  • Osteophytes on knee x-ray
  • Self-reported pain on the inner aspect of the study knee
  • Osteophytes in the medial compartment of the knee joint and
  • Medial joint space narrowing greater than lateral joint space narrowing on x-ray

Exclusion Criteria:

  • Knee surgery within the previous 6 months
  • History of lower limb joint replacements
  • Systemic arthritic conditions such as rheumatic or psoriatic arthritis
  • Valgus knee deformity (> 5º)
  • Inability to walk without the use of walking aids
  • Intending to start a lower limb strengthening program in the next 3 months
  • Seeking or currently receiving physiotherapy for OA knee

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: Factorial Assignment
  • Masking: Single

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Adduction moment
Time points: 0 and 13 weeks

Secondary Outcome Measures

Outcome Measure
Time points: 0 and 13 weeks
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire
Numerical rating scales for pain
Quadriceps and hamstrings strength
Self-selected walking speed
Dynamic balance using step test
Physical function using stair climb test

Collaborators and Investigators

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

Sponsor

University of Melbourne

Collaborators

Australian Physiotherapy Research Foundation
United Pacific Industries

Investigators

  • Principal Investigator: Rana Hinman, PhD, University of Melbourne
  • Principal Investigator: Tim Wrigley, MSc, University of Melbourne
  • Principal Investigator: Boon W Lim, MSc, University of Melbourne
  • Principal Investigator: Leena Sharma, MD, Northwestern University Medical School, Chicago

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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

May 1, 2004

Study Completion

December 1, 2006

Study Registration Dates

First Submitted

December 20, 2006

First Submitted That Met QC Criteria

December 20, 2006

First Posted (Estimate)

December 21, 2006

Study Record Updates

Last Update Posted (Estimate)

December 22, 2006

Last Update Submitted That Met QC Criteria

December 21, 2006

Last Verified

December 1, 2006

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 040850

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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