Muscle Property, Alignment and Joint Loading in People With Knee Osteoarthritis

External Tibia Torsion and Passive Muscle Stiffness of Quadriceps as Two Important Contributors of Joint Loading During Walking in People With Knee Osteoarthritis

Knee osteoarthritis (KOA) is a common chronic painful musculoskeletal condition among older adults. It poses great challenge to the health care system due to its inability to be cured. Understanding factors associated with disease progression in KOA should assist the development of novel prevention/rehabilitation strategies. This study investigate factors including muscle properties, lower limb alignment and joint loading in patients with knee osteoarthritis before and after a six-week exercise program.

Study Overview

• Status: Completed
• Conditions: Osteoarthritis, Knee
• Intervention / Treatment: Other: Exercise

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Hong Kong
  • Hong Kong, Hong Kong
    • Queen Mary Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 50 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

1. Age between 50-80
2. having radiographic tibiofemoral joint OA in the medial compartment defined as Kellgren and Lawrence grade = 2 to 3
3. having medial knee pain on most days of the month
4. having a minimum average pain score of 2 on an 11-point numerical rating scale in the past week while walking

Exclusion Criteria:

1. having lateral tibiofemoral compartment osteophytes greater than the medial side.
2. having undergone intra-articular corticosteroid injection or knee surgery to either knee within the past 3 months
3. having a systemic arthritic condition (e.g., rheumatoid arthritis)
4. having a knee joint replacement or high tibial osteotomy in the past
5. having any other muscular, joint or neurological condition influencing lower limb function
6. unable to walk unaided
7. having low back, hip, ankle or foot pain > 3 on numerical rating scale
8. having a body mass index (BMI) >36 kg/ m2

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Exercise; Six-week exercise including stretching, strengthening, endurance and gait modification	Other: Exercise; Comprehensive exercise program including strengthening, stretching, gait modification etc.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of External Knee Adduction Moment as Assessed by Visual Motion Analysis System	External knee moment in the frontal plane during early stance phase of walking	At baseline and one week after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change of Pain Severity Score as Assessed by Knee Injury and Osteoarthritis Outcome Score	Pain intensity measured by the pain subscale of Knee injury and Osteoarthritis Outcome Score (KOOS). The minimum value is 0 and maximum value is 100. The higher scores mean a better outcome.	At baseline and one week after intervention
Tibial Torsion as Assessed by X-ray Imaging	The angle between tibial and femur in the transverse plane	At baseline
Change of Young's Modulus of Quadriceps as Assessed by Ultrasound Elastography	Young's modulus by ultrasound elastography	At baseline and one week after intervention

Collaborators and Investigators

• Sponsor: The Hong Kong Polytechnic University
• Collaborators: Queen Mary Hospital, Hong Kong
• Investigators: Principal Investigator: Siu Ngor Fu, PhD, The Hong Kong Polytechnic University

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2017
• Primary Completion (Actual): December 31, 2019
• Study Completion (Actual): December 31, 2019

Study Registration Dates

• First Submitted: August 6, 2018
• First Submitted That Met QC Criteria: August 9, 2018
• First Posted (Actual): August 14, 2018

Study Record Updates

• Last Update Posted (Actual): September 16, 2021
• Last Update Submitted That Met QC Criteria: August 24, 2021
• Last Verified: August 1, 2018

More Information

Terms related to this study

• Keywords: knee osteoarthritis; muscle tension; alignment; loading
• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Osteoarthritis; Osteoarthritis, Knee
• Other Study ID Numbers: HSEARS20170406003

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No