Effects of Closed and Open Kinetic Chain Exercises

June 25, 2020 updated by: Caner Karartı, Hacettepe University

Effects of Closed and Open Kinetic Chain Exercises on Pain, Muscles Strength, Function, and Quality of Life In Patients With Knee Osteoarthritis In Patients With Knee Osteoarthritis

Osteoarthritis (OA) is a heterogeneous pathology characterized by focal cartilage degeneration and the formation of new bone around the subchondral bone and joint, which is the disruption of balance between the processes of destruction and repair in subchondral area. Knee OA is a considerable cause of disability and is present in 2-3% of all disability causes. Exercises are more noticeable than other methods because they are an easy method, low cost and long-lasting. To the best of our knowledge, the studies based on this topic are scarce. Therefore, the aim of this study was to compare the effects of open and closed kinetic chain exercises on pain, functional level, quality of life and muscle strength in patients with knee osteoarthritis.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Osteoarthritis (OA) is a heterogeneous pathology characterized by degeneration of the posterior focal cartilage and the formation of new bone around the subchondral bone and joint, which is the disruption of the balance between the processes of destruction and repair of the joint cartilage and subchondral region. Radiologically, OA was reported in the majority of people over 65 years old and in 80% of those over 75 years old. OA is the most common joint disease in the world. Knee OA is an important health problem due to pain, functional disability and reduced quality of life in patients. Studies have shown that knee OA is associated with inadequacy and pain associated with decreased quadriceps muscle strength. Strengthening education has been shown to have positive effects on OA.

Knee OA is a significant disability cause and is present in 3% of all disability causes. OA causes disability and consequent labor loss and economic loss. Therefore, OA therapy gains importance. OA therapy is classified under three headings as pharmacological methods, non-pharmacological methods and surgical methods. In non-pharmacological methods, there are a number of studies showing the effectiveness of exercise in particular. Because it is an easy method, the cost is low and it is applicable for a long time, the exercises are more important than other methods. The literature on exercise programs with optimal gains for knee osteoarthritis has not yet been established, with numerous studies reporting the importance of different types of exercise for the treatment of knee OA in the literature. Open kinetic chain exercises are frequently used to strengthen the quadriceps muscle. Closed kinetic chain exercises have been shown to increase muscle strength and improve proprioceptive function by activating more muscle spindle and joint proprioceptors. In literature, there are researches that compare closed and open kinetic chain exercises. However, these studies mostly focus on exercises after anterior cruciate ligament reconstruction. The aim of this study was to compare the effects of open and closed kinetic chain exercises on pain, functional level, quality of life and muscle strength in patients with knee osteoarthritis.

Study Type

Interventional

Enrollment (Actual)

60

Phase

  • Not Applicable

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

  • Turkey
      • Kırşehir, Turkey, 40100
        • Caner KARARTI

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

18 years to 65 years (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • the presence of knee osteoarthritis Grade 2 and Grade 3 based on Kellgren Lawrence Classification,
  • volunteering to participate in the study.

Exclusion Criteria:

  • the presence of active synovitis,
  • participation physiotherapy program in the last 6 months,
  • systemic and cardiovascular diseases,
  • neurological and orthopedic problems affecting walking and standing,
  • lower extremity surgery

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
  • Masking: SINGLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Experimental-Study Group
In addition to the conservative treatment of the control group, closed cinetic chain exercises were applied for 12 weeks.
Other: Closed Cinetic Chain Exercises
Sit to stand, mini squat, anterior lunge, step up exercises are performed as Closed Cinetic Chain Exercises.
ACTIVE_COMPARATOR: Active Comparator
In addition to the conservative treatment of the control group, opened cinetic chain exercises were applied for 12 weeks.
Other: Open Kinetic Chain Exercises
Isometric quadriceps, isotonic quadriceps, hip extension and hip adduction exercises are performed as Open Kinetic Chain Exercises.
OTHER: Control Group
Conservative treatment was applied for 12 weeks.
Other: Control Group
Control Group was followed up by conservative treatment and home program for 12 weeks and they were asked to apply the home program three days in a week. Exercise brochure was handed out for home program. Quadriceps strength and harmstring stretch exercises were applied.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Visual analogue scale (Pain)
Time Frame: 12 weeks
The Visual Analogue Scale (VAS) consists of a straight line with the endpoints defining extreme limits such as 'no pain at all' and 'pain as bad as it could be'. The patient is asked to mark his pain level on the line between the two endpoints. The distance between 'no pain at all' and the mark then defines the subject's pain. The 11-point numeric scale ranges from '0' representing no pain to '10' representing pain as bad as you can imagine or worst pain imaginable.
12 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The WOMAC Index (Functional Level)
Time Frame: 12 weeks
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) was used for functional level of participants. It is a self-administered questionnaire consisting of 24 items divided into 3 subscales: Pain (5 items): during walking, using stairs, in bed, sitting or lying, and standing upright; Stiffness (2 items): after first waking and later in the day; Physical Function (17 items): using stairs, rising from sitting, standing, bending, walking, getting in / out of a car, shopping, putting on / taking off socks, rising from bed, lying in bed, getting in / out of bath, sitting, getting on / off toilet, heavy domestic duties, light domestic duties. The test questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4).
12 weeks
Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
Time Frame: 12 weeks
Muscle strength of participants were assessed with this device. Five repeated isokinetic muscle strength tests was performed at 90º / s angular velocity in order to determine the maximal muscle strength of the muscles of the lower limb M. Quadriceps femoris and Hamstring group.
12 weeks
Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
Time Frame: 12 weeks
Muscle strength of participants were assessed with this device. Five repeated isokinetic muscle strength tests was performed at 120º / s angular velocity in order to determine the maximal muscle strength of the muscles of the lower limb M. Quadriceps femoris and Hamstring group.
12 weeks
Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
Time Frame: 12 weeks
Muscle strength of participants were assessed with this device. Five repeated isokinetic muscle strength tests was performed at 180º / s angular velocity in order to determine the maximal muscle strength of the muscles of the lower limb M. Quadriceps femoris and Hamstring group.
12 weeks
36-Item Short Form Survey (SF-36) (Quality of Life)
Time Frame: 12 weeks
The Short Form 36 (SF-36) was standardized in 1990 as a self-report measure of functional health and well-being. Version 2.0 was published in 1996 (SF-36v2), with copyright and trademark privileges belonging to the Medical Outcomes Trust, Health Assessment Lab, and QualityMetric Incorporated. The SF-36 was designed to be a brief yet comprehensive measure of general health status. Likert scales and yes/no options are used to assess function and well-being on this 36-item questionnaire. To score the SF-36, scales are standardized with a scoring algorithm or by the SF-36v2 scoring software to obtain a score ranging from 0 to 100. Higher scores indicate better health status, and a mean score of 50 has been articulated as a normative value for all scales. The SF-36 has been translated into more than 40 languages.
12 weeks

Collaborators and Investigators

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

Sponsor

Hacettepe University

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 (ACTUAL)

November 20, 2017

Primary Completion (ACTUAL)

June 20, 2018

Study Completion (ACTUAL)

July 20, 2018

Study Registration Dates

First Submitted

November 30, 2019

First Submitted That Met QC Criteria

December 3, 2019

First Posted (ACTUAL)

December 4, 2019

Study Record Updates

Last Update Posted (ACTUAL)

June 29, 2020

Last Update Submitted That Met QC Criteria

June 25, 2020

Last Verified

June 1, 2020

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2019900

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

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.

Clinical Trials on Osteo Arthritis Knee

Clinical Trials on Closed Cinetic Chain Exercises

Search Similar Trials

Sponsors and Collaborators

Medical Conditions

Drug Interventions

CROs by country

CROs in Panama

Conditions

Rare Diseases

Drug Interventions

Dietary Supplements

Sponsor/Collaborators

Locations

Subscribe