- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05997966
Investigation of the Effects of Progressive Resistance Exercises in Individuals With Knee Osteoarthritis (OA)
Investigation of the Effects of Progressive Resistance Exercises on Pain, Functional Activity, Quality of Life and Serum Biomarkers in Individuals With Knee Osteoarthritis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The researchers aim to evaluate the effectiveness of a home-based holistic progressive resistance exercise program for all lower extremity muscles (hip, knee and ankle circumference) in individuals with knee OA in detail and in a multifaceted manner. In addition, the researchers aim to examine the effect of exercise on serum biomarkers in order to understand whether exercise has an anti-inflammatory effect in these individuals and to establish standard exercise protocols. Thus, when a standard home-based exercise program can be established, it will be ensured that elderly individuals with knee OA, who have problems in reaching health centers, have difficulty in going out due to different health problems, and who are the primary care treatment, will be able to do exercises at home. At the same time, considering the global socioeconomic burden of knee OA, the researchers predict that the home-based exercise program will contribute positively to the country's economy.
All subjects who voluntarily accepted to participate in the study and met the inclusion criteria will be applied four times during the 12-week exercise program (except for the blood draw required for the evaluation of serum biomarker levels). Pain intensity, functional status based on performance and scales, quality of life, lower extremity range of motion, lower extremity muscle strength assessments will be repeated before treatment (0 weeks), 5th and 9th weeks, and after treatment (13th week). These assessments will be made at patients' homes. Blood collection will be done before treatment (week 0) and after treatment (week 13) to examine serum biomarker levels with ELISA kits.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Meltem Meran Çağlar
- Phone Number: 05412210058
- Email: meltem.meran@gmail.com
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Having signed the informed consent form,
- Male and postmenopausal female patients aged 50 and over,
- Radiologically and clinically diagnosed with Stage 1 or 2 knee OA,
- Patients with a sedentary life (patients with less than 45 minutes of moderate-intensity activity per week)
Exclusion Criteria:
- Cooperative problem or cognitive impairment,
- BMI > 35 kg/m2,
- Receiving physiotherapy in the last 3 months,
- Steroid injection to the knee joint in the last 6 months,
- Presence of neuromuscular or neurodegenerative disease,
- Presence of cardiorespiratory disease, previous hip, knee, foot-ankle surgeries,
- Use of immunosuppressive drugs,
- Presence of infection or inflammatory disease in any part of the body.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Progressive Resistance Exercises Group
In the exercise group, a home-based exercise program will be applied in addition to a 30-minute walking request twice a week, and will consist of stretching exercises for the lower extremities, isometric exercises and progressive resistance strengthening exercises (IDE) of the hip, knee and ankle.
The 12-week home-based IDE program will be applied 2 sets/day for 3 days/week (on non-consecutive days).
Resistance bands will be used for resistance in the IDE program.
In addition, the exercise intensity in the IDE program will be questioned with the perceived difficulty level (AZD).
The AZD scale shows the perceived intensity and pulse rate change during exercise between 6-20.
All exercises will be performed without resistance for the first 4 weeks, with AZD levels at 40% of 1 maximum repetition at week 5 to 8, AZD 13-15 (somewhat difficult), and after week 8 to AZD 15-16 (difficult).
Progress will be achieved by increasing the number of repetitions.
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At the beginning of the study, there will be a home visit (week 0) where the exercises will be taught.
Exercise brochures explaining the exercises in written and visual form will also be given to each participant during the first and subsequent home visits.
After the first home visit, individuals will be asked to keep an exercise diary prepared by the physiotherapist in order to control the exercises, the occurrence of side effects and dependence on the treatment, and information will be obtained from the individuals by phone calls every week.
Two more home visits will take place in weeks 5 and 9 to further the IDE program.
Apart from these visits and phone calls, the participant will be allowed to call the physiotherapist if needed.
In the exercise group, the 12-week home-based IDE program will be applied 2 sets/day for 3 days/week (on non-consecutive days).
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Sham Comparator: Control Group
In the control group, 30 minutes of walking will be requested twice a week, and no other intervention will be made.
Individuals in the control group will be called every week by phone for gait follow-up.
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After a general education about osteoarthritis in the control group, 30 minutes of walking will be requested twice a week, and no other intervention will be made.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Chair Stand Test
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
|
A standard chair will be used for the test.
First of all, the patient will be asked to sit with his back to the chair.
Then, he will be asked to get up from the seat without holding on to the arms of the chair, walk with regular steps at a predetermined length of 3 m, and return to the chair at the end of 3 m.
Each patient will be asked to walk at a normal pace and the time will be recorded in seconds with a digital stopwatch.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Timed Up and Go Test
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
|
A standard chair will be used for the test.
First of all, the patient will be asked to sit with his back to the chair.
Then, he will be asked to get up from the seat without holding on to the arms of the chair, walk with regular steps at a predetermined length of 3 m, and return to the chair at the end of 3 m.
Each patient will be asked to walk at a normal pace and the time will be recorded in seconds with a digital stopwatch.
The walking distance will be measured with a tape measure and marked with a colored tape.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
|
Range of Motion
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
|
Active hip, knee, and ankle joint range of motion will be measured using a universal goniometer.
It has been shown that goniometric measurement is a reliable and valid outcome measure in patients with knee OA (Maricar et al., 2016).
Hip flexion, abduction, adduction, ankle dorsi and plantar flexion measurements were in supine position; hip extension, knee flexion and extension measurements will be performed in the prone position.
Each assessment will be repeated three times, and their average value will be recorded.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Muscle Strength
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Assessment of muscle strength will be made with a Lafayette manual muscle tester (Lafayette Instrument Company, Lafayette, USA).
Measurements will be made in hip abduction, adduction, flexion and extension, knee flexion and extension movements.
Measurements will be made in three repetitions for hip abduction, adduction, flexion and extension, with one minute rest between each hip movement and 15 seconds between each repetition.
The best values obtained from triple repetitive measurements will be used in the analysis (Mentiplay et al., 2015).
Strength measurement of iliopsoas, gluteus maximus, gluteus medius, quadriceps femoris, harmstring, adductor longus and brevis, plantar and dorsi flexor muscles will be performed.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Serum Inflammatory Level
Time Frame: Blood collection will be done before treatment (week 0) and after treatment (week 13) to examine serum biomarker levels with ELISA kits.
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All measurements of serum biomarkers [plasma-soluble TNF-α and TNF-α receptors 1 (sTNFR1), 2 (sTNFR2), serum resistin, IL-1β, IL-6, IL-17, MMP-1 and MMP-3] are strictly aseptic.
Under these conditions, 10 ml of venous blood will be drawn from each individual.
After centrifugation of the clotted blood at 3000 rpm for 20 minutes, the separated serum samples will be portioned and frozen at -20 C and stored under these conditions until analysis.
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Blood collection will be done before treatment (week 0) and after treatment (week 13) to examine serum biomarker levels with ELISA kits.
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Visual Analogue Scale (VAS)
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
|
It will be used to evaluate the severity of pain.
The severity of the pain will be determined by marking a place on a 10 cm straight line drawn between the points of no pain (0) and unbearable pain (10).
An increase in the score indicates an increase in pain intensity.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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It is a disease-specific health status measure that is frequently used in patients with knee and hip OA, which consists of three parts (pain, stiffness, and function).
WOMAC Turkish version has been shown to be a reliable, valid, sensitive and acceptable outcome measure.
WOMAC consists of 24 questions, 5 questions in the pain section, 2 questions in the stiffness section, and 17 questions in the function section.
A total score is obtained by scoring each question between 0 and 4 points.
Patients are asked to answer the questions by considering the pain, stiffness and activities they have difficulty in performing in the last 24 hours.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Quality of Life Scale-Short Form (SF-12)
Time Frame: Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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The 12-item short form health questionnaire (SF-12) is a measure that evaluates physical and mental health.
It was reported that SF-12, which was created from the original form, SF-36, was easier to apply and had a shorter completion time and was more advantageous to use.
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Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks).
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Meltem Meran Çağlar, Medipol University
- Study Director: bayram ünver, Dokuz Eylül University
- Study Chair: eda merve kurtuluş, İstanbul Gelişim University
- Study Chair: mustafa tekkeşin, istanbul özel sondurak ümran tıp merkezi
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- BeykozU
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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