The Open Kinetic Chain and Closed Kinetic Chain Strengthening Exercises in Degenerative Meniscus Tears

Comparison of the Open Kinetic Chain and Closed Kinetic Chain Strengthening Exercises on Pain, Function, and Health-related Quality of Life in Degenerative Meniscus Tears

This randomized-controlled trial aims to compare the effect of open kinetic chain and closed kinetic chain strengthening exercises on pain, function, and health-related quality of life in degenerative meniscus tears.

Study Overview

• Status: Completed
• Conditions: Knee Pain Swelling; Meniscus Tear; Degenerative Disease
• Intervention / Treatment: Other: Open kinetic chain strengthening exercise; Other: Closed kinetic chain strengthening exercise

Detailed Description

Patients with degenerative meniscus tears between the ages of 35 and 65 will be randomly divided into two groups: Group 1 (open kinetic chain strengthening exercises) and Group 2 (closed kinetic chain strengthening exercises). Interventions will be applied for 16 sessions (twice a week for 8 weeks). The patients will be assessed at baseline and at the end of the 8-week intervention. The pain during activity, at rest, and at night will be assessed with the Visual Analog Scale (VAS). Active range of motion will be assessed with a digital goniometer. Isometric muscle strength will be measured with a handheld dynamometer. The functional status and symptoms will be evaluated by the Knee Injury and Osteoarthritis Outcome Score (KOOS) and Lysholm Knee Scoring Scale. Health-related quality of life will be assessed with the Short Form-12 (SF-12).

• Study Type: Interventional
• Enrollment (Actual): 56
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Bakırkoy
    • Istanbul, Bakırkoy, Turkey, 34147
      • Istanbul University-Cerrahpasa

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Being aged between 35 and 65 years
• Having the degenerative meniscus tear in at least one knee
• Having body mass index in the range of 18-30 kg/m2
• Feeling the pain that lasts for at least 2 months
• Having grade 1 or grade 2 degenerative meniscal tear diagnosed by an orthopedic specialist according to the MRI results
• Access to the internet via a computer or smartphone
• Ability to read and write in Turkish

Exclusion Criteria:

• Having undergone arthroscopic partial meniscectomy surgery due to degenerative meniscal tear
• Participating in a physiotherapy program for degenerative meniscal tear in the last 12 weeks
• Have received steroid injections in the last 6 months
• Accompanying conditions such as injury to the surrounding ligaments, congenital anomaly in the affected knee, coxarthrosis and spinal stenosis
• Presence of any systemic disorder that may affect assessment parameters
• Any health condition that may prevent participation in physical activity or an exercise program (e.g., severe cardiovascular, respiratory, neurological, or musculoskeletal disorders)
• Failure to cooperate with assessments

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Open Kinetic Chain Exercise Group; Each subject in Open Kinetic Chain Exercise Group will receive a treatment protocol consisting of stretching exercises, open kinetic chain strengthening exercises, and functional exercises for the knee and hip.	Other: Open kinetic chain strengthening exercise; A web-based 8-week exercise program consisting of stretching exercises, open kinetic chain strengthening exercises, and functional exercises for the knee and hip will be performed.
Active Comparator: Closed Kinetic Chain Exercise Group; Each subject in Closed Kinetic Chain Exercise Group will receive a treatment protocol consisting of stretching exercises, closed kinetic chain strengthening exercises, and functional exercises for the knee and hip.	Other: Closed kinetic chain strengthening exercise; A web-based 8-week exercise program consisting of stretching exercises, closed kinetic chain strengthening exercises, and functional exercises for the knee and hip will be performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Knee Injury and Osteoarthritis Outcome Score (KOOS)	Short-term and long-term symptoms and function will be assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) that is developed as an extension of the WOMAC Osteoarthritis Index. The score is a percentage score from 0 to 100, 0 representing extreme problems and 100 representing no problems.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analogue Scale (VAS)	Pain intensity will be measured using the visual analogue scale (VAS). The participants will be asked to indicate their perceived pain at rest, during activity and at night on the 10 cm line between no pain and terrible pain. The score will be determined by measuring the distance on 10 cm line using a ruler. The higher scores indicate an higher level of pain.	Baseline
Visual Analogue Scale (VAS)	Pain intensity will be measured using the visual analogue scale (VAS). The participants will be asked to indicate their perceived pain at rest, during activity and at night on the 10 cm line between no pain and terrible pain. The score will be determined by measuring the distance on 10 cm line using a ruler. The higher scores indicate an higher level of pain.	At the end of 8-week intervention
Knee Injury and Osteoarthritis Outcome Score (KOOS)	Short-term and long-term symptoms and function will be assessed with the Knee injury and Osteoarthritis Outcome Score (KOOS) that is developed as an extension of the WOMAC Osteoarthritis Index. The score is a percentage score from 0 to 100, 0 representing extreme problems and 100 representing no problems.	At the end of 8-week intervention
Active Range of Motion	Active knee range of motion including flexion and extension will be measured described by the American Academy of Orthopaedic Surgeons (AAOS) using a digital goniometer.	Baseline
Active Range of Motion	Active knee range of motion including flexion and extension will be measured described by the American Academy of Orthopaedic Surgeons (AAOS) using a digital goniometer.	At the end of 8-week intervention
Muscle Strength	Isometric muscle strength will be measured with a handheld dynamometer for knee flexors and extensors. The process will be repeated three times in each direction, with the average value recorded.	Baseline
Muscle Strength	Isometric muscle strength will be measured with a handheld dynamometer for knee flexors and extensors. The process will be repeated three times in each direction, with the average value recorded.	At the end of the 8-week intervention
Lysholm Score	Functional limitations related to degenerative meniscal tear will be used with the Lysholm Score that is one of the most frequently used functional questionnaires. The total score is the sum of each response to the eight questions, and may range from 0-100. Higher scores indicate a better outcome with fewer symptoms or disability.	Baseline
Lysholm Score	Functional limitations related to degenerative meniscal tear will be used with the Lysholm Score that is one of the most frequently used functional questionnaires. The total score is the sum of each response to the eight questions, and may range from 0-100. Higher scores indicate a better outcome with fewer symptoms or disability.	At the end of the 8-week intervention
Short Form-12 (SF-12)	Short Form-12 (SF-12), which is developed based on Short Form-36, consists of 12 items: 7 items dealing with the physical components scores (PCS-12) and 5 items related to the mental components scores (MCS-12) of SF-12. Range of both scores is 0 to 100, where the higher scores indicate better health related quality of life.	Baseline
Short Form-12 (SF-12)	Short Form-12 (SF-12), which is developed based on Short Form-36, consists of 12 items: 7 items dealing with the physical components scores (PCS-12) and 5 items related to the mental components scores (MCS-12) of SF-12. Range of both scores is 0 to 100, where the higher scores indicate better health related quality of life.	At the end of the 8-week intervention

Collaborators and Investigators

• Sponsor: Istanbul University - Cerrahpasa
• Investigators: Principal Investigator: Tansu Birinci, PT, PhD, Istanbul University - Cerrahpasa

Study record dates

Study Major Dates

• Study Start (Actual): June 10, 2024
• Primary Completion (Actual): October 25, 2024
• Study Completion (Actual): January 10, 2025

Study Registration Dates

• First Submitted: June 3, 2024
• First Submitted That Met QC Criteria: June 3, 2024
• First Posted (Actual): June 6, 2024

Study Record Updates

• Last Update Posted (Actual): June 13, 2025
• Last Update Submitted That Met QC Criteria: June 10, 2025
• Last Verified: June 1, 2024

More Information

Terms related to this study

• Other Study ID Numbers: 2133 (European Union Funding for Research and Innovation - HORIZON 2020)

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
• product manufactured in and exported from the U.S.: No