The Effect of Quadriceps Sets Exercise on Knee Joint Biomechanics and Functional Outcomes of Post-Total Knee Arthroplasty Patients

Lower limb strengthening, especially the quadriceps training, is of much necessity for patients with knee arthroplasty. As the quadriceps strengthening exercises play a vital role in controlling gait pattern during walking and different activities. Vastus inetrmedius muscle responsible for the last 10 degree of knee extension. This enable the knee joint to be in locked position which is the stable position during gait.

Study Overview

• Status: Completed
• Conditions: Total Knee Arthroplasty
• Intervention / Treatment: Procedure: Quadriceps Set Exercise; Procedure: Terminal Knee Extension; Procedure: Traditional Physical Therapy

• Study Type: Interventional
• Enrollment (Actual): 36
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Saudi Arabia
  • Sakakah, Saudi Arabia
    • Jouf University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

1. Age (ranging from 40 to 60 years old).
2. Weight (ranging from 65 to 75 kg).
3. Height (ranging from 150 to 165 cm)
4. Sex ( male/ female).
5. Patients who undergoing total knee arthroplasty after 1 months until one year after operation.

Exclusion Criteria:

1. Cognitive impairment.
2. Neuromuscular impairment.
3. Patient can't walk alone (need of assistive device).

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Quadriceps Set & Terminal Knee Extension Exercises Group (Study Group)	Procedure: Quadriceps Set Exercise; Quadriceps knee set exercises was introduced with the patient in sitting position and pillow was placed under his knee joint then ask patient to dorsiflex his ankle and extend knee make hold 10 second then relax. Two exercises session per week for four week.; Procedure: Terminal Knee Extension; Terminal knee extension exercise using Thera band was introduced with the patient in sitting or standing position and the theraband was placed around his knee joint. Two exercises session per week for four week.; Procedure: Traditional Physical Therapy; Traditional physical therapy program will include passive stretching exercise to the hamstrings while the patient is supine lying flex the hip while the knee extended and hold for 30-45 seconds, strengthening exercise to the guadriceps muscle by extending the knee whie the patient is in the sitting position.
Experimental: Traditional Physical Therapy Group (Control Group)	Procedure: Traditional Physical Therapy; Traditional physical therapy program will include passive stretching exercise to the hamstrings while the patient is supine lying flex the hip while the knee extended and hold for 30-45 seconds, strengthening exercise to the guadriceps muscle by extending the knee whie the patient is in the sitting position.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Visual Analoge Scale (VAS)	VAS is a straight horizontal line of usually 100 mm. The ends are defined as the extreme limits of the pain . It is orientated from the left (worst) to the right (least) pain.	Four weeks
Quadriceps Muscle Strength	it will be measured using a hand held dynamometer.	4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of Motion (ROM)	ROM of last ten degree of knee extension measured by goniometer	4 weeks
Oxford Knee Score (OKS)	The OKS is a patient reported outcome measure that consists of 12 questions about an individual's level of function, activities of daily living and how they have been affected by pain over the preceding four weeks.The Oxford Knee Score (OKS) ranges from 0 to 48, 0 = Worst possible knee pain/function. 48 = Best possible knee pain/function.	4 weeks
The Western Ontario and McMaster Universities Osteoarthritis Index (The WOMAC)	It is a questionnaire of 24-item. Self-administered tool used to assess pain, stiffness, and physical function in patients with hip and knee osteoarthritis. WOMAC Likert Version (0-96 total) Each item scored: 0 = none; = mild; = moderate; = severe; = extreme Total score ranges from: 0 = best possible (no symptoms). 96 = worst possible (severe symptoms).	4 weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2025
• Primary Completion (Actual): February 1, 2026
• Study Completion (Actual): March 1, 2026

Study Registration Dates

• First Submitted: November 14, 2025
• First Submitted That Met QC Criteria: November 14, 2025
• First Posted (Actual): November 18, 2025

Study Record Updates

• Last Update Posted (Actual): March 10, 2026
• Last Update Submitted That Met QC Criteria: March 7, 2026
• Last Verified: November 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: 10-03-46

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES

Drug and device information, study documents

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