Eccentric Versus Concentric Quadriceps Exercises in Knee Osteoarthritis

March 9, 2026 updated by: Fally Usman Arif, Indonesia University

Differences in Improvements of Knee Range of Motion, Muscle Strength, and Functional Capacity Between Eccentric and Concentric Quadriceps Femoris Exercises in Patients With Knee Osteoarthritis

This study aims to compare the effectiveness of eccentric and concentric quadriceps femoris strengthening exercises in patients with knee osteoarthritis. Knee osteoarthritis is a common musculoskeletal condition that causes pain, reduced joint movement, muscle weakness, and functional limitations.

Participants will be assigned to perform either eccentric or concentric unilateral open kinetic chain quadriceps exercises using isotonic loading based on a 10-repetition maximum (10-RM). The exercise program will be conducted three times per week for six weeks.

The primary objective is to evaluate differences in quadriceps muscle strength between the two exercise approaches. Secondary outcomes include changes in knee range of motion and functional capacity measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). The results of this study are expected to provide evidence to guide exercise prescription in rehabilitation programs for patients with knee osteoarthritis.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Knee osteoarthritis (KOA) is a leading cause of pain, disability, and reduced quality of life among older adults. Quadriceps femoris muscle weakness plays a central role in disease progression and functional impairment. Strengthening exercises are recommended as a core component of conservative management; however, the comparative effects of eccentric versus concentric muscle contractions remain incompletely defined.

This interventional comparative study is conducted at the Department of Physical Medicine and Rehabilitation, Dr. Cipto Mangunkusumo National General Hospital, Jakarta. A total of 24 patients diagnosed with knee osteoarthritis based on clinical and radiological criteria are recruited and allocated into two intervention groups.

The Eccentric Exercise Group performs unilateral open kinetic chain full-arc quadriceps exercises emphasizing eccentric contraction using the NK Table. The Concentric Exercise Group performs the same exercise emphasizing concentric contraction. Exercise sessions are conducted three times weekly for six weeks. Intensity is determined using a 10-repetition maximum (10-RM) method. During weeks 1-3, participants perform 3 sets of 6 repetitions; during weeks 4-6, the protocol progresses to 3 sets of 8 repetitions.

Outcome measures include knee range of motion (measured with a goniometer), quadriceps muscle strength (assessed using the NK Table and recorded in kilograms), and functional capacity (evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]). Measurements are obtained before and after the six-week intervention.

The study protocol has received ethical approval from the Ethics Committee of the Faculty of Medicine, Universitas Indonesia - Dr. Cipto Mangunkusumo National General Hospital. All participants provide written informed consent prior to participation.

Study Type

Interventional

Enrollment (Actual)

24

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

  • Indonesia
    • DKI Jakarta
      • Jakarta, DKI Jakarta, Indonesia, 10430
        • Department of Physical Medicine and Rehabilitation

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Female participants aged 40-59 years
  • Diagnosed with unilateral or bilateral knee osteoarthritis based on American College of Rheumatology (ACR) criteria and Kellgren-Lawrence grade II-III
  • Knee pain lasting more than 3 months with Numeric Rating Scale (NRS) score 1-3
  • Limited knee flexion range of motion

Exclusion Criteria:

  • History of unstable cardiovascular, respiratory, or metabolic disease
  • Knee joint instability due to cruciate or collateral ligament laxity or meniscal injury
  • Previous knee surgery
  • History of knee intra-articular injection within the last 3 months
  • Cognitive impairment (Montreal Cognitive Assessment Indonesian Version [MoCA-Ina] score < 26)
  • Clinical signs of tendinopathy characterized by pain during active knee extension (open or closed kinetic chain)
  • Balance disorders

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 Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Eccentric Exercise Group
Participants perform unilateral open kinetic chain full-arc quadriceps strengthening exercises emphasizing eccentric contraction using isotonic loading based on a 10-repetition maximum (10-RM), three times weekly for six weeks.
Other: Eccentric Quadriceps Exercise
Unilateral isotonic quadriceps strengthening emphasizing eccentric contraction using the NK Table, 3 sessions per week for 6 weeks, intensity based on 10-RM. Weeks 1-3: 3 sets of 6 repetitions; Weeks 4-6: 3 sets of 8 repetitions.
Experimental: Concentric Exercise Group
Participants perform unilateral open kinetic chain full-arc quadriceps strengthening exercises emphasizing concentric contraction using isotonic loading based on a 10-repetition maximum (10-RM), three times weekly for six weeks.
Other: Concentric Quadriceps Exercise
Unilateral isotonic quadriceps strengthening emphasizing concentric contraction using the NK Table, 3 sessions per week for 6 weeks, intensity based on 10-RM. Weeks 1-3: 3 sets of 6 repetitions; Weeks 4-6: 3 sets of 8 repetitions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Quadriceps Muscle Strength
Time Frame: Baseline and Week 6
Quadriceps muscle strength measured in kilograms using the 10-repetition maximum (10-RM) method on the NK Table. The outcome is defined as the difference between baseline and post-intervention values at six weeks.
Baseline and Week 6

Collaborators and Investigators

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

Sponsor

Indonesia University

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)

July 15, 2024

Primary Completion (Actual)

June 13, 2025

Study Completion (Actual)

November 21, 2025

Study Registration Dates

First Submitted

March 4, 2026

First Submitted That Met QC Criteria

March 4, 2026

First Posted (Actual)

March 10, 2026

Study Record Updates

Last Update Posted (Actual)

March 11, 2026

Last Update Submitted That Met QC Criteria

March 9, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 895/UN2.F1/ETIK/PPM.00.02/2024

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.

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