Effects of Core Stabilization Exercises in Female Patients With Gonarthrosis

Randomized Controlled Study of the Effects of Core Stabilization Exercises in Addition to Knee Exercises in Female Patients With Gonarthrosis

Osteoarthritis (OA) is a non-inflammatory degenerative disease characterized by progressive deterioration of cartilage tissue, synovial membrane, and joint capsule, primarily affecting weight-bearing joints. Individuals with knee osteoarthritis exhibit weakness in the trunk and periarticular muscles. This loss of strength in the trunk and periarticular muscles increases the load on the joint, contributing to the development and progression of the disease. This study aimed to investigate the effects of core stabilization, applied in addition to knee muscle exercise programs, on clinical symptoms and functional capacity in individuals with knee osteoarthritis.

Study Overview

• Status: Recruiting
• Conditions: Knee Osteoarthritis (Knee OA)
• Intervention / Treatment: Other: 10 days of conventional physiotherapy (Hot Pack, TENS, Ultrasound) and 6 weeks of routine knee exercises; Other: Six weeks of core stabilization exercises.

Detailed Description

Osteoarthritis is the most common chronic joint disease and a leading cause of disability worldwide. It represents a significant public health and cost problem due to reduced work productivity and early retirement. OA is a non-inflammatory degenerative disease characterized by progressive deterioration of cartilage tissue, synovial membrane, and joint capsule, particularly in weight-bearing joints, along with a series of biochemical and morphological changes. While its etiology is not fully understood, it is considered a multifactorial disease involving a combination of systemic and regional factors. Increased bone density, joint laxity, and excessive mechanical loading are some of these factors. Symptoms of knee osteoarthritis include pain, joint stiffness, swelling, loss of function, and muscle weakness. Pain and joint stiffness in individuals negatively affect daily living activities such as climbing stairs, walking, and running, leading to decreased functionality. Current literature emphasizes that strong proximal trunk stabilization is needed for safe and effective completion of movements in the distal segments, and that weakness in this region is directly related to lower extremity pain. This study aimed to investigate the effects of core stabilization, applied in addition to an exercise program for the knee muscles, on clinical symptoms and functional capacity in individuals with knee osteoarthritis.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Selvin Balki, Associate professor, Ph.D.; Phone Number: 2652 +90 346 4870000; Email: balkipt@gmail.com
• Study Contact Backup: Name: Eda Yıldırım, PT; Phone Number: +90 5056925334; Email: edaayldrm7@gmail.com

Study Locations

• Turkey (Türkiye)
  • Sivas, Turkey (Türkiye), 58140
    • Recruiting
    • Sivas Cumhuriyet University
    • Contact: Selvin Balki, Associate professor, Ph.D.; Phone Number: 2652 +90 346 4870000; Email: balkipt@gmail.com
    • Contact: Eda Yıldırım, PT; Phone Number: +90 5056925334; Email: edaayldrm7@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Kellgren-Lawrence 2-3 knee osteoarthritis
• Female patient aged 40-65
• Volunteer

Exclusion Criteria:

• Having received physical therapy within the last month
• Presence of neurological, cardiac, and respiratory problems
• Less than 90 degrees of flexion in the knee and hip joints
• Presence of any pathology in the lower extremity that may affect balance and function
• History of lower extremity surgery
• Severe visual, hearing, and speech impairment
• Illiteracy in Turkish
• Body mass index of 30 or higher

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: Experimental Group; This group will receive 10 days of conventional physiotherapy (Hot Pack, TENS, Ultrasound) and 6 weeks of routine knee exercises + 6 weeks of core stabilization exercises.	Other: 10 days of conventional physiotherapy (Hot Pack, TENS, Ultrasound) and 6 weeks of routine knee exercises; For 10 days, conventional physical therapy consisting of Hot Pack, TENS, Ultrasound, and routine knee strengthening exercises was applied in the hospital. These knee exercises were continued for four weeks after the hospital treatment period.; Other: Six weeks of core stabilization exercises.; For six weeks, Warner et al. A core stabilization exercise protocol, as defined by was provided. This protocol included neutral spine position in hook position, activation of deep abdominal muscles, supine bridge, ipsilateral and contralateral limb movements in hook position, abdominal curl (sit-up), bridge (double and single leg), plank on knees, side plank on knees, clam exercise (without resistance), and modified 100 exercises. The exercises were performed 3 days a week, with 10 repetitions each.
Other: Control Group; This group will receive 10 days of conventional physiotherapy (Hot Pack, TENS, Ultrasound) and 6 weeks of routine knee exercises.	Other: 10 days of conventional physiotherapy (Hot Pack, TENS, Ultrasound) and 6 weeks of routine knee exercises; For 10 days, conventional physical therapy consisting of Hot Pack, TENS, Ultrasound, and routine knee strengthening exercises was applied in the hospital. These knee exercises were continued for four weeks after the hospital treatment period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sit Ups	Participants are positioned supine with knees flexed and hands crossed over their shoulders. Their feet are held in place by the researcher, and the individual is asked to perform trunk flexion. The number of repetitions completed within 30 seconds is recorded.	Baseline-6 weeks follow-up
Modified Push-Up	Participants lie face down on an exercise mat with their knees flexed. They are asked to lift their head, torso, and hips off the ground, placing their hands on the floor and extending their elbows, so that they form a straight line. The number of complete repetitions the participant performs while maintaining this straight line within 30 seconds is recorded.	Baseline-6 weeks follow-up
Core Endurance Tests	Core endurance is determined by core endurance tests (right and left lateral bridge test, trunk extension test, trunk flexion test), as defined by McGgill, and the prone bridge test.	Baseline-6 weeks follow-up

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
30-Second Sit-Stand Test	Used to assess lower extremity muscle strength. The participant sits in the middle of a chair with no armrests, back support, and a seat height of 44 cm, with their arms crossed at chest level. Upon the command "Start," the participant is asked to fully stand up and sit down as quickly as possible without losing their balance for 30 seconds. The number of complete sit-ups and stands within 30 seconds is recorded as a score.	Baseline-6 weeks follow-up
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)	The index is a validated, multidimensional, patient-reported assessment tool used to evaluate pain, stiffness, and physical function in patients with knee osteoarthritis. The index consists of three subcategories and a total of 24 items: pain (5 questions; 0-20 points), stiffness (2 questions; 0-8 points), and physical function (17 questions; 0-68 points). Each item is worth 0-4 points. The total score ranges from 0 to 96. In all subcategories and the total score, higher scores indicate worse health status, while lower scores indicate better health status.	Baseline-6 weeks follow-up
Single Leg Balance Test	Participants were asked to stand on one leg on a hard surface, ensuring that the unsupported leg did not touch the other leg and without using external support. The procedure was repeated three times for each participant, and the highest value obtained was used in the statistical analysis phase. The timer was started the moment the participant lifted the supporting leg; it was stopped when the balance was lost, when the unsupported leg touched the ground, or when external support was applied. This test was repeated on both the right and left sides.	Baseline-6 weeks follow-up

Collaborators and Investigators

• Sponsor: Cumhuriyet University
• Investigators: Study Chair: Selvin Balki, Cumhuriyet University; Principal Investigator: Eda Yıldırım, Cumhuriyet University

Study record dates

Study Major Dates

• Study Start (Actual): January 5, 2026
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): September 14, 2026

Study Registration Dates

• First Submitted: March 16, 2026
• First Submitted That Met QC Criteria: March 16, 2026
• First Posted (Actual): March 19, 2026

Study Record Updates

• Last Update Posted (Actual): March 19, 2026
• Last Update Submitted That Met QC Criteria: March 16, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Knee osteoarthritis; Physiotherapy; Function; Core stabilization exercise
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee; Therapeutics; Physical Therapy Modalities; Physical Phenomena; Rehabilitation; Anesthesia and Analgesia; Radiation; Radiation, Nonionizing; Electric Stimulation Therapy; Analgesia; Ultrasonic Waves; Sound; Transcutaneous Electric Nerve Stimulation; High-Energy Shock Waves
• Other Study ID Numbers: SCU-FTR-SB-08

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