Cross-Education From Unilateral Strength and Balance Training in Older Adults With Bilateral Knee Osteoarthritis

March 18, 2026 updated by: Lara Juriša, University of Zagreb

Cross-Education of Combined Unilateral Strength and Balance Training on Motor Function in Older Adults With Bilateral Knee Osteoarthritis

Kinesitherapy is one of the main tools in the rehabilitation of knee osteoarthritis, but is often limited due to pain, reduced functionality, and fear of falling in older adults. This study will, through three sub-studies, examine the effects of unilateral training programs on strength, movement control, balance, and pain in the contralateral leg, as well as on functionality, fall risk, and kinesiophobia in older adults with bilateral knee osteoarthritis through three sub-studies. A total of 45 participants (aged 60-80 years) with bilateral knee osteoarthritis will be randomly assigned to one of three groups: 1. combined unilateral strength and balance training; 2. unilateral balance training; 3. unilateral strength training. Strength will be measured with maximal voluntary contraction, balance using a single leg stance test on an unstable surface, movement control with an active joint position reproduction test, and functionality using the six-minute walk test and the Western Ontario and McMaster Osteoarthritis Index questionnaire. Pain will be assessed with the Visual Analog Scale and the Intermittent and Constant Osteoarthritis Pain questionnaire, fall risk with the Timed Up and Go test and the Falls Efficacy Scale-International questionnaire, and kinesiophobia using the TAMPA questionnaire. This study will expand knowledge on cross-transfer and its effects on symptoms in the rehabilitation of older adults with bilateral knee osteoarthritis.

This research is a part of a doctoral thesis conducted under the supervision of assoc. prof. Tatjana Trošt, PhD.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

45

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 Contact

Study Contact Backup

Study Locations

  • Croatia
      • Zagreb, Croatia, 10000
        • University of Zagreb Faculty of Kinesiology

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
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • age 60-80 years,
  • bilateral knee osteoarthritis of grade II-III according to the Kellgren-Lawrence classification

Exclusion Criteria:

  • acute lower extremity injuries in the past year,
  • taking nonsteroidal anti-inflammatory drugs within the past month,
  • involvement in physical therapy within the past 6 months,
  • undergoing intra-articular injections and/or knee surgery within the past year,
  • rheumatoid arthritis, septic arthritis, uncontrolled diabetes, other systemic inflammatory and autoimmune diseases, and severe cardiovascular, renal, and hepatic comorbidities

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: Unilateral strength and balance training group
Other: 8-Week Unilateral Strength and Balance Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral exercises with the less affected leg, combining strength and balance training. Each session lasts 50 minutes, including warm-up, main exercises (15-20 min), and relaxation. The program consists of 24 sessions over 8 weeks.
Experimental: Unilateral balance training group
Other: 8-Week Unilateral Balance Training Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral balance exercises with the less affected leg. Each 50-minute session includes warm-up, 15-20 minutes of main balance exercises, and relaxation. The program lasts 8 weeks with 24 sessions.
Experimental: Unilateral strength training group
Other: 8-Week Unilateral Strength Training Program for the Less Affected Leg in Older Adults With Bilateral Knee Osteoarthritis
Participants perform unilateral strength exercises with the less affected leg. Each 50-minute session includes warm-up, 15-20 minutes of main strength exercises, and relaxation. The program lasts 8 weeks with 24 sessions.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Change from baseline in balance performance in older adults with bilateral knee osteoarthritis after 8 weeks of unilateral strength and/or balance training across all three intervention groups
Time Frame: From baseline (pre-intervention) to the end of the 8-week training program
From baseline (pre-intervention) to the end of the 8-week training program

Collaborators and Investigators

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

Sponsor

University of Zagreb

Collaborators

University of Zagreb, The Faculty of Kinesiology

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 (Estimated)

September 1, 2026

Primary Completion (Estimated)

December 1, 2027

Study Completion (Estimated)

December 1, 2027

Study Registration Dates

First Submitted

March 18, 2026

First Submitted That Met QC Criteria

March 18, 2026

First Posted (Actual)

March 24, 2026

Study Record Updates

Last Update Posted (Actual)

March 24, 2026

Last Update Submitted That Met QC Criteria

March 18, 2026

Last Verified

May 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 13/2025

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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