Knee Stability Training for Knee Osteoarthritis (OA)
Knee Stability Training in Individuals With Knee Osteoarthritis
People with knee osteoarthritis (OA) frequently complain of knee instability. This study will test whether certain exercises can improve knee stability, reduce pain, and improve physical function in people with knee OA.
Study hypotheses: 1) Participants in the stability training group will demonstrate less pain and higher levels of physical function, based on self-report measures of pain and function (WOMAC, Lower Extremity Function Scale), and less time to complete the Get Up and Go test, a physical performance measure of function. 2) During walking and the step down task, participants in the stability training group will demonstrate greater knee motion during weight bearing, greater vertical ground reaction forces and loading rates, and reduced ratios of co-contraction between quadriceps/hamsting and tibialis anterior/gastrocnemius muscle pairs compared to the standard group. Participants in the stability group will also demonstrate greater step lengths, single limb support times, and average walking velocity compared to the standard group.
Tutkimuksen yleiskatsaus
Tila
Ehdot
Yksityiskohtainen kuvaus
Traditional exercise therapy for knee OA primarily focuses on lower limb strength and joint motion deficits. Recent evidence has suggested that changes in lower limb biomechanical factors during weight bearing activities may have substantial impact on physical function and disease progression in individuals with knee OA. The effectiveness of exercise therapy programs might be improved by incorporating balance and agility training techniques (knee stability training). The aim of this trial is to test the effectiveness of supplementing traditional exercise therapy with knee stability training techniques tailored for individuals with knee OA.
Participants will be randomly assigned to one of two groups. The first group will participate in a standard rehabilitation program of traditional exercise therapy for knee OA. The second group will participate in a standard rehabilitation program supplemented with a knee stability program. Study visits will occur at study entry, 2 months, 6 months, and 1 year. At each study visit, changes in pain, physical function, and biomechanical factors will be assessed. This study will last for one year.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Vaihe 2
Yhteystiedot ja paikat
Opiskelupaikat
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Pennsylvania
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Pittsburgh, Pennsylvania, Yhdysvallat, 15260
- University of Pittsburgh, Department of Physical Therapy, School of Health and Rehabilitation Sciences
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Meet the 1986 American College of Rheumatology (ACR) clinical criteria for knee osteoarthritis
- Grade II or greater Kellgren and Lawrence radiographic changes
Exclusion Criteria:
- History of two or more falls within the year prior to study entry
- Unable to walk a distance of 100 feet without an assistive device or a rest period
- Total knee arthroplasty
- Uncontrolled hypertension
- History of cardiovascular disease
- History of neurological disorders that affect lower extremity function such as stroke or peripheral neuropathy
- Corticosteroid injection to the quadriceps or patellar tendon in the past month, or 3 or more within the past year
- Quadriceps tendon rupture, patellar tendon rupture, or patellar fracture that could place them at risk of re-injury during quadriceps strength testing
- Pregnancy
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Kolminkertaistaa
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
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Kokeellinen: 1
Traditional exercise program supplemented with knee stability training activities
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The addition of agility and perturbation training techniques to the traditional exercise program
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Active Comparator: 2
Traditional exercise program
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Exercises include stretching, strengthening, and aerobic exercise
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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Western Ontario and McMaster OA index (WOMAC)
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
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Measured at baseline, 2 months, 6 months, 1 year
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Lower Extremity Function Scale
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
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Measured at baseline, 2 months, 6 months, 1 year
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Get Up and Go test (a physical performance measure of function)
Aikaikkuna: Measured at baseline, 2 months, 6 months
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Measured at baseline, 2 months, 6 months
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Knee Outcome Survey - Activities of Daily Living Scale
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
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Measured at baseline, 2 months, 6 months, 1 year
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
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Cartilage morphology changes as measured by MRI
Aikaikkuna: Measured at baseline, 1 year
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Measured at baseline, 1 year
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Physical Activity Scale for the Elderly
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
|
Measured at baseline, 2 months, 6 months, 1 year
|
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Quadriceps strength and activation
Aikaikkuna: Measured at baseline, 2 months, 6 months
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Measured at baseline, 2 months, 6 months
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Radiographic severity of OA
Aikaikkuna: Measured at baseline, 1 year
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Measured at baseline, 1 year
|
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Fear Avoidance questionnaire for the knee
Aikaikkuna: Measured at baseline, 2months, 6 months, 1 year
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Measured at baseline, 2months, 6 months, 1 year
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Beck Anxiety Index
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
|
Measured at baseline, 2 months, 6 months, 1 year
|
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Center for Epidemiological Studies Depression Scale
Aikaikkuna: Measured at baseline, 2 months, 6 months, 1 year
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Measured at baseline, 2 months, 6 months, 1 year
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Motion analysis variables (knee motion, vertical ground reaction force, loading rates, knee adduction/abduction moment, and lower extremity muscle co-contractions during walking and a step-down task)
Aikaikkuna: Measured at baseline, 2 months, 6 months
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Measured at baseline, 2 months, 6 months
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Päätutkija: G. Kelley Fitzgerald, PhD, PT, University of Pittsburgh, Department of Physical Therapy, School of Health and Rehabilitation Sciences
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Fitzgerald GK, White DK, Piva SR. Associations for change in physical and psychological factors and treatment response following exercise in knee osteoarthritis: an exploratory study. Arthritis Care Res (Hoboken). 2012 Nov;64(11):1673-80. doi: 10.1002/acr.21751.
- Teixeira PE, Piva SR, Fitzgerald GK. Effects of impairment-based exercise on performance of specific self-reported functional tasks in individuals with knee osteoarthritis. Phys Ther. 2011 Dec;91(12):1752-65. doi: 10.2522/ptj.20100269. Epub 2011 Oct 14.
- Fitzgerald GK, Piva SR, Gil AB, Wisniewski SR, Oddis CV, Irrgang JJ. Agility and perturbation training techniques in exercise therapy for reducing pain and improving function in people with knee osteoarthritis: a randomized clinical trial. Phys Ther. 2011 Apr;91(4):452-69. doi: 10.2522/ptj.20100188. Epub 2011 Feb 17.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- NIAMS-117
- R01AR048760-01A2 (Yhdysvaltain NIH-apuraha/sopimus)
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