Randomized Controlled Trial of Dynamic Balance Training in People With Knee Osteoarthritis
2016年6月5日 更新者：University of British Columbia
The Effect of Dynamic Balance Training on Balance and Physical Function in Those With Knee Osteoarthritis
There is a high prevalence of falls in those with knee osteoarthritis (OA) compared to healthy older adults.
Balance is a key element of function that allows individuals to maintain posture and respond to perturbations, and poor balance control, a risk factor for falls, has been noted in those with knee OA.
There is a lack of research guiding treatment for balance deficits in knee OA, with interventions aimed at improving balance deficits in those with knee OA having mixed results.
Targeted dynamic balance interventions in other patient populations have been shown to significantly improve dynamic balance control and physical function.
If results similar to such populations can be achieved, such a program may produce a significant reduction in functional disability in the knee OA population and improve quality of life.
The purpose of this study is to examine the effect of a 10-week targeted dynamic balance intervention on dynamic balance and physical function in people with knee OA.
This will be a randomized controlled trial (RCT).
調査の概要
研究の種類
介入
入学 (実際)
40
段階
- 適用できない
連絡先と場所
このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。
研究場所
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British Columbia
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Vancouver、British Columbia、カナダ、V6T 1Z3
- Motion Analysis and Biofeedback Laboratory, The University of British Columbia
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参加基準
研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。
適格基準
就学可能な年齢
50年～80年 (大人、高齢者)
健康ボランティアの受け入れ
いいえ
受講資格のある性別
全て
説明
Inclusion Criteria:
- age 50 - 80 years (to meet the American College of Rheumatology clinical definition of OA)
- radiographically confirmed knee OA in the medial compartment of the tibiofemoral joint
- predominance of pain/tenderness over the medial (inside) region of the knee
Exclusion Criteria:
- articular cartilage degradation in the lateral tibiofemoral compartment greater than the medial
- inflammatory arthritic condition
- history of knee or hip replacement surgery
- recent use of corticosteroids (oral or via injection, within last 6 months)
- pain originating predominantly from the patellofemoral joint
- inability to ambulate without a gait aid
- non-English speaking
- recent (within 6 months) arthroscopic knee surgery
- significant hip or back pain (limits the ability to perform the testing)
- Neurological, musculoskeletal or other condition that affects movement ability or balance (i.e. stroke, diabetes, Parkinson's, heart attack, multiple sclerosis, fibromyalgia)
研究計画
このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
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介入なし：Wait list
Wait list control group.
Participants will be placed on the wait list and asked to maintain their current routine and level of activity during the 10 week period.
Control group participants will receive the dynamic balance training program in a single training session after the followup (second testing session at 10 weeks).
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実験的：Treatment (balance training)
Targeted dynamic balance training.
Dynamic balance training will consist of progressive exercise training over three phases, with exercises emphasising dynamic balance control, muscle strength and proprioception.
Exercises will be performed four times per week for ten weeks.
Exercises will be taught and supervised by a trained kinesiologist.
Difficulty of exercises will be increased progressively over time by increasing resistance, time of timed exercises, and distance of walking exercises.
Exercises will be progressed to different exercises in each new phase (total 3 phases).
Participants will complete six treatment sessions at the university (during weeks 1, 2, 3, 5, 7, and 9) that will be included in the total number of sessions per week.
All other sessions will be performed at home.
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Participants in this study group will complete dynamic balance training exercises four times per week, for ten weeks.
Exercise sessions at the university will last approximately one hour, and home exercise sessions will take approximately 30 minutes to complete.
Exercises will emphasize dynamic balance control, muscle strength and proprioception and will be progressed over three phases during the ten weeks (with more difficult exercises phased in, and exercises that have been mastered phased out).
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in dynamic balance and mobility from baseline
時間枠：0, 10 weeks
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The Community Balance and Mobility Scale (CB&M) will be used to assess dynamic balance and mobility.
The CB&M is a scale designed to assess dynamic balance and mobility and is administered by a trained assessor.
The scale consists of 13 items including bending, walking, turning, and stair descent, with a maximum possible score of 96 and minimum score of 0. The scale has been validated and deemed reliable for use in the knee osteoarthritis population.
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0, 10 weeks
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Change in self-reported physical function from baseline
時間枠：0, 10 weeks
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The Western Ontario & McMaster Universities Osteoarthritis Index (WOMAC) will be used to assess self-reported physical function.
The WOMAC physical function subscale consists of 17 questions assessing physical function capabilities during activities of daily living.
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0, 10 weeks
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Change in knee pain from baseline
時間枠：0, 10 weeks
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Average pain over the previous week will be assessed using an 11-point numerical rating scale (0 = no pain; 10 = worst pain possible).
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0, 10 weeks
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Change in fear of pain from baseline
時間枠：0, 10 weeks
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The Brief Fear of Movement Scale will be used to assess fear of pain.
This scale is based on the widely used Tampa Scale of Kinesiophobia and contains 6 questions that evaluate fear of pain, movement and re-injury.
The scale has been validated in individuals with OA.
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0, 10 weeks
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Change in self-reported physical activity level from baseline
時間枠：0, 10 weeks
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The Physical Activity Scale for the Elderly score (PASE) will be used to measure self-reported physical activity level.
This valid and reliable self-report instrument measures the type and level of recreational and occupational physical activity in the previous week.
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0, 10 weeks
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Change in knee joint proprioception from baseline
時間枠：0, 10 weeks
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Knee joint proprioception will be measured using a knee joint repositioning task, previously used in those with OA to assess joint proprioception.
Proprioception will be assessed in three randomly chosen target positions (15°, 30°, and 60° of knee flexion) while the participant is seated on an isokinetic dynamometer.
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0, 10 weeks
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Change in muscle strength from baseline
時間枠：0, 10 weeks
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Maximal concentric and eccentric muscle strength of the plantarflexors, quadriceps, and hamstrings will be measured using the same isokinetic dynamometer as for the knee joint repositioning task.
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0, 10 weeks
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Change in knee joint range of motion from baseline
時間枠：0, 10 weeks
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Range of motion will be measured using a goniometer, similar to other studies of knee OA.
Participants will be asked to flex and extend their knee joint while supine.
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0, 10 weeks
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その他の成果指標
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Ratio of number of exercise sessions attended to the maximum
時間枠：10 weeks
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Adherence to the exercise program will be assessed by calculating the number of exercise sessions attended divided by the maximum number of sessions.
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10 weeks
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Number of participants with adverse events
時間枠：10 weeks
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Adverse events experienced due to the intervention (i.e.
increased knee pain) will be recorded weekly by participants.
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10 weeks
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Change in medication use
時間枠：10 weeks
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Any change in pharmacological use by participants will be recorded.
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10 weeks
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Change in co-interventions
時間枠：10 weeks
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Other therapies that participants may be pursuing will be recorded.
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10 weeks
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協力者と研究者
ここでは、この調査に関係する人々や組織を見つけることができます。
捜査官
- 主任研究者：Michael A Hunt, PT, PhD、University of British Columbia
出版物と役立つリンク
研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。
研究記録日
これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。
主要日程の研究
研究開始
2014年6月1日
一次修了 (実際)
2015年12月1日
研究の完了 (実際)
2015年12月1日
試験登録日
最初に提出
2014年4月1日
QC基準を満たした最初の提出物
2014年4月1日
最初の投稿 (見積もり)
2014年4月4日
学習記録の更新
投稿された最後の更新 (見積もり)
2016年6月7日
QC基準を満たした最後の更新が送信されました
2016年6月5日
最終確認日
2016年6月1日
詳しくは
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