Randomized Controlled Trial of Dynamic Balance Training in People With Knee Osteoarthritis
5 juni 2016 bijgewerkt door: 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).
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Studietype
Ingrijpend
Inschrijving (Werkelijk)
40
Fase
- Niet toepasbaar
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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British Columbia
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Vancouver, British Columbia, Canada, V6T 1Z3
- Motion Analysis and Biofeedback Laboratory, The University of British Columbia
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
50 jaar tot 80 jaar (Volwassen, Oudere volwassene)
Accepteert gezonde vrijwilligers
Nee
Geslachten die in aanmerking komen voor studie
Allemaal
Beschrijving
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)
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Enkel
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Geen tussenkomst: 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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Experimenteel: 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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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change in dynamic balance and mobility from baseline
Tijdsspanne: 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
Tijdsspanne: 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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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Change in knee pain from baseline
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
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Ratio of number of exercise sessions attended to the maximum
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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
Tijdsspanne: 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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Medewerkers en onderzoekers
Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.
Sponsor
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Michael A Hunt, PT, PhD, University of British Columbia
Publicaties en nuttige links
De persoon die verantwoordelijk is voor het invoeren van informatie over het onderzoek stelt deze publicaties vrijwillig ter beschikking. Dit kan gaan over alles wat met het onderzoek te maken heeft.
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start
1 juni 2014
Primaire voltooiing (Werkelijk)
1 december 2015
Studie voltooiing (Werkelijk)
1 december 2015
Studieregistratiedata
Eerst ingediend
1 april 2014
Eerst ingediend dat voldeed aan de QC-criteria
1 april 2014
Eerst geplaatst (Schatting)
4 april 2014
Updates van studierecords
Laatste update geplaatst (Schatting)
7 juni 2016
Laatste update ingediend die voldeed aan QC-criteria
5 juni 2016
Laatst geverifieerd
1 juni 2016
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- H14-00587
- AHPA-TAS- 14-001 (Ander subsidie-/financieringsnummer: AHPA/The Arthritis Society)
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