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.
研究概览
地位
详细说明
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.
研究类型
注册 (实际的)
阶段
- 阶段2
联系人和位置
学习地点
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Pennsylvania
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Pittsburgh、Pennsylvania、美国、15260
- University of Pittsburgh, Department of Physical Therapy, School of Health and Rehabilitation Sciences
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：三倍
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的：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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|
有源比较器：2
Traditional exercise program
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Exercises include stretching, strengthening, and aerobic exercise
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研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
|---|---|
|
Western Ontario and McMaster OA index (WOMAC)
大体时间：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
大体时间：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)
大体时间：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
大体时间：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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次要结果测量
结果测量 |
大体时间 |
|---|---|
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Cartilage morphology changes as measured by MRI
大体时间：Measured at baseline, 1 year
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Measured at baseline, 1 year
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Physical Activity Scale for the Elderly
大体时间：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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Quadriceps strength and activation
大体时间：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
大体时间：Measured at baseline, 1 year
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Measured at baseline, 1 year
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Fear Avoidance questionnaire for the knee
大体时间：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
大体时间：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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Center for Epidemiological Studies Depression Scale
大体时间：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)
大体时间：Measured at baseline, 2 months, 6 months
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Measured at baseline, 2 months, 6 months
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合作者和调查者
调查人员
- 首席研究员：G. Kelley Fitzgerald, PhD, PT、University of Pittsburgh, Department of Physical Therapy, School of Health and Rehabilitation Sciences
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (估计)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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