Knee Malalignment and Thigh Muscle Strengthening in Individuals With Medial Knee Arthritis
Procedure: Quadriceps strengthening
|Study Design:||Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Factorial Assignment
Masking: Single Blind
Primary Purpose: Treatment
|Official Title:||The Effects of Knee Malalignment and Quadriceps Strengthening on the Adduction Moment in Individuals With Medial Knee Osteoarthritis|
- Adduction moment
- Time points: 0 and 13 weeks
- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire
- Numerical rating scales for pain
- Quadriceps and hamstrings strength
- Self-selected walking speed
- Dynamic balance using step test
- Physical function using stair climb test
- Time points: 0 and 13 weeks
|Study Start Date:||May 2004|
|Estimated Study Completion Date:||December 2006|
Although quadriceps strengthening is the cornerstone of physiotherapy management, recent evidence suggests that high quadriceps strength in patients with malaligned knees may increase OA progression.
This study investigates the effects of quadriceps strengthening on the adduction moment in patients with medial knee OA with and without malalignment. 107 participants with and without varus knee malalignment were recruited and randomised into an exercise or a control group. Participants in the exercise group were taught five quadriceps strengthening exercises by a project physiotherapist to be performed five days a week for twelve weeks at home. The exercises were:
- Quadriceps exercise over fulcrum using ankle weight
- Straight leg raise exercise using ankle weight
- Long arc knee extension exercise in sitting using ankle weight
- Knee extension exercise with isometric hold at 60° knee flexion using ankle weight
- Knee extension exercise with isometric hold at 60° knee flexion using an elastic band.
Each exercise was performed at 2x10 repetitions for the first 2 weeks and 3x10 repetitions thereafter.
Participants visited the physiotherapist 7 times at Week 1, 2, 3, 4, 5, 7 and 10. They were given the ankle weights and elastic band to bring home and instructed about the repetitions and weights to use by the physiotherapist, who also checked and progressed their exercises. The average duration of the physiotherapy sessions was 30 minutes. To monitor compliance, each participant was given an exercise instructions sheet and kept a training diary to record the exercises they had done.
The control group received no intervention.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00414557
|The University of Melbourne|
|Melbourne, Victoria, Australia, 3040|
|Principal Investigator:||Kim Bennell, PhD||University of Melbourne|
|Principal Investigator:||Rana Hinman, PhD||University of Melbourne|
|Principal Investigator:||Tim Wrigley, MSc||University of Melbourne|
|Principal Investigator:||Boon W Lim, MSc||University of Melbourne|
|Principal Investigator:||Leena Sharma, MD||Northwestern University Medical School, Chicago|