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Knee Malalignment and Thigh Muscle Strengthening in Individuals With Medial Knee Arthritis

This study has been completed.
Australian Physiotherapy Research Foundation
United Pacific Industries
Information provided by:
University of Melbourne Identifier:
First received: December 20, 2006
Last updated: December 21, 2006
Last verified: December 2006
To investigate the effects of quadriceps strengthening on the adductor moment in individuals with medial knee OA and whether quadriceps strengthening has a different effect on the adductor moment in individuals with and without knee malalignment

Condition Intervention Phase
Knee Osteoarthritis
Procedure: Quadriceps strengthening
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
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

Resource links provided by NLM:

Further study details as provided by University of Melbourne:

Primary Outcome Measures:
  • Adduction moment
  • Time points: 0 and 13 weeks

Secondary Outcome Measures:
  • 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

Estimated Enrollment: 107
Study Start Date: May 2004
Estimated Study Completion Date: December 2006
Detailed Description:

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:

  1. Quadriceps exercise over fulcrum using ankle weight
  2. Straight leg raise exercise using ankle weight
  3. Long arc knee extension exercise in sitting using ankle weight
  4. Knee extension exercise with isometric hold at 60° knee flexion using ankle weight
  5. 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.


Ages Eligible for Study:   50 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Pain in the knee
  • Osteophytes on knee x-ray
  • Self-reported pain on the inner aspect of the study knee
  • Osteophytes in the medial compartment of the knee joint and
  • Medial joint space narrowing greater than lateral joint space narrowing on x-ray

Exclusion Criteria:

  • Knee surgery within the previous 6 months
  • History of lower limb joint replacements
  • Systemic arthritic conditions such as rheumatic or psoriatic arthritis
  • Valgus knee deformity (> 5º)
  • Inability to walk without the use of walking aids
  • Intending to start a lower limb strengthening program in the next 3 months
  • Seeking or currently receiving physiotherapy for OA knee
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Please refer to this study by its identifier: NCT00414557

Australia, Victoria
The University of Melbourne
Melbourne, Victoria, Australia, 3040
Sponsors and Collaborators
University of Melbourne
Australian Physiotherapy Research Foundation
United Pacific Industries
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
  More Information

Publications automatically indexed to this study by Identifier (NCT Number): Identifier: NCT00414557     History of Changes
Other Study ID Numbers: 040850
Study First Received: December 20, 2006
Last Updated: December 21, 2006

Keywords provided by University of Melbourne:
Musculoskeletal diseases
Joint diseases

Additional relevant MeSH terms:
Osteoarthritis, Knee
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases processed this record on May 25, 2017