The Influence of Hip Strengthening Exercises on Walking Patterns and Muscle Strength in Persons With Knee Osteoarthritis
|Osteoarthritis, Knee||Behavioral: home exercise program for the hip abductor muscles|
|Study Design:||Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||The Influence of a Home Program of Hip Abductor Exercises on Gait Parameters and Muscle Strength in Persons With Knee Osteoarthritis|
- Walking variables: hip and knee abductor and adductor moments [ Time Frame: baseline and after 8 weeks ]
- Muscle strength measures: isometric and isokinetic peak torque measures for the hip abductor and adductor muscles [ Time Frame: baseline and after 8 weeks ]
- Radiographs: lower limb frontal plane alignment measures - limb alignment in degrees; grading of knee osteoarthritis severity (total score out of 13) [ Time Frame: baseline ]
- Speed of performance on the Five-Times-Sit-to-Stand Test [ Time Frame: baseline and after 8 weeks ]
- Total score on the WOMAC pain subscale and the WOMAC physical function subscale [ Time Frame: baseline and after 8 weeks ]
- Total score obtained for the physical activity scale (PASE) [ Time Frame: baseline and after 8 weeks ]
|Study Start Date:||January 2007|
|Study Completion Date:||September 2008|
|Primary Completion Date:||May 2008 (Final data collection date for primary outcome measure)|
Experimental: Exercise Home-Based Program
Patients with knee OA will be taught a home-based exercise program for the hip abductor muscles during the initial visit. The exercise program will be performed 3 times per week for 8 weeks.
Behavioral: home exercise program for the hip abductor muscles
All patients with knee OA will be taught a home-based exercise program for the hip abductor muscles during the initial visit. Patients will be instructed in the following program: contraction of the gluteus medius muscle during functional activities (gait, stepping sideways up on a step and standing on one leg); and side lying isotonic hip abduction exercises using graded resistance elastic bands positioned around the distal thighs.
The program will be performed 3 times per week for 8 weeks and subjects will record exercise frequency and level of resistance on exercise calendars. Follow-up visits will occur at the end of week 1 and week 4 for review and progression of exercises. A telephone follow-up call will occur for support and participants will be encouraged to call with any questions or concerns.
Knee osteoarthritis is a common age-related impairment that may progress to cause significant pain and physical disability. Excessive loading at the knee joint is believed to contribute to the progression of knee osteoarthritis. The hip joint and surrounding muscles have been shown to influence the amount of stress occurring at the knee joint during walking. In particular, the hip abductor muscles may have an effect on the knee joint by controlling the position of the pelvis and/or by acting as lateral stabilizers for the knee.
Research suggests that the function of the hip muscles during walking may be decreased in people with knee osteoarthritis and that greater loads may be placed on the knee joint as a result. Thus, interventions aimed at strengthening the hip abductor muscles may be effective for reducing stress on the arthritic knee and slowing the rate of progression of knee osteoarthritis.
The design of the study is a two-group pretest-posttest design using an untreated control group. Thirty-five individuals with medial compartment knee osteoarthritis will be recruited through newspaper advertisements and from the practices of orthopedic surgeons in Kingston, Ontario. Each participant with knee osteoarthritis will be matched with an asymptomatic volunteer for age (+/- 5 years), height (+/- 5 cm), mass (+/- 5 kg) and gender. Participants in the control group will have no clinical or radiographic diagnosis of knee or hip osteoarthritis or rheumatoid arthritis and no history of hip or knee trauma or pain.
Please refer to this study by its ClinicalTrials.gov identifier: NCT00427843
|School of Rehabilitation Therapy, Queen's University|
|Kingston, Ontario, Canada, K7L 3N6|
|Study Director:||Elsie G. Culham, PhD||Queen's University|