A Study of the Effectiveness of Different Types of Exercise for People With Knee Osteoarthritis (KBA Exercise)
|Knee Osteoarthritis||Other: Kinesthesia, Balance, and Agility (KBA) Exercise Other: Standard LE Strength Training|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Supportive Care
|Official Title:||Efficacy of Kinesthesia, Balance and Agility Exercise Training as Treatment of Knee Osteoarthritis: A Pilot Study|
- WOMAC Osteoarthritis Scale; Function subscale change pre to post intervention - KBA vs. standard strength training [ Time Frame: 8 weeks ]
- WOMAC subscale change in Pain and in Stiffness pre to post intervention [ Time Frame: 8 weeks ]
- Walking speed change in a timed Get Up & Go Test pre to post intervention [ Time Frame: 8 weeks ]
- Stair climbing and descending speed change pre to post intervention [ Time Frame: 8 weeks ]
- Gait quality measures with the GAITRite walking mat and EMG, pre to post intervention [ Time Frame: 8 weeks ]
- Spontaneous engagement in physical activity - change pre to post intervention as measured by the Human Activity Profile [ Time Frame: 8 weeks ]
- Efficacy for exercise change pre to post intervention as measured by the Self-Efficacy for Exercise scale. [ Time Frame: 8 weeks ]
|Study Start Date:||January 2008|
|Study Completion Date:||July 2008|
|Primary Completion Date:||June 2008 (Final data collection date for primary outcome measure)|
KBA = Kinesthesia, Balance, Agility Exercise Training
Other: Kinesthesia, Balance, and Agility (KBA) Exercise
Participants will exercise three times per week 20 to 30 minutes per session. Agility/Active Range of Motion exercises provide warm-up, improve joint range-of-motion & agility, dynamic proprioception,functional strength & endurance.
Kinesthesia & Balance Training will challenge the subject's proprioceptive and neuromuscular control mechanisms to adapt and stabilize the knee joints during dynamic ADL activities (walking, climbing, etc); improve static and dynamic balance and sense of stability & confidence in ADL activities.
Soft pads will be used to progress some of the kinesthesia & balance challenge training. Thera-Band® balance pads at 3 levels of softness will be used. These balance pads allow both appropriate starting difficulty and progression of difficulty level (i.e., the softer the pad, the greater the difficulty). Subjects will demonstrate safe balance on a stable surface (i.e. one-footed standing on floor) prior to progressing to the first level of the soft pads.
Active Comparator: 2
Standard Lower Extremity Strength Training
Other: Standard LE Strength Training
Standard therapeutic exercises for knee OA which are widely used. Body weight and Thera-Band® color coded elastic bands will be used as appropriate to provide resistance. Exercises will be progressed according to the individual participant's improvement. All training for the ST condition will be conducted on stable surfaces (e.g. standing on floor, sitting in chair, lying on floor). Exercises may include 4-direction straight leg lifts, heel slides, quad sets, internal & external hip rotation, heel raises, toe raises, knee extension, knee flexion, partial squats/wall slides, etc.
Radiographic knee OA is present in an estimated 37% of Americans over the age of 60, representing more than 13 million people. Current medical, non-surgical knee OA treatments focus primarily on symptomatic relief and have met with limited, temporary success. Various therapeutic exercise prescriptions have been used to help ameliorate knee OA symptoms and improve function. Leg strength training is most commonly used. However, recent evidence suggests that shorter programs of kinesthesia, balance and agility (KBA) techniques may result in more rapid symptom relief and functional improvements in comparison to traditional therapeutic exercise. These early benefits could potentially lead to greater long term exercise adherence.
In a case study of an elderly female patient with dynamic knee instability related to OA, physical therapists reported success with a combination of KBA training and traditional therapeutic exercise. These findings need to be verified in a controlled clinical trial. This pilot study will help determine the proper testing and exercise training methods for a larger clinical trial, and will indicate if KBA training done without concurrent strength training is a viable intervention.
Research Hypothesis: Among men and women age 50 and over with Kellgren and Lawrence (1957) Grade 2 or higher symptomatic tibiofemoral OA in one or both knees, an 8-week, 3-day per week kinesthesia, balance & agility (KBA) exercise program - designed to increase dynamic neuromuscular knee stability - safely and effectively changes physical function more effectively than standard leg strength training
Please refer to this study by its ClinicalTrials.gov identifier: NCT00519922
|United States, Florida|
|Morton Plant Mease Cheek-Powell Wellness Center|
|Clearwater, Florida, United States|
|Principal Investigator:||Matthew W Rogers, MS||The Arthritis Research Institute of America|
|Study Director:||Nauris Tamulevicius, PhD||Morton Plant Mease Cheek-Powell Wellness Center|
|Study Chair:||Frances V Wilder, PhD||The Arthritis Research Institute of America|