Effect Of Strengthening Hip Rotators And Ankle Muscles On Knee Osteoarthritis
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      The goal of this clinical trial is to investigate the effect of adding strengthening exercise
      for hip rotators and ankle muscles to knee exercises on pain, function, muscles strength ,
      and knee proprioception in patients with knee osteoarthritis.

      The main question it aims to answer is:

        -  What is the effect of adding strengthening exercise for hip rotators and ankle muscles
           to knee exercises on pain, function, strength of hip rotators and ankle muscles, and
           knee proprioception in patients with knee osteoarthritis?" Adult male and female
           diagnosed with unilateral or bilateral knee osteoarthritis, referred from orthopedic
           surgeons according to inclusion and exclusion criteria will be enrolled in this study,
           randomly allocated to groups and received exercise for 4 weeks.

        -  Control group Patients in this group will receive knee exercises in the form of
           stretching for hamstring and calf. Strengthening exercises in form of strengthening
           exercise for quadriceps.

        -  Experimental group In addition to the same knee exercise of control group patients will
           receive strengthening exercise for hip rotators and ankle muscles.
    

Detailed description: 
      The purpose of the current study is to investigate the effect of adding strengthening
      exercise for hip rotators and ankle muscles to knee exercises on pain, function, strength of
      muscles, and knee proprioception in patients with knee osteoarthritis. Adult male and female
      diagnosed with unilateral or bilateral knee osteoarthritis, referred from orthopedic surgeons
      according to inclusion and exclusion criteria will be enrolled in this study, randomly
      allocated to groups and received exercise for 4 weeks. Control group Patients in this group
      will receive knee exercises in the form of stretching for hamstring and calf. Strengthening
      exercises in form of strengthening exercise for quadriceps. Experimental group In addition to
      the same knee exercise of control group patients will receive strengthening exercise for hip
      rotators and ankle muscles.

      Recruited subjects will be screened with consideration of the inclusion and exclusion
      criteria. Aim of the study and all testing procedures will be verbally explained for eligible
      subjects and all relevant questions will be answered. If they agreed to participate in the
      study, an informed consent will be signed . Then, basic demographic information will be
      collected and patients will start the test. We will measure pain using visual analogue scale,
      functional level of the knee using Arabic Knee injury and Osteoarthritis Outcome Score
      questionnaire, isometric muscle strength of quadriceps, hip external and internal rotators,
      dorsi flexors, planter flexors, evertors and invertor muscles of ankle will be measured by
      handheld dynamometer and finally knee proprioception will be measured by assessing joint
      position sense by digital inclinometer. All these measurements will be done at base line and
      after (4 week) at the end of the treatment program.

      All patients will receive knee exercises according to guidelines and previous studies in the
      form of strengthening exercises that progress from 50% of the

        1. repetition maximum at first 2 week to 70% of 1 repetition maximum at last

        2. weeks, and from mild and moderate Thera band resistance in the first 2 weeks to maximum
           resistance in the last 2 weeks. In addition to knee muscle strengthening exercises,the
           experimental group will receive hip rotators and ankle muscles strengthening exercises.
           Passive stretching for hamstring and calf muscles will be done at the end of all
           exercises. Stretching will be performed three repetitions per session, holding each
           stretch for 30 seconds, with 10-seconds rest in between. All exercises will be performed
           for 30 to 45 minutes per session, 3 times per week for 4 weeks (12 sessions).
    

Intervention name(s): therapeutic exercises
Intervention type(s): Other
Intervention description(s): strengthening exercise and stretching exercise
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Triple blinded Randomized controlled trial
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment