Effect of Strengthening the Hip Abductor in Patients With Knee Osteoarthritis: Randomized Controlled Trial
Condition: Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      Osteoarthritis (OA) is a prevalent disease associated with significant morbidity and is one
      of the most common causes of joint pain. Characterized by their chronicity, slow and
      progressive evolution. The overall prevalence of symptomatic knee osteoarthritis is estimated
      at 3.8%, with peak prevalence in the population with an average age of 50 years. The main
      objectives of interventions in patients with knee OA are reduced pain and improved functional
      capacity and exercises are widely recommended. The literature shows a lack of clinical trials
      verifying the effect of strengthening the hip muscles in patients with knee osteoarthritis.
      Thus, the aim of this study is to assess the effect of strengthening the hip abductor muscles
      versus hip adductor muscles in patients with symptomatic OA of the knee.
    

Detailed description: 
      The physical therapy sessions will average duration of one hour, often twice a week for six
      weeks. The exercise intensity will be monitored by the physiotherapist as determined by the
      participant's ability to complete 10 repetitions for a particular exercise and its difficulty
      of execution perceived by the modified Borg scale (CR-10). The exercises are performed with
      load between 60-80% of their capacity, the load will be increased from 2 to 10% when the
      patient can perform 14 full repetitions in the last series (76). It will be set to 30 seconds
      of rest between reps and 2 minutes between sets of exercise.

      Both groups will perform prior heating exercises exercise bike for 10 minutes with moderate
      intensity with the Borg scale. Then there will be two stretches repetitions held for 30
      seconds of muscle groups: hamstrings, quadriceps, abductors, adductors and gastrocnemius.
      Manual therapy for patellofemoral and tibiofemoral joint will be held after the completion of
      stretching. Recent clinical guidelines on knee OA strongly recommend the use of strengthening
      exercises of the lower limbs, both in closed kinetic chain and open. Thus, they will be
      performed strengthening exercises in extension and knee flexion in open kinetic chain, squat
      up and down a step and exercises to sural triceps. For symptom control during exercise in CKC
      will be used the numeric scale of pain before and after its execution.

      The GABQ add the hip abduction exercises in lateral decubitus, exercise "Clam" and pelvic
      elevation. Studies prior point out that these exercises are among those with higher
      electromyographic activity of the gluteus medius muscle.

      The GADQ add the adduction exercises hip in lateral recumbency, bilateral adduction with a
      ball between the legs and functional diagonal leg.

      The exercises will be carried out to load 60-80% of 1 repetition maximum 8-12 reps, 1-3 sets
      and 2-3 times a week. All exercises are performed without worsening pain and intensity of
      exercise will be controlled according to the perceived exertion scale of Borg.
    

Intervention name(s): Hip Abductor Exercise; Hip Aductor Exercise
Intervention type(s): Other; Other
Intervention description(s): 12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip abductors.; 12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip aductors.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment