The Effect of Exercise Combination on Pain, Function and Proprioception in Knee Osteoarthritis

This study will include 3 different groups of intervention. First group of knee osteoarthritis patients will be applied both strengthening and 30 minutes bicycle exercises in the same session, 2 days strecthing exercises and 30 minutes walking will be given in seperate days as home program, Second group of knee osteoarthritis patients will be applied both stretching and 30 minutes bicycle exercises in the same session, strengthening exercises and 30 minutes walking will be given in seperate days as home program.Third group of knee osteoarthritis patients will be applied all stretching, strengthening and 30 minutes bicycle exercises in the same session, only 30 minutes walking will be given as home program. The primary outcome measures include the pain, function and the secondary outcome measures include the joint proprioception. The aim of this study is to investigate the effects on outcome measures increasing number of exercises in one session and to determine which exercise types are more suitable to prescribe as a home program.

This study will include 3 different groups of intervention. First group of knee osteoarthritis patients will be applied both strengthening and bicycle exercises in the same session and strecthing exercises and walking will be given as home program in the days other than treatment session. Second group of knee osteoarthritis patients will be applied both stretching and bicycle exercises in the same session and strengthening exercises and walking will be given as home program in the days other than treatment session. Third group of knee osteoarthritis patients will be applied all stretching, strengthening and bicycle exercises in the same session and only walking exercise will be given as home program in the days other than treatment session. The primary outcome measures include the pain, function and the secondary outcome measures include the joint proprioception and aerobic capacity. The aim of this study is to investigate the effects increasing number of exercises in one session on outcome measures consisting of pain, function and proprioception. The pain will be evaluated both subjectively with numeric pain scale and WOMAC scale and objectively with pressure algometer. The function will be subjectively evaluated with WOMAC scale and objectively by measuring the knee joint range of motion and muscle strength for both flexor and extensor muscles. The evaluation of joint proprioception will be evaluated with inclinometer. The aerobic capacity will be objectively evaluated with 6 minute walk test. All the groups will be treated 2 days per week. The duration of total treatment lasts 8 weeks. All the groups practice aerobic exercises 2 days with bicycle ergometer application in the clinic, and 2 days walking outside as home program. Strecthing exercises will be applied for knee flexor and knee extensor muscles. Isometric strengthening exercises will be applied for knee extensor muscles. Isotonic strengthening exercises will be applied for hip abductor muscles, hip extensor muscles, hip flexor muscles, knee flexor muscles and knee extensor muscles. The treatment outcomes will be evaluated both at the beginning of treatment and at the end of treatment.

Eligibility Criteria:
Inclusion Criteria:

* Being diagnosed as knee osteoarthritis
* Being between the ages 45-74
* Being at stage 2-3 according to Kellegren Lawrence Classification
* Having body mass index lower than 30
* Being volunteer for participation to this study

Exclusion Criteria:

* Refusing to participation to study
* Having another orthopeadic problem ralated to lower extremity
* Having uncontrollable hypertension
* Having arterial and venous disease
* Having neurological disease
* Having perceptual problem
* Having cardiac pacemaker
* Participation to physiotherapy program in the last 6 months for the same extremity
* Taking injection from the same extremity in the last 6 months