Effect of Hip Abductors Versus Knee Extensor Strengthening in Knee Osteoarthritis

Study Overview
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Brief Summary
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This study will try to answer the following question: Would strengthening of hip abductors be equal to, or more effective than, knee extensors strengthening in improving pain, function and knee extensors isometric strength in patients with knee Osteoarthritis

Detailed Description
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A total of 70 patients with knee Osteoarthritis will be recruited All patients who will participate in the study will be referred by orthopedists. Patients with knee osteoarthritis will be included with age ranges from 50-70. They will be randomized into 2 groups; hip abductors strengthening (HAS) group a will receive hip abductors strengthening exercises, and knee extensors strengthening (KES) group will receive quadriceps strengthening exercise. All patients who will meet the study criteria will get a complete knowledge of the objectives and procedures of the study. Inclusion criteria: Patients with knee Osteoarthritis grade II- III Kellgren- Lawrence scores Their age is 50-70[Wang et al.,2019]. Body mass index (BMI) 25-30. Exclusion criteria: Patients who had surgical intervention in the knee and/or hip. Fracture in the lower limbs. Malignancy Any associated ligamentous injuries in knee or ankle. Spinal Cord Injury. Hormonal imbalance or on hormonal therapy Knee injection within the last 6 months prior to the study. Outcome parameters including Quadriceps Muscle Strength, the arabic version of Western Ontario and McMaster Universities Arthritis Index questionnaire total score and 3 subscales and Timed Up and Go test score

Official Title
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Effect of Hip Abductors Versus Knee Extensor Strengthening on Pain,Function and Quadriceps Isometric Strength in Knee Osteoarthritis

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with knee OA grade II- III Kellgren- Lawrence scores Their age is 50-70[Wang et al.,2019]. Body mass index (BMI) 25-30. Exclusion Criteria: Patients who had surgical intervention in the knee and/or hip. Fracture in the lower limbs. Malignancy Any associated ligamentous injuries in knee or ankle. Spinal Cord Injury. Hormonal imbalance or on hormonal therapy Knee injection within the last 6 months prior to the study.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 2 groups; hip abductors strengthening (HAS) group a will receive hip abductors strengthening exercises, and knee extensors strengthening (KES) group will receive quadriceps strengthening exercise.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: HAS group<br>hip abductors strengthening group Hip abduction -standing[Ferber et al.,2015]. Sidelying hip abduction(clamshell)[Schache et al.,2016]. lateral leg raise: in brief, the patients lie down on bed on the unaffected side, with the resistance band positioned around the distal thigh of the affected limb.;later, they raise the above lower limbs upwards for about 30 degrees, stay for 5- 10 s and slowly lay down[Xie et al.,2018]. pelvic lift training, specifically, patients stand single-leg off the side at a 10-cm step. Later, they begin with the other limb that is lower than the step level, and contract the stance-limb hip abductor to raise the free leg to the step level while keeping the stance knee extended[Xie et al.,2018]. Stretching Hamstrings [Fukuda et al.,2012]. Number of sets = 3, Repetitions =10 repetitions for each set | Other: Exercises<br>* already included in arm/group descriptions.<br>|
| Active Comparator: KES group<br>knee extensors strengthening group Isometric quadriceps setting Knee extensions from sitting with knee bend to 90 Terminal knee extension from sitting. Stretching Hamstrings Number of sets = 3, Repetitions =10 repetitions for each set | Other: Exercises<br>* already included in arm/group descriptions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quadriceps Muscle Strength assessment | Quadriceps Muscle Strength assessment using Hand held Dynamometer | 6 weeks | 
| lower limb functional disability | Measuring lower limb functional disability using The Arabic version of reduced WOMAC (ArWOMAC) index | 6 weeks | 
| Knee function | Measuring function using The Timed Up & Go Test (TUG): | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Knee Osteoarthritis AND Hip Abductors AND Quadriceps