Identification of Sarcopenia in Knee Osteoarthritis With Ultrasonography and Evaluation of Muscle Architecture Change by Ultrasonography After Isokinetic Exercise Program

Study Overview
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Brief Summary
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The aim of this thesis; To define sarcopenia in knee osteoarthritis with ultrasonography and to evaluate changes in muscle structure in sarcopenia after isokinetic exercise application ultrasonographically. The investigators will evaluate the effect of isokinetic exercise therapy in sarcopenic patients with knee osteoarthritis with VAS (Visual Analog Scale) and WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index). Then, the hand grip strength will be evaluated with a dynamometer, and its effects on physical performance will be evaluated by 6 meters walking and chair rising tests.

Detailed Description
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Among the 45-65 age group who applied to Mustafa Kemal University Faculty of Medicine, Physical Medicine and Rehabilitation outpatient clinic, 30 female patients diagnosed with knee osteoarthritis (stage 1-2-3) and sarcopenia together, and 30 individuals without osteoarthritis and sarcopenia will be included in the study as the control group.Patients with knee osteoarthritis who have been diagnosed with sarcopenia by ultrasonography will be Group I, and the control group without osteoarthritis and sarcopenia will be Group II.30 patients in Group I will be given an exercise program with isokinetic dynamometer for both knees, 30 minutes of TENS (transcutaneous electrical nerve stimulation), 20 minutes of hot packs, and home exercise program will be given lower extremity strengthening for a total of 6 weeks (18 sessions), 3 sessions per week.A diet program (protein, mineral, vitamin D supplemented) will also be given to these patients. The control group, which is group II, will be offered a home exercise program and diet for lower extremity strengthening only.Those with a history of complicated Diabetes Mellitus, Severe Coronary Artery Disease / Congestive Heart Failure, severe Liver Failure, neuromuscular disease, previous lower extremity surgery, rheumatological disease, use of walking aids will not be included in the study.The patient group and control group pre-treatment (week 0) and post-treatment (week 6) clinical; hand grip strength will be evaluated with Jamar dynamometer, walking speed will be evaluated with 6 meters walking test, lower extremity endurance will be evaluated with chair rise test, functional assessment of knee osteoarthritis will be evaluated by WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) and pain assessment will be evaluated by VAS (Visual Analogue scale) will be evaluated with a pain questionnaire.In addition, changes in the Rectus Femoris and Vastus Lateralis muscle architecture on the dominant side of the patients; muscle thickness, fascicle length, echogenicity, pennation angle and cross-sectional area measurements will be evaluated before treatment (0 weeks) and after treatment (6 weeks) by ultrasonography.

Official Title
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Identification of Sarcopenia in Knee Osteoarthritis With Ultrasonography and Evaluation of Muscle Architecture Change by Ultrasonography After Isokinetic Exercise Program

Conditions
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Osteoarthritis of the Knee, Sarcopenia

Intervention / Treatment
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* Other: Knee strengthening exercises with isokinetic dynamometer
* Other: Strengthening around the knees with home exercise programe


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Among the 45-65 age group, 30 female patients diagnosed with knee osteoarthritis (Stage 1-2-3) and sarcopenia together Among the 45-65 age group, 30 females without osteoarthritis and sarcopenia will be included in the study as the control group. Exclusion Criteria: Diabetes Mellitus, Severe Coronary Artery Disease / Congestive Heart Failure, Severe Liver Failure, Neuromuscular disease, Lower extremity surgery, Rheumatological disease, Those who use walking aids

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Sarcopenia and osteoarthritis group<br>Women aged 45-65 years diagnosed with sarcopenia and knee osteoarthritis | Other: Knee strengthening exercises with isokinetic dynamometer<br>* 18 sessions of strengthening exercises around the knee with an isokinetic dynamometer 3 days a week<br>|
| Other: Without osteoarthritis and sarcopenia group<br>Women aged 45-65 years without a diagnosis of knee osteoarthritis and sarcopenia | Other: Strengthening around the knees with home exercise programe<br>* 18 sessions of strengthening exercises for the muscles around the knee at home, 3 days a week<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Muscle architecture | Determination of muscle architecture change with ultrasonography after isokinetic exercise | Six weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Knee pain | The effect of isokinetic exercise with VAS (visual analog scale) on pain level | Six weeks | 
| Functional status | Effect of isokinetic exercise on activities of daily living with WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) | Six weeks | 
| Hand grip strength | Evaluating the effect of isokinetic exercise on hand grip strength with a hand dynamometer | Six weeks | 
| Walking speed | Evaluation of the change in walking speed with isokinetic exercise | Six weeks | 
| Time to get out of the chair | Evaluation of the change in sitting time by standing up from the chair 5 times with isokinetic exercise | Six weeks |