Effects of Body Awareness Therapy in Knee Osteoarthritis

Study Overview
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Brief Summary
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The aim of this study is to investigate the effect of Body Awareness Therapy (BAT) on pain, balance and functional capacity in patients with knee osteoarthritis. Individuals will divided into two groups: training group and control group. Both groups will receive exercise training as a home program. Individuals in study group will participate in BAT training 3 days for 6 weeks. Assessments will be made before and after the 6-week study program.

Detailed Description
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Symptoms such as pain, morning stiffness, and decreased muscle strength lead to a decrease in functional capacity and quality of life in knee osteoarthritis. It is estimated that 80% of patients with osteoarthritis have movement limitation and 25% are unable to perform significant daily activities. It is also stated that increases the risk of falls due to decrease proprioception in patients with knee osteoarthritis. In addition to physical symptoms, it is reported in the literature that symptoms such as sleep disturbance, depression and anxiety are seen and play a role in pain experience. It is stated in the literature that hypersensitivity of the central nervous system causes painful perception of normal body functions in chronic osteoarthritis, which leads patients to compensatory and dysfunctional movement strategies. Body Awareness Therapy (BAT) is a mind-body treatment approach directed towards awareness of body senses and how the body is used. The aim is to integrate the body and soul in the individual's experiences and to restructure body awareness and control. The aim of this study is to investigate the effect of BAT on pain, balance and functional capacity in patients with knee osteoarthritis. The study will consist of patients with stage 2-3 knee osteoarthritis according to Kellgren-Lawrence classification. The individuals included in the study will be divided into two groups as training and control groups using a computer-based randomization program. Both groups will be given a home program consisting of joint range of motion, stretching, strengthening and proprioceptive exercises. The control group will perform home exercise program and follow up will be made at once a week. The training group will participate in BAT for 3 days/week for 6 weeks in addition to home exercise program. Assessments will be made before and after the 6-week study program.

Official Title
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The Effects of Body Awareness Therapy on Pain, Balance and Functional Capacity in Patients With Knee Osteoarthritis

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: Body Awareness Therapy
* Other: Home exercise program


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary knee Osteoarthritis Stage 2 -3 according to Kellgren - Lawrence Classification Exclusion Criteria: Previous surgery in the lower extremity Neuromuscular disease Vestibular pathology Physiotherapy intervention or intra-articular injection within the last 6 months

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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Female

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
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: BAT+Home exercise program<br>The patients in this group will participate in BAT for 3 days a week for 6 weeks in addition to home exercise program. | Other: Body Awareness Therapy<br>* Body scanning, stretch-release movements, centralization, contact with the ground, postural stability, movement flow and free breathing will be performed during sessions in lying, sitting and standing positions.<br>Other: Home exercise program<br>* Home exercise program will consist of joint range of motion, stretching, strengthening and proprioceptive exercises for lower extremity.<br>|
| Active Comparator: Home exercise program<br>The patients in the control group will perform home exercise program, two times a day, 7 days a week for 6 weeks. | Other: Home exercise program<br>* Home exercise program will consist of joint range of motion, stretching, strengthening and proprioceptive exercises for lower extremity.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual analog scale | change in knee pain intensity from baseline at 6 weeks,0 point means that there is no pain, 10 point indicates severity of pain | six weeks | 
| Single leg stability | change in overall stability index of athlete single leg stability test in Biodex Balance System (BBS) from baseline at 6 weeks. Stability level of platform will be set as static. The results can be compared with normative values in the BBS. Lower scores indicate better stability and higher scores mean poor balance. | six weeks | 
| 6 minute walk test | change in walking distance from baseline at 6 weeks | six weeks | 
| 5 times sit to stand test | change in time needed to complete the test from baseline at 6 weeks | six weeks | 
| Stair climb test | change in time needed to complete the test form baseline at 6 weeks | six weeks | 
| Hand-held dynamometer | changes quadriceps muscle strength from baseline at 6 weeks | six weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Western Ontario and McMaster Universities osteoarthritis index (WOMAC) | change in scores from baseline at 6 weeks. Index consists of 24 items. In index maximum score is 96 points and minimum score is 0 point. Higher scores indicate worse symptoms, physical limitation. | six weeks | 
| Fall risk | change in overall stability index of fall risk test in Biodex Balance System from baseline at 6 weeks. Lower scores indicate better balance and high scores mean high risk for fall. | six weeks | 
| joint range of motion | change in knee joint range of motion from baseline at 6 weeks | six weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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knee osteoarthritis, body awareness therapy, pain, functional capacity