DAPRE Exercises Technique and CKC Exercises on Extensor Lag in Post Knee Stiffness

Study Overview
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Brief Summary
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This project was a Randomized clinical trial conducted on extensor lag in post-operative knee stiffness patient to compare the effects of The Daily Adjustable Progressive Resistive Exercise (DAPRE) technique versus Close kinetic chain (CKC) exercise training in people who had undergone knee stiffness, m so that we can have best treatment option for patients with extensor lag.

Detailed Description
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Probability Convenient sampling was done. Patients following eligibility criteria from Physiotherapy department of PSRD, Lahore, were considered. Sample size was calculated with Epi-tool calculator. 22 Participants were randomly allocated in two groups equally via convenient sampling method. Baseline assessment was done initially. Group A, 11 participants will receive Conventional physiotherapy treatment in addition to DAPRE technique by leg extension machine. In DAPRE technique, four sets of exercises were performed. The first two sets of exercise consisted of ten and then six repetitions, per- formed against one-half and three-fourths of the previously established working weight. Working weight is the amount of weight a patient uses during an individual session. The full working weight was used on the third set, and the patient performed as many repetitions as possible. After performing each of the third and fourth sets, patients rested for 1 min. 6 weeks (3 sessions per week)• Hot pack: 10 min• Stretching of calf and hamstring muscle: 10 min. Group B, 11 participants will receive Conventional physiotherapy treatment in addition to close kinetic chain exercises. Close kinetic chain exercises for extensor lag is seated leg press, double or single one third knee bend, step up and down exercise, wall slide with weight. Treatment time will be 30 minutes and three session per week will be applied on alternate day for up to 6 weeks. Pre interventional readings will be taken at baseline & post interventional readings at 6th week. 6 weeks (3 sessions per week) • Hot pack: 10 min • Stretching of calf and hamstring muscle: 10 min. All participants were provided written informed consent prior to commencement of the procedures. They were free to quit the treatment at any stage of research. Data was analyzed by using SPSS version 23.

Official Title
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Comparative Effects of Daily Adjustable Progressive Resistance Exercises Technique and Close Kinetic Chain Exercises on Extensor Lag in Post-operative Knee Stiffness

Conditions
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Extensor Lag, Post-operative Knee Stiffness

Intervention / Treatment
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* Procedure: Daily adjustable progressive resistance exercises (DAPRE)
* Procedure: Close kinetic chain exercises (CKC).


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Post-operative knee stiffness (patients with 1-3 month stiffness). Both male and female , age 30-60 years. Willing to participate in research. Exclusion Criteria: Pre-operative knee stiffness Severe cardiopulmonary disease Patients undergoing chemotherapy Any traumatic injury/ Acute inflammatory muscular pathology TKR & hip pathology and replacement Meniscal tear

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 60 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
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Daily adjustable progressive resistance exercises (DAPRE)<br>DAPRE technique, hot pack, stretching exercises. | Procedure: Daily adjustable progressive resistance exercises (DAPRE)<br>* Daily adjustable progressive resistance exercises (DAPRE) In Group A, 11 participants were received Conventional physiotherapy treatment in addition to DAPRE technique by leg extension machine. In DAPRE technique, four sets of exercises were performed. The first two sets of exercise consisted of ten and then six repetitions, per- formed against one-half and three-fourths of the previously established working weight. Working weight is the amount of weight a patient uses during an individual session. The full working weight was used on the third set, and the patient performed as many repetitions as possible. After performing each of the third and fourth sets, patients rested for 1 min.6 weeks (3 sessions per week)• Hot pack: 10 min• Stretching of calf and hamstring muscle: 10 min. Assessment was done via WOMAC index, universal goniometer, numeric pain rating scale & sphygmomanometer.<br>|
| Experimental: Close kinetic chain exercises (CKC).<br>CKC exercises, hot pack, stretching exercises | Procedure: Close kinetic chain exercises (CKC).<br>* Close kinetic chain exercises (CKC). In Group B, 11 participants was received Conventional physiotherapy treatment in addition to close kinetic chain exercises. Close kinetic chain exercises for extensor lag was seated leg press, double or single one third knee bend, step up and down exercise, wall slide with weight. Treatment time was 30 minutes and three session per week was applied on alternate day for up to 6 weeks. Pre interventional readings will be taken at baseline & post interventional readings at 6th week. 6 weeks (3 sessions per week) • Hot pack: 10 min • Stretching of calf and hamstring muscle: 10 min. Assessment was done via WOMAC index, universal goniometer, numeric pain rating scale & sphygmomanometer.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in knee functional Improvement by WOMAC index | By using WOMAC index, knee functional improvement was checked at baseline & post interventional readings at 6th week. | 6 weeks (3 sessions per week). | 
| Change in knee range of motion by universal goniometer. | Change in ROM at baseline & post interventional readings at 6th week. | 6 weeks (3 sessions per week). | 
| Change in pain by 'Numeric Pain Rating Scale' | Change in pain was measured at baseline & post interventional readings at 6th week. | 6 weeks (3 sessions per week). | 
| Change in strength by Sphygmomanometer | Change in strength was measured at baseline & post interventional readings at 6th week. | 6 weeks (3 sessions per week). | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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DAPRE, CKC exercises, Extensor lag