Assessing the Impact of Isokinetic Muscular Strengthening in Eccentric Mode in the Medical Treatment of Knee Osteoarthritis

Study Overview
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Brief Summary
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Knee osteoarthritis (O.A. from now on) is associated to muscular weakness of inferior limbs, especially the quadriceps; leading to disease progression. Advantages of muscular strength training for the treatment of this kind of O.A. is now well established. In this therapeutic field, isokinetic exercises seem to have a better efficiency than other, more frequently used, kinds of exercises such as isometric or isotonic exercises. Functional impairment caused by knee O.A. is mainly affecting walking. Walking induces muscles to work in eccentric mode. The hypothesis of this study is that muscular strengthening using isokinetic exercises in eccentric mode would have a more important benefit than isokinetic exercises in concentric mode. Such an hypothesis, if verified, could lead to a better management of rehabilitative knee exercises in the treatment of knee O.A.

Detailed Description
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Knee osteoarthritis (O.A. from now on) is associated to muscular weakness of inferior limbs, especially the quadriceps; leading to disease progression. Advantages of muscular strength training for the treatment of this kind of O.A. is now well established. In this therapeutic field, isokinetic exercises seem to have a better efficiency than other, more frequently used, kinds of exercises such as isometric or isotonic exercises. Functional impairment caused by knee O.A. is mainly affecting walking. Walking induces muscles to work in eccentric mode. The hypothesis of this study is that muscular strengthening using isokinetic exercises in eccentric mode would have a more important benefit than isokinetic exercises in concentric mode. Such an hypothesis, if verified, could lead to a better management of rehabilitative knee exercises in the treatment of knee O.A.

Official Title
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Assessing the Impact of Isokinetic Muscular Strengthening in Eccentric Mode in the Medical Treatment of Knee Osteoarthritis.

Conditions
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Unilateral Knee Osteoarthritis

Intervention / Treatment
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* Other: Exercise in eccentric or concentric mode


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient male or female, age ranging from 40 to 70 years old Patient suffering from one-sided knee O.A. regarding criteria of the American College of Rheumatology (A.C.R.), with radiologic score ranging from 2 to 3 according to the Kellgren & Lawrence classification. Patient receiving medical support Patient that did not receive any infiltration on knee within two months before randomisation. Patient free from any disease that could be a contraindication to the study treatment Patient able to understand the protocol and willing to comply with its rules. Patient willing to give consent. Patient affiliated to the french social secu Exclusion Criteria: Patient carrying prosthesis. Patient suffering from inflammatory arthritis, or flare of arthritis. Patient suffering from symptomatic patellofemoral osteoarthritis. Patient suffering from cardio-vascular or pneumologic disease that could a contraindication to the study treatment. Patient suffering from any pathology that could cause muscular weakness (myopathy, neuropathy, hemiplegia...)

Ages Eligible for Study
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Minimum Age: 40 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

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: isokinetic exercises in eccentric mode<br> | Other: Exercise in eccentric or concentric mode<br>* In this therapeutic field, isokinetic exercises seem to have a better efficiency than other, more frequently used, kinds of exercises such as isometric or isotonic exercises.<br>|
| Other: isokinetic exercises in concentric mode<br> | Other: Exercise in eccentric or concentric mode<br>* In this therapeutic field, isokinetic exercises seem to have a better efficiency than other, more frequently used, kinds of exercises such as isometric or isotonic exercises.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Difference of peak torque of quadriceps |  | 6 months after treatment start | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Walk speed (50 meters and 200 meters) |  | at day 1, 6 weeks, and 6 months : | 
| Knee pain (via analogic visual scales) |  | at day 1, 6 weeks, and 6 months | 
| Posture parameters (posturography) |  | at day 1, 6 weeks, and 6 months | 
| WOMAC Scores |  | at day 1, 6 weeks, and 6 months | 
| Knee perimeter |  | at day 1, 6 weeks, and 6 months | 
| Knee range of motion (goniometer) |  | at day 1, 6 weeks, and 6 months | 
| Kellgren & Lawrence scores |  | at day 1, 6 weeks, and 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Knee Osteoarthritis, Exercise, Isokinetic, Muscle strength, Rehabilitation