Muscle Property, Alignment and Joint Loading in People With Knee Osteoarthritis

Study Overview
=================
Brief Summary
-----------------
Knee osteoarthritis (KOA) is a common chronic painful musculoskeletal condition among older adults. It poses great challenge to the health care system due to its inability to be cured. Understanding factors associated with disease progression in KOA should assist the development of novel prevention/rehabilitation strategies. This study investigate factors including muscle properties, lower limb alignment and joint loading in patients with knee osteoarthritis before and after a six-week exercise program.

Official Title
-----------------
External Tibia Torsion and Passive Muscle Stiffness of Quadriceps as Two Important Contributors of Joint Loading During Walking in People With Knee Osteoarthritis

Conditions
-----------------
Osteoarthritis, Knee

Intervention / Treatment
-----------------
* Other: Exercise


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age between 50-80 having radiographic tibiofemoral joint OA in the medial compartment defined as Kellgren and Lawrence grade = 2 to 3 having medial knee pain on most days of the month having a minimum average pain score of 2 on an 11-point numerical rating scale in the past week while walking Exclusion Criteria: having lateral tibiofemoral compartment osteophytes greater than the medial side. having undergone intra-articular corticosteroid injection or knee surgery to either knee within the past 3 months having a systemic arthritic condition (e.g., rheumatoid arthritis) having a knee joint replacement or high tibial osteotomy in the past having any other muscular, joint or neurological condition influencing lower limb function unable to walk unaided having low back, hip, ankle or foot pain > 3 on numerical rating scale having a body mass index (BMI) >36 kg/ m2

Ages Eligible for Study
-----------------
Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Exercise<br>Six-week exercise including stretching, strengthening, endurance and gait modification | Other: Exercise<br>* Comprehensive exercise program including strengthening, stretching, gait modification etc.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of External Knee Adduction Moment as Assessed by Visual Motion Analysis System | External knee moment in the frontal plane during early stance phase of walking | At baseline and one week after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change of Pain Severity Score as Assessed by Knee Injury and Osteoarthritis Outcome Score | Pain intensity measured by the pain subscale of Knee injury and Osteoarthritis Outcome Score (KOOS). The minimum value is 0 and maximum value is 100. The higher scores mean a better outcome. | At baseline and one week after intervention | 
| Tibial Torsion as Assessed by X-ray Imaging | The angle between tibial and femur in the transverse plane | At baseline | 
| Change of Young's Modulus of Quadriceps as Assessed by Ultrasound Elastography | Young's modulus by ultrasound elastography | At baseline and one week after intervention | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
loading, muscle tension, alignment, knee osteoarthritis