Effects of Strength and Balance Training to Reduce the Fall Risk in Knee Osteoarthritis Patients

Study Overview
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Brief Summary
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This study will address the scarcity of research and the variations in recommendations regarding the effects of strength and balance training to reduce the fall risk in knee osteoarthritis patients.

Detailed Description
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This Study will be conducted in Alkhidmat Raazi Hospital. Written informed consent for inclusion in the study was taken. Patients of experimental group will receive balance training with conventional along with TENS, heating pad for one hour 3 times weekly. Assessment will be performed pre and post of intervention. Intervention will be given 3 days a week for 8 weeks.

Official Title
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Effects of Strength and Balance Training to Reduce the Fall Risk in Knee Osteoarthritis Patients

Conditions
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Sports Physical Therapy

Intervention / Treatment
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* Other: Experimental Group
* Other: Control Group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age from 55 and 80 year Both male and female patients. Participants will need to have had knee pain for at least 6 months and experience current average pain of at least 3 (on an 11-point Numerical Pain Rating Scale (NRS) Patients having no other physical and mental illness. Osteoarthritis of knee (Stage-II) by kallgren and lawrence scale Exclusion Criteria: Patients with lab results abnormal (malignancy) Nonmusculoskeletal conditions Patient's undergone surgery of knee. Other than osteoarthritis

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

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: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Balance training + conventional exercises<br>Assessment will be performed pre and post of intervention. Intervention will be given 3 days a week for 8 weeks. Each session will include a 5-min warm-up on a fitness bike or treadmill before commencement of the program and a 5-min cool period. Participants of this group will receive balance training with conventional treatment. Participants will perform between 2 sets of 5 and 7 repetitions of each exercise. Single leg balance Walking forward Walking backward Side stepping Walk heel to toe Static exercises with eyes close or open CONVENTIONAL EXERCISE PROGRAM : TENS for 15 minutes Hot pack for 15 minutes Participants will perform between 2 sets of 7 and 10 repetitions of each exercise: Quadriceps/hamstring isometric exercises. ROM and active stretching of the hamstring and quadriceps muscle. Active ankle pump. Squats,step-up, sit to stand, calf raises Straigh leg raising exercise in crook lying position | Other: Experimental Group<br>* Assessment will be performed pre and post of intervention. Intervention will be given 3 days a week for 8 weeks. Each session will include a 5-min warm-up on a fitness bike or treadmill before commencement of the program and a 5-min cool period. Participants of this group will receive balance training with conventional treatment. Participants will perform between 2 sets of 5 and 7 repetitions of each exercise. Single leg balance Walking forward Walking backward Side stepping Walk heel to toe Static exercises with eyes close or open CONVENTIONAL EXERCISE PROGRAM : TENS for 15 minutes Hot pack for 15 minutes Participants will perform between 2 sets of 7 and 10 repetitions of each exercise: Quadriceps/hamstring isometric exercises. ROM and active stretching of the hamstring and quadriceps muscle. Active ankle pump. Squats,step-up, sit to stand, calf raises Straigh leg raising exercise in crook lying position<br>|
| Active Comparator: Only conventional<br>CONVENTIONAL EXERCISE PROGRAM : TENS for 15 minutes Hot pack for 15 minutes Participants will perform between 2 sets of 7 and 10 repetitions of each exercise: Quadriceps/hamstring isometric exercises. ROM and active stretching of the hamstring and quadriceps muscle. Active ankle pump. Squats,step-up, sit to stand, calf raises Straigh leg raising exercise in crook lying position | Other: Control Group<br>* Participants of this group will receive only conventional therapy which will include; before beginning the program, each session will feature a 5-minute warm-up on a fitness bike or treadmill, followed by a 5-minute cool-down. Participants of this group will receive only conventional therapy which will include. CONVENTIONAL EXERCISE PROGRAM : TENS for 15 minutes Hot pack for 15 minutes Participants will perform between 2 sets of 7 and 10 repetitions of each exercise: Quadriceps/hamstring isometric exercises. ROM and active stretching of the hamstring and quadriceps muscle. Active ankle pump. Squats,step-up, sit to stand, calf raises Straigh leg raising exercise in crook lying position<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Western Ontario and McMaster Universities Arthritis Index (WOMAC) | It is widely used in the evaluation of Knee Osteoarthritis. It is a questionnaire consisting of 24 items divided into 3 subscales. Pain (5 items), Stiffness (2 items) and Physical Function (17 items). The test questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. Usually a sum of the scores for all three subscales gives a total WOMAC score, however there are other methods that have been used to combine scores. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations. | 6-8 Weeks | 
| Numeric rate pain scale | This is the scale to measure pain level of participants. is a subjective measure in which individuals rate their pain on an eleven-point numerical scale. The scale is composed of 0 (no pain at all) to 10 (worst imaginable pain). | 6-8 Weeks | 
| Berg balance scale (BBS) | To measure the functional performance of muscle, balance system. It grade the individual as having high, low and moderate risk of fall. It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function and takes approximately 20 minutes to complete. It does not include the assessment of gait. | 6-8 Weeks |