Effect of Exercises on Dynamic Balance in Knee Osteoarthritis Patients.

Study Overview
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Brief Summary
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This study is a randomized controlled trial which aims to compare the effect of weight bearing exercises and non-weight bearing exercises on the dynamic balance in knee osteoarthritis patients as 60 patients will divided in three groups where one group is control group and others two groups one of them perform weight bearing exercises and the other perform non weight bearing exercises.

Official Title
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Effect of Weight Bearing Versus Non-weight Bearing Strengthening Exercises on Dynamic Balance in Knee Osteoarthritis Patients.

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Combination Product: stretching exercises
* Combination Product: Transcutaneous electrical nerve stimulation
* Combination Product: weight bearing strengthening exercises
* Combination Product: Non-weight bearing strengthening exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The patient's age > 50 years. Recent radiographs confirming the presence of knee OA, grade II-III (mild to moderate) Kellgren Lawrence (K/L). Body mass index (BMI) from 20 to 30 kg/m2. Met the American College of Rheumatology clinical criteria for mild to moderate knee OA. knee pain > 3 cm on a 10 cm visual analog scale (VAS) on most days of the previous week. Bilateral knee osteoarthritis. Exclusion Criteria: Congenital or acquired inflammatory or neurological (systemic or local) diseases involving the knee. Patients who have mental or cognitive illness that interfere their ability to perform the exercises or the evaluation tests. Intra articular knee injection of steroids in the past 6 months. Patients who had received joint replacement surgery in either Knee or hip. Patients with rheumatoid arthritis. Patients who received physical therapy sessions on the knee in the past 6 months.

Ages Eligible for Study
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Minimum Age: 50 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

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: weight bearing exercises group<br>20 patients were assigned to this group with bilateral knees osteoarthritis, they received TENS, stretching exercises and weight bearing strengthening exercises. | Combination Product: stretching exercises<br>* stretching exercises for Hamstring, quadriceps and calf muscle for both lower limbs of the same patients. each exercise was repeated 5 times and each repetition hold for 30 seconds in the same session.<br>Combination Product: Transcutaneous electrical nerve stimulation<br>* it is one of the electrical stimulation modalities which is used to relief pain, each patient receive it on both knees every session.<br>* Other names: TENS;Combination Product: weight bearing strengthening exercises<br>* strengthening exercises for quadriceps, gluteus maximus, gluteus Medius and calf muscle in the form of weight bearing from standing position each exercise was repeated for 10 times with 5 seconds hold in the same set and patient perform three sets in the same session for both lower limbs.<br>|
| Active Comparator: non-weight bearing exercises group<br>20 patients were assigned to this group with bilateral knees osteoarthritis, they received TENS, stretching exercises and Non-weight bearing strengthening exercises. | Combination Product: stretching exercises<br>* stretching exercises for Hamstring, quadriceps and calf muscle for both lower limbs of the same patients. each exercise was repeated 5 times and each repetition hold for 30 seconds in the same session.<br>Combination Product: Transcutaneous electrical nerve stimulation<br>* it is one of the electrical stimulation modalities which is used to relief pain, each patient receive it on both knees every session.<br>* Other names: TENS;Combination Product: Non-weight bearing strengthening exercises<br>* strengthening exercises for quadriceps, gluteus maximus, gluteus Medius and calf muscle in the form of non-weight bearing from lying and setting positions each exercise was repeated for 10 times with 5 seconds hold in the same set and patient perform three sets in the same session for both lower limbs.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change happened in the dynamic balance from the baseline | Biodex Balance System which is a device used to measure the balance of a person who stand on the platform of the device that give a measurement called over all stability index where 0 score means the best balance and the largest number indicate bad balance. | one day after the end of treatment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| change happened in pain from the baseline | Visual Analog Scale which is a scale for pain from 0 to 10 where 0 mean no pain and 10 is the maximum pain. | one day after the end of treatment | 
| change happened in the joint angle repositioning from baseline | Joint Repositioning Accuracy where the knee is moved passively to a certain angel and the patient hold it in this angle and then it moved to the start position and then the patient asked to move his knee joint actively to the previous the same previous angle then the absolute error between the true angle and the reproduced angle is measured. | one day after the end of treatment |