Clinical trial NCT01586130: Assessing the Impact of Isokinetic Muscular Strengthening in Eccentric Mode in the Medical Treatment of Knee Osteoarthritis
Official title: Assessing the Impact of Isokinetic Muscular Strengthening in Eccentric Mode in the Medical Treatment of Knee Osteoarthritis.
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Unilateral Knee Osteoarthritis
Keywords: Knee Osteoarthritis
Exercise
Isokinetic
Muscle strength
Rehabilitation
Lead sponsor: University Hospital, Clermont-Ferrand
Sponsor class: OTHER
First posted: 2012-04-26
Enrollment: 40
Sex: ALL
Minimum age (years): 40
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: 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: 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.

Eligibility criteria: 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...)

Primary outcomes:
measure: Difference of peak torque of quadriceps
timeFrame: 6 months after treatment start
Secondary outcomes:
measure: Walk speed (50 meters and 200 meters)
timeFrame: at day 1, 6 weeks, and 6 months :
measure: Knee pain (via analogic visual scales)
timeFrame: at day 1, 6 weeks, and 6 months
measure: Posture parameters (posturography)
timeFrame: at day 1, 6 weeks, and 6 months
measure: WOMAC Scores
timeFrame: at day 1, 6 weeks, and 6 months
measure: Knee perimeter
timeFrame: at day 1, 6 weeks, and 6 months
measure: Knee range of motion (goniometer)
timeFrame: at day 1, 6 weeks, and 6 months
measure: Kellgren & Lawrence scores
timeFrame: at day 1, 6 weeks, and 6 months
Other outcomes:
Locations:
city: Clermont-Ferrand
country: France
facility: CHU Clermont-Ferrand
Study officials:
affiliation: University Hospital, Clermont-Ferrand
name: Emmanuel COUDEYRE
role: PRINCIPAL_INVESTIGATOR
References:
citation: Jegu AG, Pereira B, Andant N, Coudeyre E. Effect of eccentric isokinetic strengthening in the rehabilitation of patients with knee osteoarthritis: Isogo, a randomized trial. Trials. 2014 Apr 2;15:106. doi: 10.1186/1745-6215-15-106.