Clinical trial NCT04186143: Effects of Closed and Open Kinetic Chain Exercises
Official title: Effects of Closed and Open Kinetic Chain Exercises on Pain, Muscles Strength, Function, and Quality of Life In Patients With Knee Osteoarthritis In Patients With Knee Osteoarthritis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Osteo Arthritis Knee
Lead sponsor: Hacettepe University
Sponsor class: OTHER
First posted: 2019-12-04
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Randomized
Primary purpose: TREATMENT

Brief summary: Osteoarthritis (OA) is a heterogeneous pathology characterized by focal cartilage degeneration and the formation of new bone around the subchondral bone and joint, which is the disruption of balance between the processes of destruction and repair in subchondral area. Knee OA is a considerable cause of disability and is present in 2-3% of all disability causes. Exercises are more noticeable than other methods because they are an easy method, low cost and long-lasting. To the best of our knowledge, the studies based on this topic are scarce. Therefore, the aim of this study was to compare the effects of open and closed kinetic chain exercises on pain, functional level, quality of life and muscle strength in patients with knee osteoarthritis.

Detailed description: Osteoarthritis (OA) is a heterogeneous pathology characterized by degeneration of the posterior focal cartilage and the formation of new bone around the subchondral bone and joint, which is the disruption of the balance between the processes of destruction and repair of the joint cartilage and subchondral region. Radiologically, OA was reported in the majority of people over 65 years old and in 80% of those over 75 years old. OA is the most common joint disease in the world. Knee OA is an important health problem due to pain, functional disability and reduced quality of life in patients. Studies have shown that knee OA is associated with inadequacy and pain associated with decreased quadriceps muscle strength. Strengthening education has been shown to have positive effects on OA.

Knee OA is a significant disability cause and is present in 3% of all disability causes. OA causes disability and consequent labor loss and economic loss. Therefore, OA therapy gains importance. OA therapy is classified under three headings as pharmacological methods, non-pharmacological methods and surgical methods. In non-pharmacological methods, there are a number of studies showing the effectiveness of exercise in particular. Because it is an easy method, the cost is low and it is applicable for a long time, the exercises are more important than other methods. The literature on exercise programs with optimal gains for knee osteoarthritis has not yet been established, with numerous studies reporting the importance of different types of exercise for the treatment of knee OA in the literature. Open kinetic chain exercises are frequently used to strengthen the quadriceps muscle. Closed kinetic chain exercises have been shown to increase muscle strength and improve proprioceptive function by activating more muscle spindle and joint proprioceptors. In literature, there are researches that compare closed and open kinetic chain exercises. However, these studies mostly focus on exercises after anterior cruciate ligament reconstruction. The aim of this study was to compare the effects of open and closed kinetic chain exercises on pain, functional level, quality of life and muscle strength in patients with knee osteoarthritis.

Eligibility criteria: Inclusion Criteria:

* the presence of knee osteoarthritis Grade 2 and Grade 3 based on Kellgren Lawrence Classification,
* volunteering to participate in the study.

Exclusion Criteria:

* the presence of active synovitis,
* participation physiotherapy program in the last 6 months,
* systemic and cardiovascular diseases,
* neurological and orthopedic problems affecting walking and standing,
* lower extremity surgery

Primary outcomes:
measure: Visual analogue scale (Pain)
timeFrame: 12 weeks
Secondary outcomes:
measure: The WOMAC Index (Functional Level)
timeFrame: 12 weeks
measure: Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
timeFrame: 12 weeks
measure: Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
timeFrame: 12 weeks
measure: Biodex System Pro 4 Isokinetic Strength Dynamometer (Muscle Strength)
timeFrame: 12 weeks
measure: 36-Item Short Form Survey (SF-36) (Quality of Life)
timeFrame: 12 weeks
Other outcomes:
Locations:
city: Kırşehir
country: Turkey
facility: Caner KARARTI
Study officials:
References:
citation: Heywood S, McClelland J, Geigle P, Rahmann A, Villalta E, Mentiplay B, Clark R. Force during functional exercises on land and in water in older adults with and without knee osteoarthritis: Implications for rehabilitation. Knee. 2019 Jan;26(1):61-72. doi: 10.1016/j.knee.2018.11.003. Epub 2019 Jan 2.
citation: Olagbegi OM, Adegoke BO, Odole AC. Effectiveness of three modes of kinetic-chain exercises on quadriceps muscle strength and thigh girth among individuals with knee osteoarthritis. Arch Physiother. 2017 Jul 19;7:9. doi: 10.1186/s40945-017-0036-6. eCollection 2017.
citation: Resende RA, Kirkwood RN, Deluzio KJ, Morton AM, Fonseca ST. Mild leg length discrepancy affects lower limbs, pelvis and trunk biomechanics of individuals with knee osteoarthritis during gait. Clin Biomech (Bristol). 2016 Oct;38:1-7. doi: 10.1016/j.clinbiomech.2016.08.001. Epub 2016 Aug 3.