Clinical trial NCT06343909: Foot and Hip Abductor Strengthening in Patients With Knee Osteoarthritis.
Official title: Comparison of Intrinsic Foot Muscle Strengthening and Hip Abductor Strengthening on Pain, Range of Motion, Function, Foot Arches and Knee Alignment in Patients With Knee Osteoarthritis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Knee Osteoarthritis
Keywords: Knee Osteoarthritis, KOOS, Strengthening Exercises
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-04-03
Enrollment: 30
Sex: ALL
Minimum age (years): 40
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The study will be Randomized controlled trail, Subject diagnosed with knee osteoarthritis meeting predetermined inclusion and exclusion criteria will be divided into two groups.

Pre assessment will be done using pain, ROM, function, foot arches and knee alignment as subjective measurement through KOOS questionnaire, goniometer, 2D frontal plane projection, Berkemann foot prints using ink and paper ,30s chair stand test, nine step stair climb,40m fast paced walk test,Global rating of change score respectively . One group will be treated with hip abductor strengthening exercise along with conventional exercises and second group will be treated with intrinsic foot muscle strengthening exercise along with conventional exercises. Post treatment values recorded after the session.After data collection from defined study setting,data will be entered and analyzed at Riphah International University,Lahore

Detailed description: Knee osteoarthritis (OA) is a leading cause of joint pain1 and disability2 in middle- and older-aged individuals, and is one of the most commonly managed conditions in primary care3. Recent incidence rates suggest around 6% of people aged over 45 years develop knee symptoms. Knee OA symptoms and radiographic change that worsen over time can lead to costly surgical intervention.

Compressive forces on the knee caused by knee adduction moment on the medial compartment of the joint are associated with the severity of the disease and intensity of pain. In addition, decreased strength of the quadriceps is one of the contributing factors for the onset of the disease.

short foot exercises (SFE) have shown to be effective using the IFM and excluding the EFM found that SFE contracted the intrinsic muscles of the foot to increase the inner arch of the foot, thereby shortening the longitudinal arch.Pronated foot is deeply related to the medial longitudinal arch (MLA) where the presence of a pronated foot consequently leads to a decrease in the MLA.

Eligibility criteria: Inclusion criteria:

* pain at medial side of the knee.
* patient can walk without walking aids.

Exclusion criteria:

* patient with previous hip, knee and ankle surgery.
* patient who received intraarticular injection.
* patient with neurologic and muscle problem.

Primary outcomes:
measure: Knee Osteoarthritis Outcome Score (KOOS)
timeFrame: 8 weeks
measure: Berkemann foot prints
timeFrame: 8 weeks
Secondary outcomes:
measure: Frontal plane projection
timeFrame: 8 weeks
measure: Goniometer
timeFrame: 8 weeks
measure: 30 seconds chair stand test
timeFrame: 8 weeks
measure: Overall self-perception by Global Rating of Change Score
timeFrame: 8 weeks
measure: 9 step stairs climb test.
timeFrame: 8 weeks
measure: 40-m fast-paced walk test
timeFrame: 8 weeks
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: THQ hospital KRK.
state: Punjab
Study officials:
affiliation: Riphah International University
name: Muhammad Sanaullah, MS
role: PRINCIPAL_INVESTIGATOR
References:
citation: Messier SP, Mihalko SL, Beavers DP, Nicklas BJ, DeVita P, Carr JJ, Hunter DJ, Lyles M, Guermazi A, Bennell KL, Loeser RF. Effect of High-Intensity Strength Training on Knee Pain and Knee Joint Compressive Forces Among Adults With Knee Osteoarthritis: The START Randomized Clinical Trial. JAMA. 2021 Feb 16;325(7):646-657. doi: 10.1001/jama.2021.0411.
citation: Dantas G, Sacco ICN, Dos Santos AF, Watari R, Matias AB, Serrao PRMS, Pott-Junior H, Salvini TF. Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial. BMJ Open. 2020 Sep 25;10(9):e039279. doi: 10.1136/bmjopen-2020-039279.
citation: Samuel AJ, Kanimozhi D. Outcome measures used in patient with knee osteoarthritis: With special importance on functional outcome measures. Int J Health Sci (Qassim). 2019 Jan-Feb;13(1):52-60.
citation: Hashimoto T, Sakuraba K. Strength training for the intrinsic flexor muscles of the foot: effects on muscle strength, the foot arch, and dynamic parameters before and after the training. J Phys Ther Sci. 2014 Mar;26(3):373-6. doi: 10.1589/jpts.26.373. Epub 2014 Mar 25.
citation: Kim I, Kim HA, Seo YI, Song YW, Hunter DJ, Jeong JY, Kim DH. Tibiofemoral osteoarthritis affects quality of life and function in elderly Koreans, with women more adversely affected than men. BMC Musculoskelet Disord. 2010 Jun 22;11:129. doi: 10.1186/1471-2474-11-129.