EFFECT OF INDOOR SLACKLINING EXERCISES ON PAIN,FUNCTIONAL PERFORMANCE AND BALANCE AMONG PATIENTS WITH GRADE 1 OSTEOARTHRITIS OF KNEE-A RANDOMIZED CONTROLLED TRIAL

Aim : To study the effect of indoor slacklining exercises on pain, functional performance and balance in grade 1 osteoarthritis knee patients.

 Objectives are:

1.     To find out the effect of indoor slacklining exercises on pain using Numerical pain rating scale [NPRS]

2.     To find out effect of indoor slacklining exercises on functional performance using Western Ontario and Mcmaster Universities Osteoarthritis Index [WOMAC]

To find out effect of indoor slacklining exercises on balance using Y Balance test.

§  Procedure:

1.     Ethical clearance will be obtained from the institutional ethical committee.

2.     The purpose and procedure of the study will be explained to participant.

3.     A written informed consent will be obtained.

4.     Selected participant will be evaluated for the presence of knee pain by following assessment and procedure.

5.     Subjects will be included with diagnosed with grade 1 osteoarthritis knee based on Xray and clinical examinations.

6.     Subjects will be screened according to inclusion & exclusion criteria.

7.     The subjects will be allocated to experimental and control group respectively by other person, selected patients will be randomly allocated into 2 groups experimental and control group.

8.     Physiotherapist and patients will be blinded to group allocation. Allocation concealment will be done using envelop method.

9.     The subjects random allocation will be done by randomized number sequence generator software and respectively subjects will be randomized in experimental and control group.

10.  The pretest outcome measures will be recorded.

11.  And the treatments will proceed till 4 weeks.

12.  After 4 weeks the outcome measures will be assessed and the data will be interpretated by statistical analysis tests.

13.  The result data will be represented in tabular formats.

14.  CONSORT guidelines will be followed in study.

Intervention Protocol

 EXPERIMENTAL GROUP – INDOOR SLACKLINING EXERCISES

Patients will follow protocol of

1.    Warm up- 5 min of warm up protocol comprising of ankle toe movements, hip-knee flexion, heel raises, trunk flexion-extension-rotations,hamstring stretch,TA stretch,Quadriceps stretch.[9]

2.    Slacklining exercises- Step up for 10 repetitions

Step down for 10 repetitions

Single leg stand — dominant for 10 repetitions

Single leg stand — nondominant for 10 repetitions

Walk forward (2 steps) for 10 repetitions

Walk back (2 steps) for 10 repetitions

Tandem stance dominant back for 10 repetitions

Tandem stance dominant forward for 10 repetitions

 Slackline is at standard height house-step of 250 mm [25cm] is height of slackline along with mat down for protective measures anchored at 3 m of length with 10 repetitions of activities 3 alternate days a week for 4 weeks. Each of the steps involves single-leg standing. Initially, the dominant or unaffected extremity is weight-bearing, which is followed by single-leg support on the nondominant extremity. This is initiated by walking forward, then walking backward. The activity is then progressed to stationary balancing in the Tandem position, which is alternately performed with the dominant and nondominant extremities in the forward versus behind positions.[1,2]

 DOSAGE: 10 repetitions for each activity, rest interval of 5 mins; 1 session/day for 3 days/ week upto 4 weeks

  CONTROL GROUP:

Participants will be receiving routine physiotherapy. The exercise program comprises a combination of closed kinetic chain and open kinetic chain exercises, including straight leg raising, isometric quadriceps, isometric hip adduction, terminal knee extension, VMO strengthening and semi-squat. In addition, all participants received ultrasound therapy (1.5 watts/cm2 for 7 min in continuous mode) at the knee joint prior to exercise. These all exercises will be for 10 repetitions 2 sets 3 times a week for 4 weeks.[10]

Dosage:- (1 session/day with rest interval of 1 min) 3times/week alternate days for 4 weeks

After 4 weeks post intervention the outcome measures will be assessed again for NPRS, WOMAC, Y balance test