Clinical and Tissue Outcomes of a Biomechanical Exercise Program for Knee Osteoarthritis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Osteoarthritis, Knee
- Sponsor
- McMaster University
- Enrollment
- 31
- Locations
- 1
- Primary Endpoint
- Change in Lower Extremity Function
- Status
- Completed
- Last Updated
- 9 years ago
Overview
Brief Summary
Prescribing exercise for people with painful knee osteoarthritis (OA) is essential for pain management, improved function, and chronic disease prevention. Exercise that decreases joint exposure to damaging loading while eliciting adequate muscular activation for strength improvements is ideal. The purpose of this 3-arm RCT is to compare mobility, strength, pain, and MRI outcomes between the low-loading biomechanical exercise program (BE), a traditional exercise program for knee OA (TE), and a control group completing meditation classes (M).
Detailed Description
Osteoarthritis (OA) is a common joint disease affecting 1 in 10 Canadians. Osteoarthritis commonly presents in the knee joint and is associated with mobility limitations, pain, and an increased risk of other chronic health conditions such as heart disease. It is critical to implement exercise for people with knee OA as it can be an effective method for improving pain, mobility, and cardiovascular health. A biomechanical exercise program using static yoga postures has been established in the investigators lab based on minimizing damaging knee joint loads, while effectively exercising the musculature around the knee joint. The investigators pilot project (REB#13-510) showed that a 12-week yoga program using these biomechanical exercises improved pain and mobility while keeping the medial joint loading well below that experienced during normal level walking. The next step with this exercise program is to compare clinical and tissue outcomes with that of a regularly prescribed aerobic and strengthening program, as well as a control group completing meditation classes. The investigators aim to identify differences in clinical mobility performance outcomes, muscle and fat volumes using magnetic resonance imaging (MRI), and cartilage integrity using MRI between the three groups using a randomized controlled trial (RCT) design.
Investigators
Eligibility Criteria
Inclusion Criteria
- •50 years of age or older
- •Knee pain on most days of the week
- •Less than 30 minutes of morning stiffness
- •Bony enlargement
- •Bony tenderness to palpation
- •Signs of inflammation
- •Able to safely climb 2 flights of stairs without aid
Exclusion Criteria
- •Any other forms of arthritis
- •Osteoporosis
- •History of patellofemoral symptoms
- •Active non-arthritic knee disease
- •Knee surgery
- •Use of cane or walking aid
- •Unstable heart condition
- •Neurological conditions
- •Skin allergy to medical tape
- •Hip or ankle injuries in past 3 months
Outcomes
Primary Outcomes
Change in Lower Extremity Function
Time Frame: Week 1 and Week 13
The Lower Extremity Function Scale (LEFS) consists of 20 items, on an adjectival scale, that assess difficulty during mobility tasks ranging from transfers to running. The LEFS is scored from 0 to 80 with higher scores represent better self-reported physical function. It is reliable and valid in knee OA and has superior sensitivity to change compared to similar measures. The mean (95% confidence interval) difference score (follow-up score - baseline score) was computed for each of the three study arms.
Secondary Outcomes
- Change in Mobility Performance (40m Walk Test)(Week 1 and Week 13)
- Change in Grip Strength (Absolute)(Week 1 and Week 13)
- Change in Self-reported Knee Pain(Week 1 and Week 13)
- Change in Depression Status(Week 1 and Week 13)
- Change in Arthritis-related Self-efficacy(Week 1 and Week 13)
- Change in Muscle and Fat Volume(Indented to be collected on week 1 and week 13)
- Change in Cartilage Morphology(Week 1 and Week 13)
- Change in Isokinetic Knee Extensor and Flexor Power(Week 1 and Week 13)
- Change in Mobility Performance (Six-Minute Walk Test)(Week 1 and Week 13)
- Change in Mobility Performance (Timed Up and Go Test)(Week 1 and Week 13)
- Change in Mobility Performance (Stair Ascent)(Week 1 and Week 13)
- Change in Inflammatory Markers (CRP)(Week 1 and Week 13)
- Change in Cardiovascular Fitness(Intended to be collected on week 1 and week 13)
- Change in Isometric Knee Extensor and Flexor Strength(Week 1 and Week 13)
- Change in Grip Strength (Relative)(Week 1 and Week 13)
- Change in Frailty Status(Week 1 and Week 13)
- Change in Mobility Performance (30-second Chair Stand Test)(Week 1 and Week 13)
- Change in Inflammatory Markers (IL6, TNF, IL10)(Week 1 and Week 13)