Effect of Knee and Heel Off-Loader Brace With Non Weight Bearing Strength Training on Pain, Gait Variability, and Functional Outcome in Knee Osteoarthritis: A Randomized Controlled Trial
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 发起方
- 入组人数
- 20
- 主要终点
- Pain Intensity
研究概览
简要总结
The current study is a single-blinded, parallel-group pilot randomized controlled trial involving 20 participants diagnosed with knee osteoarthritis (KOA). The trial will compare the effects of a knee and heel off-loader brace combined with non-weight bearing (NWB) strength training versus a conventional knee off-loader brace combined with NWB strength training. Interventions will be delivered three times per week for four weeks.
The primary outcome of the study is pain intensity, while secondary outcomes include gait variability and functional outcome. Assessments will be conducted at baseline and after completion of the intervention period. The study will be carried out at the outpatient physiotherapy departments of Kaazi Hospital and Ghurki Trust Hospital, Lahore.
The hypothesis is that the combination of knee and heel off-loader brace with NWB strength training will result in greater reductions in pain, improved gait variability, and enhanced functional outcomes compared to the conventional knee off-loader brace with NWB strength training.
详细描述
KOA is a degenerative joint disorder characterized by progressive cartilage breakdown, joint pain, stiffness, muscle weakness, and impaired functional mobility. One of the key biomechanical issues in KOA is increased medial compartment loading, which contributes to disease progression and functional limitations. Additionally, individuals with KOA commonly exhibit altered gait patterns and increased gait variability, reflecting impaired neuromuscular control and increased risk of falls.
Conservative management strategies for KOA primarily focus on pain reduction, improving joint function, and enhancing quality of life. Among these, biomechanical interventions such as knee off-loader braces aim to redistribute joint loading, while strengthening exercises target neuromuscular deficits. However, traditional weight-bearing exercises may increase joint stress and pain, making NWB strength training a safer and more effective alternative.
Knee and heel off-loader braces have been introduced as an advanced biomechanical intervention designed to reduce joint loading by altering lower limb alignment and redistributing forces away from the affected knee compartment. While these braces effectively address mechanical stress, they do not directly improve muscle strength and neuromuscular control. Conversely, NWB strength training improves muscular support and joint stability but does not correct abnormal loading patterns.
Despite the individual effectiveness of these interventions, limited research has explored their combined effect. Therefore, this study aims to evaluate the synergistic impact of combining knee and heel off-loader brace with NWB strength training on pain, gait variability, and functional outcome in KOA.
This study will adopt a single-blinded, two-arm parallel randomized controlled design. A total of 20 participants will be randomly allocated into two groups. The experimental group will receive a knee and heel off-loader brace along with a structured NWB strength training program, while the control group will receive a conventional knee off-loader brace with the same exercise protocol.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 35 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Clinically diagnosed KOA with radiographic Kellgren and Lawrence grade II-III, confirmed within the previous six months
- •History of knee pain for at least three months, consistent with chronic KOA
- •Ability to ambulate independently, with or without assistive devices
- •No change in pharmacological management for KOA during the previous three months
- •Ability to understand instructions and complete self reported outcome measures
- •Willingness to participate and provision of written informed consent
排除标准
- •Severe venous insufficiency or history of deep vein thrombosis
- •Acute inflammatory knee conditions (e.g., septic arthritis, acute synovitis)
- •Rheumatic or systemic inflammatory joint diseases (e.g., rheumatoid arthritis)
- •Traumatic onset of knee pain within the previous six months
- •History of major lower limb injury or surgery requiring rehabilitation within the past year
- •Neurological or neurodegenerative disorders affecting gait or balance, including Parkinson's disease
研究组 & 干预措施
EXPERIMENTAL GROUP
Participants in the experimental group will receive a structured intervention consisting of two integrated components: knee and heel off-loader brace for approximately 6-8 hours per day as tolerated and NWB strength training exercises three times per week for four weeks each session lasting approximately 45-60 minutes.
干预措施: Knee and Heel Off-Loader Brace with NWB Strength Training (Device)
CONTROL GROUP
Participants in the control group will receive a conventional knee off-loader brace combined with the same NWB strength training program.
干预措施: Conventional Knee Off-Loader Brace with NWB Strength Training (Device)
结局指标
主要结局
Pain Intensity
时间窗: Baseline and after 4 weeks of intervention
Pain intensity refers to the subjective perception of knee pain experienced by individuals with knee osteoarthritis. In this study, pain will be measured using the Numeric Pain Rating Scale (NPRS) an 11-point self reported scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates worst imaginable pain. Participants will be asked to rate their pain at rest, during walking, and during daily functional activities. The NPRS is a reliable and valid tool commonly used in musculoskeletal conditions and demonstrates excellent test retest reliability and strong construct validity. The primary objective is to evaluate the reduction in pain intensity following the intervention. A decrease in NPRS scores after the intervention period will indicate improvement in pain
次要结局
- Gait Variability(Time Frame: Baseline and after 4 weeks of intervention)
- Functional Outcome(Time Frame: Baseline and after 4 weeks of intervention)
研究者
Dr. Muhammad Tariq Rafiq
Associate Professor
Lahore University of Biological and Applied Sciences