Effect of manual therapy on selected biomechanical outcomes of gait in people with knee osteoarthritis

Not Applicable

Recruiting

• Conditions: knee osteoarthritis; Musculoskeletal - Osteoarthritis; Physical Medicine / Rehabilitation - Physiotherapy

• Registration Number: ACTRN12624000157572
• Lead Sponsor: Dr Cathy Chapple (Primary supervisor of the applicant), School of Physiotherapy, University of Otago

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2024-02-19
• Last Update Posted: 22 July 2024

Recruitment & Eligibility

• Status: Recruiting
• Sex: All
• Target Recruitment: 20

Inclusion Criteria

1. Unilateral tibiofemoral OA fulfilling the American College of Rheumatology clinical classification criteria for knee OA (knee pain >15 days in last month; the presence of at least 3 out 6 following criteria - age > 50 years, stiffness < 30 mins, crepitus, bony tenderness, bony enlargement, no palpable warmth)(Altman et al., 1986)

2. Reported knee pain while walking>3 on 11-point numeric pain-rating scale (NPRS) (0=no pain; 10=maximal pain).

3. Restricted overall range of motion (ROM) greater than or equal to 10 degrees in the involved knee as compared to non-involved knee.

4. Participant score should be less than 75 on Knee Injury and Osteoarthritis Outcome Score (KOOS4) symptoms subscales pain, symptoms, function of daily living and quality of life defined as the average score for the subscales pain, symptoms, function of daily living (ADL) and quality of life.

Altman, R., Asch, E., Bloch, D., Bole, G., Borenstein, D., Brandt, K., Christy, W., Cooke, T. D., Greenwald, R., Hochberg, M., Howell, D., Kaplan, D., Koopman, W., Longley, S., Mankin, H., McShane, D. J., Medsger, T., Meenan, R., Mikkelsen, W., . . . Wolfe, F. (1986). Development of criteria for the classification and reporting of osteoarthritis: Classification of osteoarthritis of the knee. Arthritis & Rheumatism, 29(8), 1039-1049. https://doi.org/10.1002/art.1780290816

Exclusion Criteria

1. Any previous lower extremity fracture or surgery to either limb such as a history of hip or knee joint replacement or tibial osteotomy, and spine surgery.

2. Knee injury within 6 months requiring medical attention or physiotherapy treatment

3. Intra-articular corticosteroid injection within 6 months.

4. current or past (within 4 weeks) oral corticosteroid use.

5. Systemic inflammatory arthritic conditions; concurrent pain and/or pathology in the foot or ankle; neurological disorders e.g., stroke, parkinsons; concurrent musculoskeletal disorders e.g., back pain, neck pain, hip OA.

6. Diagnosed case of metabolic bone disease such as osteoporosis (lower bone density).

7. Participants referred to secondary care for an orthopaedic consultation to consider surgery for hip or knee OA, or on a waiting list for Total Knee Arthroplasty (TKA).

8. Intention to start or currently participating in a supervised physiotherapy program.

9. Currently using gait aid or orthotics such as foot insoles or knee-brace to ambulate.

10. Body mass index>35 due to difficulty in accurate marker placement for gait analysis.

11. A medical condition that precluded safe participation in manual therapy intervention such as osteoporosis requiring medication, prolonged use of oral steroid medication.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Peak knee adduction moment (KAM) will be used as a primary outcome measure.[3-dimensional gait analysis will be performed during level walking with 12-infra-red cameras (Motion Analysis Corporation, Santa Rosa, CA, USA), synchronized with two floor-mounted force plates (BP2436 AMTI Inc., Newton, MA, USA) to measure biomechanical outcomes during gait (Peak KAM). Data processing & analysis will be done using standardized software (Cortex 8.1.0.2017, Version 2020, Motion Analysis Corporation, Santa Rosa, CA, USA; Visual3D Professional, C-Motion, Inc., Germantown, MD, USA). <br><br>Inverse dynamics analyses will be applied to the model kinematics and ground reaction forces to calculate the net joint moments. The moments will be normalized to body size and expressed as (Nm/BW*HT). Baseline I, baseline II at 4-week and post-intervention assessment at 8-week after enrolment into the study<br>]