Effects of Progressive Neuromuscular Training on Pain, Function and Balance in patients with Knee Osteoarthritis: A Randomized Control Trial.

This was a Randomized, Double-blinded, Active control, Parallel group trial that studies the effects of Progressive Neuromuscular Training on Pain, Function, and Balance in Patients with Knee Osteoarthritis. 62 subjects were randomly allocated into two groups. The intervention group received Progressive Neuromuscular Training exercise,  and the control group performed strengthening exercises Both the groups performed exercises for 60 minutes per session, twice a week for 6 weeks. The outcome measures Pain (Visual Analogue Scale), Function (Patient Specific Function Scale, Timed Up and Go test, Sit to Stand Test, Stair Climb Test), Balance (Y - balance Test) were assessed before and after 6 weeks of intervention. Out of 160 subjects that were screened for eligibility 98 were excluded as 94 did not meet the inclusion criteria (32 subjects were KL grade 1 OA, 40 were KL grade 4 OA, 7 subjects had systemic arthritis and 15 had associated back pain) and 4 declined to participate. 62 subjects were included in the study and were randomly allocated into two groups viz. Group A (NMT) and Group B (Strength training). 8 subjects were lost to follow-up - 2 withdrew due to unrelated health reasons, 4 failed to comply, and 2 had injuries unrelated to the intervention. Data of 54 subjects who completed the intervention (Group A = 28) and Group B (n=26) was analyzed using SPSS version 26 (IBM Chicago)with an alpha level set at 0.05. Baseline data were analyzed to determine whether both groups were matched at preintervention using an unpaired t-test ( Y balance, TUG)  and Mann- Whitney U test (NPRS, WOMAC, PSFS, Chair-stand test, Stair climb test). Except for TUG scores, all outcome measures matched the baseline. Within-group differences for both the groups were analyzed using Wilcoxon- signed-rank test (Non - parametric data - NPRS, chair stand test, stair climb test, PSFS, and WOMAC) and paired t-test (parametric data - Y -  balance test). Between-group differences were analyzed using an unpaired t-test ( Y balance, TUG)  and Mann- Whitney U test (NPRS, WOMAC, PSFS, Chair-stand test, Stair climb test). Results of within-group comparisons displayed significant improvements in both groups for all measured variables whereas between-group comparisons were significantly greater in the NMT group in reducing pain (NPRS), improvement in function(PSFS, WOMAC, Chair-stand test, TUG), and balance when compared to controls.