Combined Kinetic Chain Exercises on Knee Osteoarthritis

Not Applicable

Recruiting

Brief Summary: study will be conducted at faculty of physical therapy cairo university to investigate the effect of combined kinetic chain exercises on static and dynamic hamstring and quadriceps strength in knee osteoarthritis patients

Detailed Description: the study will be conducted at faculty of physical therapy cairo university to investigate the effect of combined kinetic chain exercises on static and dynamic hamstring and quadriceps strength ,knee pain ,function ,H/Q ratio in knee osteoarthritis patients .using lafayette hand held dynamometer to measuring static strength of hamstring and quadriceps ,and free weight by Brzycki formula for measuring dynamic hamstring and quadriceps strength by determining 1 repetition maximum ,and pain measured by visual analogue scale (VAS) rating from (0 = no pain ) to (10= worst pain ) ,and function by Western Ontario and McMaster Universities Osteoarthritis Index questionnaire lower score indicate patient get better ,number of patients will be 34 divided into 2 groups ,each group will include 17 patient ,with 2 drop out according to sample size calculation ,each group will receive conventional tens for 20 min. and hot back for 15 min. and stretching exercises for hamstring,quadriceps,calf muscles ,while the experimental group will be increased by combined kinetic chain exercises

Recruitment & Eligibility

Inclusion Criteria

Exclusion Criteria

neurological disorders
wheelchair bound
significant cognitive impairment
present systemic inflammatory arthritis
history of hip and knee arthroplasty
- history of trauma or surgical arthroscopy of either knee in the last 6 months
received knee intra-articular injection within the last 3 months
under anticoagulant therapy ,recent or imminent surgery (within 3 months)

Arm && Interventions

Group	Intervention	Description
interventional group	combined kinetic chain exercises	patients take conventional tens with a frequency of 100 Hz , a pulse duration of 60 micro seconds for 20 min. ,hot backs for 15 min,stretching exercises for hamstring ,quadriceps ,calf muscles with combined kinetic chain exercises (terminal knee extension,semi squat (wall slide) ,foreword step up and down ,straight leg raise ,seated knee extension )
conventional group	conventional	patients take conventional trans cutaneous electrical stimulation (tens) with a frequency of 100 Hz , a pulse duration of 60 micro seconds for 20 min. ,hot backs for 15 min,stretching exercises for hamstring ,quadriceps ,calf muscles

Primary Outcome Measures

Name	Time	Method
static quadriceps strength	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	measuring static quadriceps from sitting position at angle 60 and 90
Hamstring /Quadriceps ((H/Q) ratio	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	dividing static hamstring on static quadriceps strength and dynamic hamstring on dynamic quadriceps strength
dynamic quadriceps strength	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	measuring dynamic quadriceps strength from sitting position by randomised free weight and Brzycki formula
static hamstring strength	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	measuring static hamstring strength from sitting position at angle 60 and 90
dynamic hamstring strength	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	measuring dynamic hamstring strength from prone position by randomised free weight and Brzycki formula

Secondary Outcome Measures

Name	Time	Method
function	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	BYWestern Ontario and McMaster Universities Osteoarthritis Index questionnaire ,Lower score indicate patient gets better
change in neck pain	Evaluation will be performed prior to the first treatment session ;as a baseline measure,and at last treatment session (after 4 weeks) as a post -treatment measure	by Visual Analog Scale (VAS) , (0=no pain ) and (10=worst pain)