Importance of lumbar core stabilization exercises on pulmonary functions, pain, dynamic balance and functional activities in patients with knee Osteoarthritis

Phase 3

Not yet recruiting

• Conditions: Osteoarthritis of knee, unspecified,

• Registration Number: CTRI/2023/10/059073
• Lead Sponsor: Government Hospital

Brief Summary

Osteoarthritis (OA) is adegenerative joint disease & the knee is the most common site for OA with the prevalence varying from 26% to 63% depending on age andgender. Knee OA is a multifactorialdisorder resulting from several contributing factors including trauma,anatomical factors, biomechanical muscle imbalance, and occupational hazards.

Few studies havefocused on the contribution of core stability to dynamic knee joint stability,mobility & function. The core of the body provides a foundation upon whichthe muscles of the lower extremities produce or resist force. The core is constructively a muscular box in which diaphragm ison the top, the pelvic floor and hip girdle musculature as the bottom,abdominals in the anterior, and the paraspinal and gluteal muscles behind. Allthe hip musculatures have their origins in pelvic and lumbar regions s o thatthe compromised core can be responsible for an unstable proximal base andquality muscle recruitments for stability as well as mobility.

There isalways a vicious cycle related to weakness of core stabilizers/ spinalstabilizers and lower extremity muscles. Initially there would be weakness oflower limb muscles that overburdened core muscles due to length – tensionrelationship between them.Decreased core stability and muscular synergism of the trunk and hipstabilizers may affect performance in ADLs as well affect balance &mobility.

The weakening of core muscles inknee OA patients also affects their primary and secondary respiratory muscles. StrongAbdominal muscle contraction is needed to increase intra-abdominal pressure,dis­charges the air to the outside of the diaphragm, and is necessary forbucking for airway clearance. Weak abdominals used to affect FEV1 & FVCvalue, thus affecting respiratory functions.

**NEED OF THE STUDY**

In spite of many researches doneon proximal stability training i.e. core and hip strengthening

for prevention of lower extremityinjuries and also studies done on deficits of neuromuscular control of the trunkto predict risks of knee injuries, there are no studies correlating the coreand lower limb muscles strength, functional activity level as well ascorrelation between core strength and pulmonary functions influencing the most commonmusculoskeletal condition i.e. knee osteoarthritis. Therefore, the purpose ofour study is to find out Effects of lumbar coreendurance training and stabilization exercises on pulmonary function, pain,dynamic balance and functional activities in patients with knee OA.

**AIM & OBJECTIVES**

The aim of the present work is tostudy the Effects of lumbar core endurancetraining and stabilization exercises on pulmonary function, pain,dynamic balance and functionalactivities in patients with knee OA.

**OBJECTIVES**

·        To study the additiveeffect of lumbar core endurance training andstabilization exercises on pulmonary function, pain, dynamic balance and functionalactivities in patients with knee OA.

 Â·        To study theeffect of conventional physiotherapy treatment onpulmonary function, pain, dynamic balance and functional activities in patientswith knee OA.

 Â·        To compare theeffect of lumbar core endurance training andstabilization exercises andconventional physiotherapy on pulmonary function,pain, dynamic balance and functional activities in patients with knee OA.

Detailed Description

Not available

Study Timeline

• Study Start: 2023-06-11
• Last Update Posted: 2023-10-23

Recruitment & Eligibility

• Status: Not Yet Recruiting
• Sex: Not specified
• Target Recruitment: 310

Inclusion Criteria

• Patient referred to physiotherapy department by orthopedician or any medical practioner for Knee OA with kellgren Lawrence classification grade II & grade III from x ray defined by an orthopedician.
• 2.Patients’ chief complaint is related to pain around the knee joint with difficulties in ADLs like sit to stand, stair climbing etc...
• 3.Age of patient- 40 years & above 4.Genders : Male & females both are included 5.Patients who are able to comprehend commands.

Exclusion Criteria

• 1.Trauma and neurological condition of lumbosacral spine.
• 2.Previous surgery over lumbar spine/ hip / knee / ankle 3.Systemic illness like lower extremity vascular disorder 4.Patients with known case of pulmonary disorders 5.History of lower limb fracture 6.Medical red flags 7.Non-cooperative patient The above stated conditions will be ruled out on the discretion of a Medical Professional.

Study & Design

• Study Type: Interventional
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Score with Numeric Pain Rating Scale, Score With Modified WOMAC Scale, Score with Community Balance & Mobility Scale, Litre with FEV1, Litre with FVC, % with FEV1/FVC	NPRS, Modified WOMAC scale score, Value of FEV1 & FVC will be measured at the first day of treatment & 6 weeks of treatment.

Secondary Outcome Measures

Name	Time	Method
Sociodemographic Charecteristics Questionnaire, Visual analogue scale to evaluate Fatigue Severity, Visual Analogue Scale, Beck depresson inventory.	Follow up would be taken at 6 months regular intervals for 3 years.

Trial Locations

Locations (1)

Civil Hospital,Gondal; 🇮🇳 Rajkot, GUJARAT, India

Civil Hospital,Gondal

🇮🇳Rajkot, GUJARAT, India

DR Maulik Shah

Principal investigator

9426818495

maulikshah50@yahoo.com