The Effect of Contralateral Isokinetic Lower Extremity Exercises Added to Conventional Rehabilitation in Unilateral Painful Knee Osteoarthritis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 32
- 试验地点
- 2
- 主要终点
- The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score
研究概览
简要总结
Patients with unilateral knee pain due to knee osteoarthritis presenting to our clinic will be included in a 20-session treatment program, either on an outpatient basis or as inpatients at our clinic. The patients will be divided into 2 groups, and conventional treatments including isometric exercises, TENS (Transcutaneous Electrical Nerve Stimulation) and hot pack therapy for the painful knee will be administered to both groups. In addition to these treatments, the intervention group will receive isokinetic exercise sessions using the Cybex 770 Norm isokinetic dynamometer system (Lumex Inc., Ronkonkoma, New York) at speeds of 60°/s and 180°/s according to the device's standard protocol, targeting the contralateral lower extremity. Subsequently, examinations and measurements will be conducted to evaluate patients for reduction in pain, increase in muscle strength, improvement in functionality, and increase in thigh muscle thickness.
详细描述
Osteoartritis is the most common form of arthritis, originating from the failed repair of joint damage caused by stress initiated by any joint or periarticular tissue abnormality. Its most common symptom is pain. The long-term consequences of osteoarthritis include decreased physical activity, loss of conditioning, sleep disturbances, fatigue, depression, and disability. Factors associated with increased risk of knee osteoarthritis include advanced age, female gender, overweight or obesity, knee injury, occupational factors, and varus or valgus alignment of the knee.
With the increasing aging population, degenerative joint problems have become relevant to a large portion of society. Exercise is a fundamental component in the treatment of this chronic disease, which limits functionality and reduces quality of life.
A systematic review including 32 randomized controlled trials evaluating 5362 participants showed that various types of exercise provide improvement in pain, functionality, and quality of life in knee osteoarthritis.
Musculoskeletal pains can lead to cortical reorganization in both somatosensory and motor areas, which can reduce motor activity in both the affected and unaffected contralateral extremities. For example, a decrease in motor activity in both painful and pain-free contralateral extremities has been identified during acute pain and/or in the presence of chronic pain.
If exercise is performed to increase muscle strength on one side of the body, strength may also increase on the opposite side. This effect, called the contralateral exercise phenomenon, is typically measured in homologous muscles. Although known for over a century, most studies have not been well-designed to demonstrate the exact magnitude of the strength increase effect. However, an updated meta-analysis of 16 studies indicates that the size of the contralateral exercise effect is approximately 8% of baseline strength or about half of the increase in strength on the exercised side.
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
- Double (Investigator, Outcomes Assessor)
盲法说明
Clinical and demographic data collection and statistical analyses will be conducted by a blinded researcher with respect to the treatment group and clinical findings.
入排标准
- 年龄范围
- 50 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •To agree to participate in the study
- •To be aged 50 years or older
- •To have a clinically and radiographically confirmed diagnosis of knee osteoarthritis
- •To have unilateral knee pain due to osteoarthritis (VAS <2 in the contralateral knee, VAS >2 in the painful knee)
- •To have Kellgren-Lawrence Grade 1-3 in the painful knee and Kellgren-Lawrence Grade <4 in the contralateral knee
- •To have dominance of the right lower extremity
排除标准
- •A history of previous lower extremity fractures or orthopedic surgery that would interfere with isokinetic and isometric exercises in both lower extremities
- •The presence of significant sensorimotor deficits due to neurological diseases
- •The presence of known inflammatory rheumatic diseases
- •The presence of non-curable malignant tumors with bone metastasis
- •The presence of neuropsychiatric diseases or conditions that would hinder cooperation
- •Having undergone interventions such as injections for pain relief within the last 3 months
结局指标
主要结局
The Western Ontario and McMaster Universities Arthritis Index (WOMAC) score
时间窗: From enrollment day to the end of the rehabilitation program at 4 weeks.
WOMAC score evaluation following the last treatment session. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, validated questionnaire designed to assess pain, stiffness, and physical function in patients with knee and hip osteoarthritis. It consists of 24 items divided into three subscales: pain (5 items), stiffness (2 items), and physical function (17 items). Patients rate their symptoms on a Likert scale, with higher scores indicating worse pain, stiffness, or functional limitations. The WOMAC is commonly used in clinical research to evaluate the efficacy of various treatments for osteoarthritis.
次要结局
- Pain level; VAS score(From enrollment day to the end of the rehabilitation program at 4 weeks)
- Muscle strength(From enrollment day to the end of the rehabilitation program at 4 weeks)
- Physical function(From enrollment day to the end of the rehabilitation program at 4 weeks)
- Lower extremity function(From enrollment day to the end of the rehabilitation program at 4 weeks)
- Ultrasonographic Measurement of Thigh muscle thickness(From enrollment day to the end of the rehabilitation program at 4 weeks)
- Range of motion(From enrollment day to the end of the rehabilitation program at 4 weeks)
研究者
Emine METIN IPEK
Research Assistant, Physical Medicine and Rehabilitation, Principal Investigator, M.D.
Gazi University