The Influence of Hip Strengthening Exercises on Walking Patterns and Muscle Strength in Persons With Knee Osteoarthritis

This study has been completed.
Sponsor:
Information provided by:
Queen's University
ClinicalTrials.gov Identifier:
NCT00427843
First received: January 25, 2007
Last updated: October 14, 2008
Last verified: October 2008
  Purpose

The purpose of this study is to determine the influence of a home program of exercises for the hip muscles which support the pelvis on walking patterns and hip muscle strength in people with knee osteoarthritis. Following a hip muscle strengthening program, we hypothesize that participants with knee osteoarthritis will demonstrate decreased loading at the knee joint during walking and greater strength of the hip muscles.


Condition Intervention
Osteoarthritis, Knee
Behavioral: home exercise program for the hip abductor muscles

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: The Influence of a Home Program of Hip Abductor Exercises on Gait Parameters and Muscle Strength in Persons With Knee Osteoarthritis

Resource links provided by NLM:


Further study details as provided by Queen's University:

Primary Outcome Measures:
  • Walking variables: hip and knee abductor and adductor moments [ Time Frame: baseline and after 8 weeks ] [ Designated as safety issue: No ]
  • Muscle strength measures: isometric and isokinetic peak torque measures for the hip abductor and adductor muscles [ Time Frame: baseline and after 8 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Radiographs: lower limb frontal plane alignment measures - limb alignment in degrees; grading of knee osteoarthritis severity (total score out of 13) [ Time Frame: baseline ] [ Designated as safety issue: No ]
  • Speed of performance on the Five-Times-Sit-to-Stand Test [ Time Frame: baseline and after 8 weeks ] [ Designated as safety issue: No ]
  • Total score on the WOMAC pain subscale and the WOMAC physical function subscale [ Time Frame: baseline and after 8 weeks ] [ Designated as safety issue: No ]
  • Total score obtained for the physical activity scale (PASE) [ Time Frame: baseline and after 8 weeks ] [ Designated as safety issue: No ]

Enrollment: 80
Study Start Date: January 2007
Study Completion Date: September 2008
Primary Completion Date: May 2008 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Exercise Home-Based Program
Patients with knee OA will be taught a home-based exercise program for the hip abductor muscles during the initial visit. The exercise program will be performed 3 times per week for 8 weeks.
Behavioral: home exercise program for the hip abductor muscles

All patients with knee OA will be taught a home-based exercise program for the hip abductor muscles during the initial visit. Patients will be instructed in the following program: contraction of the gluteus medius muscle during functional activities (gait, stepping sideways up on a step and standing on one leg); and side lying isotonic hip abduction exercises using graded resistance elastic bands positioned around the distal thighs.

The program will be performed 3 times per week for 8 weeks and subjects will record exercise frequency and level of resistance on exercise calendars. Follow-up visits will occur at the end of week 1 and week 4 for review and progression of exercises. A telephone follow-up call will occur for support and participants will be encouraged to call with any questions or concerns.


Detailed Description:

Knee osteoarthritis is a common age-related impairment that may progress to cause significant pain and physical disability. Excessive loading at the knee joint is believed to contribute to the progression of knee osteoarthritis. The hip joint and surrounding muscles have been shown to influence the amount of stress occurring at the knee joint during walking. In particular, the hip abductor muscles may have an effect on the knee joint by controlling the position of the pelvis and/or by acting as lateral stabilizers for the knee.

Research suggests that the function of the hip muscles during walking may be decreased in people with knee osteoarthritis and that greater loads may be placed on the knee joint as a result. Thus, interventions aimed at strengthening the hip abductor muscles may be effective for reducing stress on the arthritic knee and slowing the rate of progression of knee osteoarthritis.

The design of the study is a two-group pretest-posttest design using an untreated control group. Thirty-five individuals with medial compartment knee osteoarthritis will be recruited through newspaper advertisements and from the practices of orthopedic surgeons in Kingston, Ontario. Each participant with knee osteoarthritis will be matched with an asymptomatic volunteer for age (+/- 5 years), height (+/- 5 cm), mass (+/- 5 kg) and gender. Participants in the control group will have no clinical or radiographic diagnosis of knee or hip osteoarthritis or rheumatoid arthritis and no history of hip or knee trauma or pain.

  Eligibility

Ages Eligible for Study:   40 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • age greater than or equal to 40 years
  • self-reported pain in the knee(s) for most days of the month
  • at least some difficulty in daily function due to knee osteoarthritis
  • radiographic evidence of knee osteoarthritis or documented evidence of cartilage loss in the knee by arthroscopy surgery or magnetic resonance imaging.

Exclusion Criteria:

  • corticosteroid injection into either knee within the previous three months
  • other significant medical problems (including significant heart disease, stroke and active treatment for cancer) that would prevent participants from being able to perform a hip exercise program or to participate in tests of walking performance and hip muscle strength
  • known osteoarthritis or previous trauma affecting one or both hips
  • previous replacement of any joint in the lower extremities.
  • receiving rehabilitation services for knee osteoarthritis or performing a hip strengthening program at the time of testing
  • participants who have had a dual-energy x-ray absorptiometry (DEXA) for bone density analysis or more than one x-ray of the chest, abdomen or hip in the past 6 months
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00427843

Locations
Canada, Ontario
School of Rehabilitation Therapy, Queen's University
Kingston, Ontario, Canada, K7L 3N6
Sponsors and Collaborators
Queen's University
Investigators
Study Director: Elsie G. Culham, PhD Queen's University
  More Information

No publications provided by Queen's University

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Elsie Culham, PhD, School of Rehabilitation Therapy, Queen's University
ClinicalTrials.gov Identifier: NCT00427843     History of Changes
Other Study ID Numbers: REH-324-06
Study First Received: January 25, 2007
Last Updated: October 14, 2008
Health Authority: Canada: Ethics Review Committee

Keywords provided by Queen's University:
osteoarthritis
knee
gait
muscle strength
hip
exercise

Additional relevant MeSH terms:
Osteoarthritis, Knee
Osteoarthritis
Arthritis
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases

ClinicalTrials.gov processed this record on September 16, 2014