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Effect of Strengthening the Hip Abductor in Patients With Knee Osteoarthritis: Randomized Controlled Trial

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ClinicalTrials.gov Identifier: NCT02901964
Recruitment Status : Completed
First Posted : September 15, 2016
Last Update Posted : November 2, 2018
Sponsor:
Information provided by (Responsible Party):
Gabriel Peixoto Leão Almeida, Universidade Federal do Ceara

Brief Summary:
Osteoarthritis (OA) is a prevalent disease associated with significant morbidity and is one of the most common causes of joint pain. Characterized by their chronicity, slow and progressive evolution. The overall prevalence of symptomatic knee osteoarthritis is estimated at 3.8%, with peak prevalence in the population with an average age of 50 years. The main objectives of interventions in patients with knee OA are reduced pain and improved functional capacity and exercises are widely recommended. The literature shows a lack of clinical trials verifying the effect of strengthening the hip muscles in patients with knee osteoarthritis. Thus, the aim of this study is to assess the effect of strengthening the hip abductor muscles versus hip adductor muscles in patients with symptomatic OA of the knee.

Condition or disease Intervention/treatment Phase
Osteoarthritis, Knee Other: Hip Abductor Exercise Other: Hip Aductor Exercise Not Applicable

Detailed Description:

The physical therapy sessions will average duration of one hour, often twice a week for six weeks. The exercise intensity will be monitored by the physiotherapist as determined by the participant's ability to complete 10 repetitions for a particular exercise and its difficulty of execution perceived by the modified Borg scale (CR-10). The exercises are performed with load between 60-80% of their capacity, the load will be increased from 2 to 10% when the patient can perform 14 full repetitions in the last series (76). It will be set to 30 seconds of rest between reps and 2 minutes between sets of exercise.

Both groups will perform prior heating exercises exercise bike for 10 minutes with moderate intensity with the Borg scale. Then there will be two stretches repetitions held for 30 seconds of muscle groups: hamstrings, quadriceps, abductors, adductors and gastrocnemius. Manual therapy for patellofemoral and tibiofemoral joint will be held after the completion of stretching. Recent clinical guidelines on knee OA strongly recommend the use of strengthening exercises of the lower limbs, both in closed kinetic chain and open. Thus, they will be performed strengthening exercises in extension and knee flexion in open kinetic chain, squat up and down a step and exercises to sural triceps. For symptom control during exercise in CKC will be used the numeric scale of pain before and after its execution.

The GABQ add the hip abduction exercises in lateral decubitus, exercise "Clam" and pelvic elevation. Studies prior point out that these exercises are among those with higher electromyographic activity of the gluteus medius muscle.

The GADQ add the adduction exercises hip in lateral recumbency, bilateral adduction with a ball between the legs and functional diagonal leg.

The exercises will be carried out to load 60-80% of 1 repetition maximum 8-12 reps, 1-3 sets and 2-3 times a week. All exercises are performed without worsening pain and intensity of exercise will be controlled according to the perceived exertion scale of Borg.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 66 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Investigator)
Primary Purpose: Treatment
Official Title: Effect of Strengthening the Hip Abductor in Patients With Knee Osteoarthritis: Randomized Controlled Trial
Study Start Date : September 2016
Actual Primary Completion Date : May 2018
Actual Study Completion Date : November 2018

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: Group Hip Abductor Exercise
12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip abductors.
Other: Hip Abductor Exercise
12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip abductors.

Active Comparator: Group Hip Aductor Exercise
12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip aductors.
Other: Hip Aductor Exercise
12 treatments sessions at 6 weeks: Heating, lower limb stretching, tibiofemoral and patellofemoral mobilization, strengthening the quadriceps, hamstrings, triceps sural and hip aductors.




Primary Outcome Measures :
  1. Numeric Pain Scale [ Time Frame: Six weeks ]
    Pain was assessed by use of an 11-point Numeric Pain Scale, where 0 corresponded to no pain and 10 corresponded to worst imaginable pain.

  2. Pain and Function subscale - Knee Injury and Osteoarthritis Outcome Score [ Time Frame: Six weeks ]
    Pain and Function subscale - KOOS was assessed, where 0 corresponded to no pain and normal function and 100 corresponded to worst pain and function.


Secondary Outcome Measures :
  1. Others subscales - Knee Injury and Osteoarthritis Outcome Score [ Time Frame: Six weeks ]
  2. 30 s Chair Stand Test [ Time Frame: Six weeks ]
  3. Timed Up & Go Test [ Time Frame: Six weeks ]
  4. Global Perceived Effect Scale [ Time Frame: Six weeks ]
  5. Numeric Pain Scale [ Time Frame: Six months ]
  6. Knee Injury and Osteoarthritis Outcome Score [ Time Frame: Six months ]
  7. Global Perceived Effect Scale [ Time Frame: Six months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   50 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • OA knee radiograph grades 2 - 4 according to the Kellgren-Lawrence scale;
  • Reporting knee pain with minimum intensity of 3 on Numerical Pain Scale;
  • Complaints of pain and functional reduction in the last three months;
  • Meet at least one of the American College of Rheumatology classification criteria;
  • Deambulation independent;
  • Absence of prostheses or orthoses
  • Predominant pain in the medial aspect of the knee.

Exclusion Criteria:

  • Contraindications for physical exercises evaluated by the Physical Activity Readiness Questionnaire (PAR-Q);
  • Diabetes type I or decompensated;
  • Hypertension decompensated;
  • Cardiac pacemaker;
  • Cancer History
  • Neurological deficits (sensory or motor)
  • Body mass index above 40 kg / m2
  • Hip symptomatic osteoarthriti
  • Orthopedic surgery of the lower limbs
  • Systemic inflammatory disease
  • Can not walk.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02901964


Locations
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Brazil
Federal University of Ceara
Fortaleza, Ceará, Brazil, 60430-160
Sponsors and Collaborators
Universidade Federal do Ceara
Investigators
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Principal Investigator: Gabriel Peixoto Leão Almeida, PhD student Federal University of Ceará (UFC), Brazil.

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Responsible Party: Gabriel Peixoto Leão Almeida, Professor, Universidade Federal do Ceara
ClinicalTrials.gov Identifier: NCT02901964    
Other Study ID Numbers: Doutorado
First Posted: September 15, 2016    Key Record Dates
Last Update Posted: November 2, 2018
Last Verified: October 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Plan Description: IPD will not be shared.
Additional relevant MeSH terms:
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Osteoarthritis
Osteoarthritis, Knee
Arthritis
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases