Knee Osteoarthritis Clinical Trial
Official title:
Mixed Methods Study to Evaluate Pain, Function, Postural Stabilisation, and Fear of Movement Following a Lower Limb Exercise Programme for Knee Osteoarthritis
Verified date | May 2016 |
Source | University of Salford |
Contact | n/a |
Is FDA regulated | No |
Health authority | United Kingdom: Research Ethics Committee |
Study type | Interventional |
Osteoarthritis (OA) is a condition that causes cartilage loss, bony remodeling, joint stiffness and generalized muscle weakness. 90% of OA presentation has been reported within the leg; with 44% affecting the knee joint. Knee OA is expected to increase by 50% over the next twenty years due to an ageing population, obesity, and societal trends such as lack of activity. Only 13% of knee OA sufferers reach the recommended levels of exercise therefore an understanding of how psychological and functional relationships effect exercise engagement, which in turn would provide a more comprehensive rehabilitation programme for patients with knee OA. The aim of this study is to investigate exercise in knee OA and it it's correlation with fear of movement, using a mixed methods approach. Quantitative methodology will investigate lower limb exercises for pain and function and fear of movement. The desired outcome of the study will show that a reduction in pain with patient specific exercise will also reduce the fear of movement and allow patients to self-manage their symptoms without fear. Other quantitative factors such as intensity of exercise and postural stabilization using the Y balance test will also be utilized to review the functional relationship of muscle strength and balance to kinesiophobia. A semi-structured interview will be completed at the end of the course of treatment to highlight what patients think about exercise as an intervention. Participants aged forty-five and above with specific clinical symptoms will be invited into the study and will be asked to attend eight exercise sessions within a class environment, which will last for 1 hour within the Physiotherapy Department.
Status | Recruiting |
Enrollment | 44 |
Est. completion date | April 2017 |
Est. primary completion date | April 2017 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 45 Years and older |
Eligibility |
Inclusion Criteria: Patients must elicit 3 of the 6 symptoms to be included: - forty five years of age and over. - stiffness for less than thirty minutes; - crepitus; - bony tenderness; - bony enlargement; - no palpable joint warmth. Exclusion Criteria: - previous lower limb joint injection within three months; - previous hip or knee joint replacement; - any severe cognitive, cardio- respiratory, musculoskeletal or neurological - diagnosis that prevents participants from exercising; - insoles or braces; - ligament instability; - participants with a body mass index (BMI) over 40 will be issued with a choice of completing in the study or being managed by the National Health Service weight management service; - other minor health related issues will be assessed prior to the commencement of the study to ensure safe practice. |
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
United Kingdom | Bridgewater Community Healthcare Foundation Trust | Leigh |
Lead Sponsor | Collaborator |
---|---|
University of Salford |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Change in the level of function, pain,quality of life, sport and recreation, activities of daily living and symptoms in patients during an exercise programme and 6 weeks after the programme. | Knee injury and Osteoarthritis Outcome Score (KOOS) is a valid, highly reliable, and responsive for evaluating changes after OA interventions. This is a questionnaire that consists of 42 questions covering Pain; Symptoms; Function in Daily Living Function in Sport and Recreation and Knee-Related Quality of Life. The score is then normalized to a 0-100 scale with the higher score being better. | At the beginning, through study completion, an average 10 weeks. | No |
Other | Change in the level of physical activity during an exercise programme and 6 weeks after the programme. | Physical activity will be measured using the physical activity scale for the elderly (PASE), which is a valid and reliable measurement tool. It is a self-administered questionnaire, which assesses a wide range of activities such as leisure time activity, household activity, and work related activity. It consists of 12 questions and is calculated by multiplying either the time spent in each activity (hours per week) or participation in an activity. The overall scores ranges' from 0-400. | At the beginning, through study completion, an average 10 weeks. | No |
Other | Change in the distance walked within a 6 minute period during an exercise programme and 6 weeks after the programme. | A 6 minute walk test to assess aerobic walking capacity; dynamic balance whilst changing direction and maximal distance covered in a 6-minute period. | At the beginning, through study completion, an average 10 weeks. | No |
Other | Change in the level of pain intensity during an exercise programme and 6 weeks after the programme. | Visual Analogue Scale (VAS) is an horizontal line, 100 mm in length, anchored by word descriptors at each end. The patient marks on the line the point that they feel represents their perception of their current pain intensity. The VAS score is determined by measuring in millimetres from the left hand end of the line to the point that the patient marks. | At the beginning, through study completion, an average 10 weeks. | No |
Other | Change in the level of perceived exertion during an exercise programme . | Modified Borg scale for exercise intensity tool will be used. It will be used to document the patient's exertion after the exercise programme and is used to assess the intensity of training. The exertion is rated on a scale of 6-20, where 6 means "no exertion at all" and 20 means "maximal exertion. | At the beginning, through study completion, an average 4 weeks. | No |
Other | Change in the level of physical activity during an exercise programme and 6 weeks after the programme. | An activity monitor will be issued to monitor physical activity and should be worn continuously for 7 days during waking hours. The Activity monitor is a device that measures the postural aspect of inactivity. It is a small monitor that is placed on the midline anterior aspect of the upper thigh and can determine body position, such as sitting, lying, being upright and movements between these postures, stepping and stepping speed. | At the beginning and 6 weeks after the exercise programme. | No |
Other | Change in the level of lower extremity functional strength during an exercise programme and 6 weeks after the programme. | The 30 second chair test is administered using a folding chair without arms, with seat height of 17 inches (43.2 cm). The chair, with rubber tips on the legs, is placed against a wall to prevent it from moving. The participant is seated in the middle of the chair, back straight; feet approximately shoulder width apart and placed on the floor at an angle slightly back from the knees, with one foot slightly in front of the other to help maintain balance. Arms are crossed at the wrists and held against the chest. The participant is encouraged to complete as many full stands as possible within 30 seconds. The participant is instructed to fully sit between each stand.The 30 second chair stand involves recording the number of stands a person can complete in 30 seconds. |
At the beginning, through study completion, an average 10 weeks. | No |
Primary | Change in the level of kinesiophobia with exercise assessed using the Tampa Kinesiophobia Scale during an exercise programme and 6 weeks after the programme. | Patients will be asked to complete the Tampa Kinesiophobia Scale at the beginning of the study, before exercise session 4, before session 8 and 6 weeks after the exercise programme. This will measure the level of kinesiophobia associated with exercise. If an individual scores highly, this indicates a high level of kinesiophobia. | At the beginning, through study completion, an average 10 weeks. | No |
Secondary | Change in the level of psychological and functional relationships using the Y balance test during an exercises programme and 6 weeks after the programme. | The Y balance test is a quick, efficient, objective, portable, and consistent tool and will be used to evaluate dynamic and asymmetrical balance whilst utilising muscle strength and flexibility at the hip, knee and ankle joints. It consists of a stance platform to which three pieces of plastic pipe are attached in the three reach directions; anterior (ANT), posteromedial (PM), and posterolateral (PL). The PM and PL pipes are positioned 135 degrees from the ANT pipe with 45 degrees between the posterior pipes. The pipes are marked at 5 mm intervals for measurement. To perform the test the subject pushes the reach indicator along each of the pipes and a score is calculated. Each leg will be tested. | At the beginning, through study completion, an average 10 weeks. | No |
Secondary | Change in the understanding of key factors that patients think about exercise as an intervention using a semistructured interview. | A semi-structured interview will be completed at the end of course of treatment to highlight what patients think about exercise as an intervention. | 6 weeks post exercise class | No |
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