Osteoarthritis, Knee Clinical Trial
— OAOfficial title:
Investigation of the Effects of Progressive Resistance Exercises on Pain, Functional Activity, Quality of Life and Serum Biomarkers in Individuals With Knee Osteoarthritis
It is known that the global socioeconomic burden of individuals with knee osteoarthritis (OA) is on a constantly rising curve. In addition, it is predicted that this burden will increase with the increase in the aging rate of countries. While the evidence level of exercise in the treatment of individuals with knee OA is at A level, a standard exercise program has still not been established for these individuals. One of the most important elements in establishing a standard exercise protocol can be realized by understanding how exercise provides positive effects in these individuals. Today, the gold standard practice used in examining the effectiveness of treatments such as exercise is the follow-up of biomarkers. However, for this purpose, biological fluids (blood, urine, synovial fluid) samples are not taken from individuals with knee OA during routine health controls. Existing laboratory detection methods, especially ELISA analysis, are very detailed, time-consuming and expensive, among the reasons why they cannot be included in routine clinical practice. This situation makes it difficult to examine which biomarkers the exercise programs applied in individuals with knee OA have an effect on and to establish a standard exercise protocol. Therefore, the number of randomized controlled studies examining this issue is very few in the literature, and this number is much less in Turkey. The researchers aimed to create a standard home-based exercise program by examining the effects of the holistic exercise approach for all lower extremity muscles, which the researchers created considering the EMG studies in the literature for individuals with knee OA and the age group to be included in the study, both at the physical (pain, functional status, quality of life) and biochemical level (inflammatory biomarkers that have not been examined together before and whose relationship with OA has been newly discovered).
Status | Not yet recruiting |
Enrollment | 40 |
Est. completion date | November 1, 2024 |
Est. primary completion date | September 1, 2024 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 50 Years and older |
Eligibility | Inclusion Criteria: - Having signed the informed consent form, - Male and postmenopausal female patients aged 50 and over, - Radiologically and clinically diagnosed with Stage 1 or 2 knee OA, - Patients with a sedentary life (patients with less than 45 minutes of moderate-intensity activity per week) Exclusion Criteria: - Cooperative problem or cognitive impairment, - BMI > 35 kg/m2, - Receiving physiotherapy in the last 3 months, - Steroid injection to the knee joint in the last 6 months, - Presence of neuromuscular or neurodegenerative disease, - Presence of cardiorespiratory disease, previous hip, knee, foot-ankle surgeries, - Use of immunosuppressive drugs, - Presence of infection or inflammatory disease in any part of the body. |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Meltem Meran Çaglar |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Chair Stand Test | A standard chair will be used for the test. First of all, the patient will be asked to sit with his back to the chair. Then, he will be asked to get up from the seat without holding on to the arms of the chair, walk with regular steps at a predetermined length of 3 m, and return to the chair at the end of 3 m. Each patient will be asked to walk at a normal pace and the time will be recorded in seconds with a digital stopwatch. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Timed Up and Go Test | A standard chair will be used for the test. First of all, the patient will be asked to sit with his back to the chair. Then, he will be asked to get up from the seat without holding on to the arms of the chair, walk with regular steps at a predetermined length of 3 m, and return to the chair at the end of 3 m. Each patient will be asked to walk at a normal pace and the time will be recorded in seconds with a digital stopwatch. The walking distance will be measured with a tape measure and marked with a colored tape. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Range of Motion | Active hip, knee, and ankle joint range of motion will be measured using a universal goniometer. It has been shown that goniometric measurement is a reliable and valid outcome measure in patients with knee OA (Maricar et al., 2016). Hip flexion, abduction, adduction, ankle dorsi and plantar flexion measurements were in supine position; hip extension, knee flexion and extension measurements will be performed in the prone position. Each assessment will be repeated three times, and their average value will be recorded. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Muscle Strength | Assessment of muscle strength will be made with a Lafayette manual muscle tester (Lafayette Instrument Company, Lafayette, USA). Measurements will be made in hip abduction, adduction, flexion and extension, knee flexion and extension movements. Measurements will be made in three repetitions for hip abduction, adduction, flexion and extension, with one minute rest between each hip movement and 15 seconds between each repetition. The best values obtained from triple repetitive measurements will be used in the analysis (Mentiplay et al., 2015). Strength measurement of iliopsoas, gluteus maximus, gluteus medius, quadriceps femoris, harmstring, adductor longus and brevis, plantar and dorsi flexor muscles will be performed. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Serum Inflammatory Level | All measurements of serum biomarkers [plasma-soluble TNF-a and TNF-a receptors 1 (sTNFR1), 2 (sTNFR2), serum resistin, IL-1ß, IL-6, IL-17, MMP-1 and MMP-3] are strictly aseptic. Under these conditions, 10 ml of venous blood will be drawn from each individual. After centrifugation of the clotted blood at 3000 rpm for 20 minutes, the separated serum samples will be portioned and frozen at -20 C and stored under these conditions until analysis. | Blood collection will be done before treatment (week 0) and after treatment (week 13) to examine serum biomarker levels with ELISA kits. | |
Primary | Visual Analogue Scale (VAS) | It will be used to evaluate the severity of pain. The severity of the pain will be determined by marking a place on a 10 cm straight line drawn between the points of no pain (0) and unbearable pain (10). An increase in the score indicates an increase in pain intensity. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) | It is a disease-specific health status measure that is frequently used in patients with knee and hip OA, which consists of three parts (pain, stiffness, and function). WOMAC Turkish version has been shown to be a reliable, valid, sensitive and acceptable outcome measure. WOMAC consists of 24 questions, 5 questions in the pain section, 2 questions in the stiffness section, and 17 questions in the function section. A total score is obtained by scoring each question between 0 and 4 points. Patients are asked to answer the questions by considering the pain, stiffness and activities they have difficulty in performing in the last 24 hours. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). | |
Primary | Quality of Life Scale-Short Form (SF-12) | The 12-item short form health questionnaire (SF-12) is a measure that evaluates physical and mental health. It was reported that SF-12, which was created from the original form, SF-36, was easier to apply and had a shorter completion time and was more advantageous to use. | Evaluations will be repeated before treatment (week 0), weeks 5 and 9, and post treatment (13 weeks). |
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