Different Modalities of Aquatic Physiotherapy in Patients With Knee Osteoarthrosis

Osteoarthritis of the Knee Clinical Trial

Official title:

Effects of Different Modalities of Aquatic Physiotherapy on Biomechanical and Functional Behavior of Subjects With Knee Osteoarthrosis

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05610696
• Other study ID #: FUHSPortoAlegreCesar
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 30, 2023
• Est. completion date: January 31, 2024

Study information

• Verified date: January 2023
• Source: Federal University of Health Science of Porto Alegre
• Contact: Fernanda Cechetti
• Phone: 3303-8700
• Email: nandacecheti[@]gmail.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The aim of this study is to evaluate the effects of different modalities of aquatic physiotherapy on the biochemical and functional behavior of patients with knee's Osteoarthritis.

Description:

The subjects will be informed about the study and its potentials risks and sign the informed consent. The sample will be submitted to three different modalities of AF interventions: (a) low impact immersion, (b) conventional aquatic physiotherapy and (c) high intensity aquatic physiotherapy. The functional variables of flexibility, pain, joint volume will be evaluated before and immediately after each intervention whereas the biochemical variables will be evaluated from the analysis of peripheral blood following times: baseline moment (immediately before the intervention), moment 1 (immediately after the intervention), and moment 2 (24 hours after the intervention).

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 15
• Est. completion date: January 31, 2024
• Est. primary completion date: December 3, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 50 Years to 95 Years

Eligibility

Inclusion Criteria:

• Patients over 50 years old and diagnosed with OA in at least one knee
• Presence of pain and at least one functional dysfunction for at least 6 months
• Absence of physical limitation that prevents the exercise protocol from being performed
• Kellgren and Lawrence ranking between I and IV
• walk independently and without auxiliary device

Exclusion Criteria:

• Inflammatory, rheumatic or autoimmune conditions
• Use of psychotropic, immunosuppressive and steroid medications
• Antioxidant consumption
• Alcohol and tobacco consumption
• Progressive ankylosis states
• neurological injuries
• Infections or skin diseases that contraindicate swimming pool immersion
• Surgical procedures on the knee joint in the last 12 months (excluding meniscectomy or arthroscopy)
• Lower Limb Joint Prosthesis
• Presence of inflammatory or infectious diseases, uncontrolled systemic arterial hypertension, uncontrolled diabetes, chronic obstructive pulmonary disease and history of ischemic heart disease
• Self-report of aquatic phobia and chlorine allergies

Related Conditions & MeSH terms

• Osteoarthritis
• Osteoarthritis of the Knee
• Osteoarthritis, Knee

Intervention

Other:
• Low impact immersion
Consists of a sequence of shoulder, trunk and hip movements. In this modality, the aim will be to understand the physiological effects of immersion in heat water. Resisted movements (either by turbulence or by floats) or interventional maneuvers in the knee joints will not be performed. Considering the period of 5 minutes for acclimatization to the liquid environment, the program will last approximately 47 minutes.
• Conventional aquatic physiotherapy
include warm-up, strengthening and calming down activities. Aquatic steppes will be used to ensure that all participants will maintain the waterline level approximately in the xiphoid appendix. For strengthening activities, the exercises must be performed at an adequate speed, which ensures a comfortable level for the activity. For this purpose, a subjective feedback will be extracted from the participants constantly. The warm-up sequence consists of six different active hip and knee movements performed at maximum range of motion and contributes to neuromuscular activation. For strengthening, each movement should be performed for 1 minute (30 seconds for each lower limb) followed by a period of 30 seconds of rest between each movement.
• High intensity aquatic physiotherapy
In this modality subjects will perform the same sequence of exercises of the Conventional Aquatic Physiotherapy program will be respected. However the work load and speed will be adjusted to the maximum level. For strengthening, each movement should be performed for 2 minutes (1 minute for each lower limb) followed by a period of 30 seconds of rest between each movement. To guarantee the maximum effort of the participants, verbal stimuli will be constantly provided. The program will last approximately 68 minutes.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Federal University of Health Science of Porto Alegre

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Biochemical variables over time	Variations in the concentration of and Glutathione perioxidase in peripheral blood resulting from three aquatic physical therapy interventions evaluated comparatively between the different interventions in U/L	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions
Primary	Biochemical variables over time	Variations in the concentration of Metalloproetinase	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions in mg/mL
Secondary	Degree of pain over time	Performed using the visual analogue pain scale, from a scale graduated from zero to 10, in which zero corresponds to cases without pain and 10 corresponds to the worst imaginable pain.	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions.
Secondary	Edema over time	Performed based on the measurement of the circumference of the affected knee. Result expressed in centimeters	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention)
Secondary	Flexibility over time	Assessed by measuring the amplitude of the active and passive movement for the knee flexion and, for that, a conventional goniometer will be used. Result expressed in degrees	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions.
Secondary	Muscle strength over time	Measured by dynamometer to assess knee extension strength. Results expressed in kg of force.	Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions.