Osteoarthritis Clinical Trial
Official title:
Effects of Exercise on Joint Stiffness and Dynamic Balance in Individuals With Knee Osteoarthritis Evaluated Through Star Excursion Balance Test
Osteoarthritis is a prevalent and disabling condition. Exercise is recommended to maintain strength and mobility, and to decrease pain. However, acute bouts of exercise have conflicting outcomes: they are fatiguing and they also can increase coordination and balance. The purpose of this study is to assess the effects of a single bout of exercise (30 minutes) on balance performance of individuals with self-identified unilateral knee osteoarthritis. Balance will be assessed using the star excursion balance test before and after the exercise session. Differences in performance between the two star excursion balance tests will reflect the changes due to exercise. The changes between their balance performance on each limb will reflect the changes due to osteoarthritis.
Knee OA affects over 241 million people worldwide, and poses a significant burden to the
healthcare system (Cross et al., 2014). Knee OA leads to decreased quadriceps muscle
strength, and impaired postural control and joint proprioception (Hurley et al., 1997). These
factors lead to balance impairments in individuals with osteoarthritis compared to controls
(Wegener et al., 1997). It has been reported that the completion of a warm-up program
improves the dynamic and static balance of healthy individuals (Daneshjoo et al., 2012).
Therefore, exercise may acutely facilitate neuromuscular control, reduce stiffness and
significantly improve dynamic balance in individuals with knee OA. Alternatively, muscular
fatigue that may negate these benefits (Nardone et al., 1997). Given that falls are a
devastating injury in the elderly (Sri-On et al, 2017), and that exercise programs improve
balance (Carter et al, 2001; Tse et al, 2015) it is important to evaluate the acute effects
of a single bout of exercise on balance performance in individuals with osteoarthritis. The
Star Excursion Balance Test (SEBT) has been validated for quantifying dynamic balance in
healthy individuals (Kinzey & Armstrong, 1998) and individuals with knee OA (Kanko, 2017). It
is important to evaluate the effects of exercise on balance in individuals with OA as changes
in balance following exercise may lead to either impairments or improvements, and have direct
implications for the safety of exercise as a recommended approach in OA.
This study will recruit 35 individuals with self-identified unilateral knee osteoarthritis,
according to clinical criteria for classification of idiopathic knee OA (Altman et al.,
1986). They will complete a Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)
to clear them for participation in physical activity (Warburton et al, 2011). They will
complete a standard questionnaire assessing knee function: the Knee injury and Osteoarthritis
Outcome Score (KOOS) (Roos et al, 2003). They will complete the star excursion balance test,
on each of their affected and unaffected limbs, before and after completing a 30 minute bout
of exercise. This exercise session will be supervised, and emphasizes optimal alignment of
the trunk and lower limb joints relative to one another, as well as quality of movement
performance, while dynamically and functionally strengthening the lower limb muscles (Bennell
et al, 2011). The research participants will dictate the intensity and duration of the
program.
Differences in performance between the two star excursion balance tests will reflect the
changes due to exercise. The changes between their balance performance on each limb will
reflect the changes due to osteoarthritis.
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