Osteoarthritis, Knee Clinical Trial
Official title:
Effect of Strengthening the Hip Abductor in Patients With Knee Osteoarthritis: Randomized Controlled Trial
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.
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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