None listed
Conditions
Brief summary
Knee osteoarthritis (OA) is a major public health problem with significant personal, social and economic burden. Being overweight is a known risk factor for the development and progression of symptomatic knee OA. One potential reason may be due to the increased forces placed on the knee joint during weight bearing activities in people that are overweight. The development of targeted treatments for people at high risk of disease progression, such as those who are overweight, is a research priority. Our primary aim will therefore be to evaluate whether people with knee OA and obesity respond differently to two different types of exercise; 1) weight bearing functional exercise and ii) non-weight bearing quadriceps strengthening exercise. Participants will be randomly allocated to one of the two exercise groups. Over 12 weeks participants will attend 5 in clinic physiotherapist appointments. The physiotherapist will prescribe a home based exercise program following the exercise protocol assigned to the participant. The home based exercise program will be completed 4 times a week, in addition to the physiotherapy sessions. Primary outcomes are overall knee pain and physical function measured at 12 weeks. As body mass index is easily measured our findings will potentially provide clinicians with a simple and effective means to tailor their exercise prescription and optimise outcomes for their patients with knee osteoarthritis.
Interventions
Description of intervention(s) / exposure: This randomised controlled trial will compare two exercise interventions.
Both interventions will comprise of 5 individual, in clinic physiotherapist-supervised exercise sessions (30-40-minute) and a 4 x weekly home exercise program over the same 12 week period.
In clinic physiotherapy sessions will occur at weeks 1, 2, 4, 7 and 10.
Home exercise sessions will be approximately 20-30 minutes in duration and occur at the participants chosen time 4 ti
Description of intervention(s) / exposure: This randomised controlled trial will compare two exercise interventions. Both interventions will comprise of 5 individual, in clinic physiotherapist-supervised exercise sessions (30-40-minute) and a 4 x weekly home exercise program over the same 12 week period. In clinic physiotherapy sessions will occur at weeks 1, 2, 4, 7 and 10. Home exercise sessions will be approximately 20-30 minutes in duration and occur at the participants chosen time 4 times each week. The two exercise interventions are; i) weight bearing functional exercise which includes 5 weight bearing exercises with progressions performed using body weight resistance, elastic bands, foam mats and a small step; and, ii) non-weight bearing quadriceps strengthening which includes 5 non-weight bearing exercises, with resistance provided by ankle weights or elastic bands. The intensity and progressions of the exercise programs will be determined by the physiotherapist in discussion with the participant. Participants will be provided exercise equipment required. Adherence to the exercise program will be captured via questionnaire at the 12 week time point. Adherence to the 5 clinic physiotherapy sessions will be recorded by the physiotherapists in their study case notes. Treatment fidelity will be scored by an assessment of the physiotherapist treatment notes, and fidelity will be maintained through regular tele-conferences between physiotherapists and the research team.
Sponsors
The University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
I. aged 50 years and above; II. report knee pain on most days of the past month; III. suffered knee pain for 3 months or more; IV. report a minimum average overall pain score of 4 on an 11-point numeric rating scale over the previous week; V. demonstrate tibiofemoral osteophytes on x-ray; VI. obesity (BMI of 30 kg/m2 and over); VII. have a mobile phone that has text messaging functionality and be happy to receive text message reminders if required during the study.
Exclusion criteria
I. Lateral joint space narrowing greater than or equal to medial joint space narrowing on x-ray; II. knee surgery/joint injection in past 6 months or planned surgery in the next 9 months; III. current or past (4 weeks) oral corticosteroids; IV. systemic arthritic conditions; V. past knee fracture or malignancy; VI. past hip/knee joint replacement/tibial osteotomy; VII. other condition currently affecting lower limb function; VIII. participation in knee strengthening or neuromuscular exercise in past 6 months or planning to start exercise in next 9 months; IX. unable to walk unaided; X. unable to commit to study requirements (Unable to attend study appointments or complete study outcomes)
Outcome results
None listed