Knee Osteoarthritis, Pain, Joint
Conditions
Brief summary
Knee osteoarthritis (KOA) is a chronic progressive disease that imparts substantial socioeconomic burden to society and healthcare systems. The prevalence of KOA has dramatically risen in recent decades due to consistent increases in life expectancy, and demand for joint replacement continues to rise. Total knee replacement is indicated for end-stage KOA, as it is very effective in terms of pain relief, improvement of function, and quality of life. However, the investigators will be facing an unsustainable joint replacement burden, with significant healthcare budget and health workforce implications. To alleviate this problem, different strategies including reinforce the importance of education and exercise are included; as previous studies showed that less than 40% of patients with KOA received non-pharmacological treatment, indicating that the uptake of evidence-based guidelines in clinical practice and rehabilitation is still suboptimal. Several literatures revealed that quadriceps and hamstrings strength exercise could effectively reduce pain. It has widely accepted that patients with end stage KOA will eventually pursue total knee replacement as the only viable option, and exercise has low efficacy in reduction of pain and disability in this group of patients. So, the investigators would like to know whether exercise therapy can help severe KOA patients
Interventions
OTHERWhole-Body Vibration
10 minutes of whole-body vibration when performing semi-squatting or forward lunges (12-16 Hz, varying intensity from low to high depending on patients' tolerance
OTHERExercise
Four to five sessions of a physiotherapist-led exercise program with education talk (20 minutes), group exercises (30 minutes) and individual exercises (30 minutes) per week supplemented with home exercises
Sponsors
Chinese University of Hong Kong
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with end-stage knee osteoarthritis on queue for scheduling primary total knee replacement * Completed 8-week course of physiotherapy program
Exclusion criteria
* TKR during the last 12 months * Severe heart failure or neurological diseases affecting physical functions
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numerical pain rating scale | Baseline, 8 weeks | Pain assessment. Minimum value = 0, Maximum value = 10; the higher the score the worse the pain level |
| Range of motion (ROM) of the diseased knee | Baseline, 8 weeks | Measure the angle of knee bending from straight (0 degree) to fully bended (180 degrees) |
| Gait analysis | Baseline, 8 weeks | Measure the movement of legs from point A to B, measure the distance in cm between steps walking on a flat surface |
| Knee Society Score | Baseline, 8 weeks | Score from 0 to 100. Lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. |
| Knee Society Functional Assessment | Baseline, 8 weeks | Score from 0 to 100. Lower scores being indicative of worse knee conditions and higher scores being indicative of better knee conditions. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timed Up and Go test | Baseline, 8 weeks | Score from 1 to 5. 1 indicates normal function and 5 indicates severely abnormal function |
| Knee injury and Osteoarthritis Outcome Score (KOOS)-Knee pain (KP) | Baseline, 8 weeks | Score from 0 to 100. 0 representing extreme knee problems and 100 representing no knee problems. |
| Functional reach test | Baseline, 8 weeks | In standing, measures the distance between the length of an outstretched arm in a maximal forward reach; 10/25 cm or greater: Low risk of falls; 6/15cm to 10/25cm: Risk of falling is 2x greater than normal; 6/15cm or less: Risk of falling is 4x greater than normal; Unwilling to reach: Risk of falling is 8x greater than normal |
| 30-sec chair stand test | Baseline, 8 weeks | Score as 3-tier categories. Below Average; Average; Above Average. Sex- and age range-specific. Below average indicates a high risk of falls. |
| Knee injury and Osteoarthritis Outcome Score (KOOS)-Other Symptoms (S) | Baseline, 8 weeks | Score from 0 to 100. 0 representing extreme knee problems and 100 representing no knee problems. |
| Knee injury and Osteoarthritis Outcome Score (KOOS)- Activities of Daily Living (ADL) | Baseline, 8 weeks | Score from 0 to 100. 0 representing extreme knee problems and 100 representing no knee problems. |
| Knee injury and Osteoarthritis Outcome Score (KOOS)-Sport and Recreation function | Baseline, 8 weeks | Score from 0 to 100. 0 representing extreme knee problems and 100 representing no knee problems. |
| Knee injury and Osteoarthritis Outcome Score (KOOS)-knee-related Quality of Life (QOL) | Baseline, 8 weeks | Score from 0 to 100. 0 representing extreme knee problems and 100 representing no knee problems. |
Countries
Hong Kong
Outcome results
None listed