Balance Impairment, Falls, Knee Osteoarthritis, Mobility Limitation
Conditions
Keywords
Telerehabilitation, Onsite Rehabilitation
Brief summary
This randomized controlled trial aims to determine the effects of telerehabilitation versus onsite rehabilitation on balance, mobility, and risk of fall among geriatric patients with knee osteoarthritis (KOA). Knee osteoarthritis is a common musculoskeletal condition in older adults that is associated with pain, impaired balance, reduced mobility, and an increased risk of falls. Although onsite rehabilitation is effective, many elderly patients face barriers to accessing physiotherapy services because of transportation difficulties, physical limitations, and geographical distance. Telerehabilitation has emerged as an alternative approach that allows patients to receive supervised rehabilitation remotely using smartphone-based communication. In this study, eligible participants will be randomly assigned to either a telerehabilitation group or an onsite rehabilitation group. Both groups will receive the same balance and mobility exercise program for six weeks, with four sessions per week. Outcomes including balance, mobility, and risk of fall will be assessed at baseline, week 3, and week 6 to compare the effectiveness of the two rehabilitation approaches.
Detailed description
Knee osteoarthritis is a prevalent degenerative joint disorder among the geriatric population and is associated with pain, reduced functional mobility, impaired balance, and an increased risk of falls. These impairments often reduce independence and quality of life in older adults. Conventional onsite physiotherapy is widely recommended for managing knee osteoarthritis; however, many elderly individuals encounter barriers to receiving regular treatment due to transportation problems, limited access to rehabilitation facilities, and physical restrictions. Telerehabilitation provides an alternative model of care by delivering rehabilitation services remotely through telecommunication technology and may improve accessibility and continuity of care. � FINAL SYNOPSIS FURQAN KHAN.docx The objective of this study is to determine the effects of telerehabilitation versus onsite rehabilitation on balance, mobility, and risk of fall among geriatric patients with knee osteoarthritis. The study will use a single-blinded randomized controlled trial design. A total sample of 44 participants aged 65 years or older with diagnosed knee osteoarthritis will be recruited according to the predefined inclusion and exclusion criteria. Participants will be randomly allocated into two groups by coin toss: a telerehabilitation group and an onsite rehabilitation group. � FINAL SYNOPSIS FURQAN KHAN.docx Both groups will receive the same rehabilitation program consisting of balance training and mobility exercises. The intervention will be performed four days per week for six weeks, with approximately 30-minute sessions, resulting in 24 treatment sessions. Balance training will progress through static balance, dynamic balance, sensory integration with visual integration, and reactive balance exercises. Mobility exercises will include heel raises, sit-to-stand activities, and step-up/step-down exercises. Participants in the telerehabilitation group will perform the exercises at home under remote supervision using a smartphone, while participants in the onsite rehabilitation group will receive the same program in the clinic. A caregiver will be required to remain present during tele-rehabilitation sessions to ensure participant safety. � FINAL SYNOPSIS FURQAN KHAN.docx Outcome assessments will be conducted at baseline (week 0), week 3, and week 6 using the Berg Balance Scale to evaluate balance, the Timed Up and Go (TUG) Test to assess mobility, and a Fall Risk Assessment Tool to evaluate the risk of falls. Data will be analyzed using SPSS version 20. Normality of the data will be assessed using the Shapiro-Wilk test. Ethical approval will be obtained from the Ethical Committee of Ibadat International University Islamabad. Written informed consent will be obtained from all participants before enrollment, and participant confidentiality and privacy will be maintained throughout the study.
Interventions
PROCEDURETelerehabilitation
Participants will receive a supervised home-based rehabilitation program through a smartphone. The intervention includes balance training (static balance, dynamic balance, sensory integration with visual integration, reactive balance) and mobility exercises. The program will be delivered four days per week for six weeks, with approximately 30-minute sessions (24 sessions total). Participants will be instructed during the assessment session, and a caregiver will remain present during each tele-rehabilitation session to ensure safety. If a video call is interrupted because of connectivity issues, the session will be resumed immediately.
PROCEDUREOnsite Rehabilitation
Participants will receive the same balance and mobility exercise program in the clinic under physiotherapist supervision. The intervention includes static balance, dynamic balance, sensory integration with visual integration, reactive balance, and mobility exercises. Treatment will be provided four days per week for six weeks, with approximately 30-minute sessions (24 sessions total). The exercise protocol, frequency, intensity, duration, and assessment schedule will be identical to the telerehabilitation group
Sponsors
Ibadat International University, Islamabad
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Masking description
Outcome assessments will be performed by a blinded assessor to minimize assessment bias. Participants receive either telerehabilitation or onsite rehabilitation and therefore are not blinded.
Intervention model description
Participants will be randomly assigned into two parallel groups: a telerehabilitation group and an onsite rehabilitation group. Both groups will receive the same balance and mobility exercise program for six weeks. The telerehabilitation group will perform supervised exercises remotely using a smartphone, while the onsite rehabilitation group will receive the same intervention in the clinic.
Eligibility
Sex/Gender
ALL
Age
65 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age ≥65 years. History of fall (within one month). Timed Up and Go (TUG) test score \>14 seconds. Older adult having a smartphone. Older adult having at least Matric education. Berg Balance Scale score between 21 and 40. Osteoarthritis affecting one or both knees (already diagnosed)
Exclusion criteria
\- Vision loss. Spinal pathology (monoplegia, hemiplegia, quadriplegia). Cognitive impairments. Neurological impairment. Physical handicap (loss of vision or loss of one limb).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Balance | Baseline (Week 0), Week 3, and Week 6 | Balance will be assessed using the Berg Balance Scale (BBS) to evaluate changes in balance performance following telerehabilitation and onsite rehabilitation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mobility | Baseline (Week 0), Week 3, and Week 6 | Mobility will be assessed using the Timed Up and Go (TUG) Test, which measures the time required for a participant to stand up from a chair, walk 3 meters, return, and sit down |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORMuhammad Nazim, Phd
Ibadat International University, Islamabad
Outcome results
None listed