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Effect of a physical therapy protocol with focus on the muscles of the abdomen, hip and trunk in patients with knee Osteoarthritis

Grant number: 12/18497-6
Support Opportunities:Scholarships in Brazil - Scientific Initiation
Effective date (Start): January 01, 2013
Effective date (End): December 31, 2013
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Stela Márcia Mattiello
Grantee:Paulo Silva Pedrazzani
Host Institution: Centro de Ciências Biológicas e da Saúde (CCBS). Universidade Federal de São Carlos (UFSCAR). São Carlos , SP, Brazil


Osteoarthritis (OA) is one of the most common diseases of the musculoskeletal system and can be defined as an inflammatory and degenerative condition that affects synovial joints. Individuals with knee OA present a decrease in knee flexor and extensor muscle strength. Furthermore, subjects with knee OA can also present weakness of the hip abductor muscles, which could lead to increased external knee adductor moment. The increase in external knee adductor moment can result in more compression in the knee medial compartment, contributing to the progression of the disease. Therefore, a physical therapy program focusing not only on the knee flexor and knee extensor muscles but also focusing the hip abductor muscles seems relevant. The aim of this study will be to evaluate the effect of a physical therapy program focusing on hip muscles, abdomen muscles, and muscles of the trunk, in subjects with knee OA. Ten healthy individuals who do not perform regular physical activity will be included in a control group (CG) and ten patients with early stages of knee OA will be included in an osteoarthritis group (OAG). The patients with knee OA will be subjected to a functional protocol treatment (8 weeks). Initially, all participants will undergo an isokinetic evaluation (Biodex Multi-Joint System 3), concentric and eccentric at 60°/s and 120°/s (knee extensor/ knee flexor muscles and hip adductor/hip abductor muscles). The Total work parameter (for these muscles) and the relationship between antagonist/agonist (hamstrings/quadriceps muscles and hip adductor/ hip abductor muscles) will be analyzed. In addition, these individuals will answer a specific questionnaire for lower limbs OA, WOMAC (Western Ontario McMaster Universities Osteoarthritis Index), which quantifies pain, function, and stiffness. OAG will be also evaluated after physical therapy treatment. Appropriate statistical tests will be used for intergroup comparisons and to check the effect of the treatment protocol in OAG. The significance level is 5% (± <0.05).(AU)

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