Quadriceps strength training and knee joint motion training in knee osteoarthritis

Abstract

The quadriceps weakness is one of the risck factor for development of knee osteoarthritis (OA), therefore it has long been focus of physical therapy program and scientific research. The studies show that all exercise programs, not only muscular strengthening, result in improvement pain, disability, balance, and quality of life. While quadriceps strengthening is widely studied and related with clinical improvement status of patients with knee OA, there are no evidences about biomechanical mechanism associated with increased quadriceps strength. The purpose of the study is to compare the effects of quadriceps muscle strengthening vs knee joint motion training on pain, disability, postural control, and locomotion biomechanics in knee OA patients. We suggest there is a common element across exercises that elicits the beneficial outcomes. Further, we hypothesize the common element through which exercise works is joint motion. Methods/Design: 45 adults, both genders, age 40 to 60, with physician-diagnosed tibiofemoral knee OA will be recruited. They will be randomly assigned to strength training, motion training or untrained group (n=15 each) after providing written informed consent. Quadriceps strength, knee pain, disability, balance, and level walking motions will be measured using isokinetic dynamometry, WOMAC questionnaire, 3D motion capture, and force plate instruments before and after 12 week intervention. Training groups will participate in 3 supervised training sessions per week in the ECU PT Department. Quadriceps muscle force, work, and power during gait will be quantified using the gait data in combination with a validated musculoskeletal knee model. Three way (Group x Gait x Time) ANOVA with repeated measures on Gait & Time and post-hoc tests will be used to identify significant differences in strength, pain, disability, balance, and quadriceps force, work, and power in gait (p<0.05). (AU)