Effects of a therapeutic exercise program for ankle and foot muscles on pain, stiffness and self-reported function and foot strength in individuals with knee osteoarthritis: a randomized, blinded clinical trial

Abstract

Osteoarthritis is a chronic degenerative disease with global impact. The knee is the most affected joint and, currently, quadriceps strengthening exercises are recommended. However, exercises with a high load on the knee worsen symptoms and decrease treatment adherence. At the same time, the literature increasingly describes the influence of the ankle and feet on the biomechanics of the knee and its relationship with the severity of the clinical and radiological findings of the disease. It is known that weakness of this musculature is related to the increase in pain, dysfunction and severity of OAJ. Although studies have shown deficits in the intrinsic and extrinsic musculature of the feet in individuals with OAJ, it remains to be seen whether a therapeutic exercise program to strengthen the ankle-foot complex is effective in reducing pain and stiffness and improving self-reported function and strength of the feet in these individuals. Objective: To analyze the effects of a therapeutic exercise program to strengthen the muscles of the ankle-foot complex on pain, stiffness, self-reported function and foot strength in individuals with OAJ. Materials and methods: Participants will be selected according to the American College of Rheumatology criteria and randomly allocated to the GE (experimental group) and CG (control group) groups. Pain, stiffness and self-reported function in addition to foot strength will be assessed before and after the intervention. The exercises will be in person, with a weekly frequency of 3 times for 45 minutes, for 8 weeks. Data analysis will be performed using ANOVAs, with a significance level of ± = 0.05 and a 95% confidence interval. Ankle and foot exercises are expected to improve pain, stiffness, foot strength and self-reported function in individuals with OAJ. Keywords: osteoarthritis; exercise therapy; foot; ache; physical function (AU)