Efficacy of Open versus Closed Kinetic Chain Exercises on Dynamic Balance and Health Status in Individuals with Osteoarthritis of Knee Joint: A Quasi-experimental Study

Abstract

Introduction: Osteoarthritis is an inflammatory disorder characterised by changes in the biomechanics, biochemistry and genetic background of joint cartilage and subchondral bone. When distal parts move freely throughout exercises in a weight-bearing position, the phrase open kinetic exercises is employed. Closed kinetic exercises are employed in a weight-bearing position when the body travels through a hard and quick distal phase. Aim: To compare the efficacy of Open Kinetic Chain (OKC) and Closed Kinetic Chain (CKC) exercises on dynamic balance and health status in individuals with osteoarthritis of knee joint. Materials and Method: A single-blinded experimental study was conducted from April 2020 to May 2021 at Dr D.Y. Patil college of Physiotherapy, Pimpri-Chinchwad area, Pune, Maharashtra, India. A sample of 30 subjects with unilateral osteoarthritis of knee joint, between the age of 40-60 years of both genders, were recruited. They were divided into open kinetic group (Group A) and closed kinetic group (Group B) using convenient sampling method. Y-balance and Western Ontario and McMaster Universities Index of Osteoarthritis (WOMAC) (Pune CRD version) were used as outcome measures-preintervention, post two weeks and post four weeks of intervention. Data normality was tested by Shapiro-wilk test. Significance was tested using paired t-test within the groups for WOMAC and Y-balance test. Unpaired t-test was used between the groups. Results: Among 30 subjects, 17 were males and 13 females. There was a significant improvement in dynamic balance (p-value=0.001) and WOMAC (p-value=0.001) in both the groups. In group A, preintervention mean values for WOMAC was 41.2±10.53, and post four weeks of intervention it was 34.53±10.12 (p-value=0.001). Preintervention mean for Y-balance test was 0.554±14.6 and after four weeks of intervention mean was 0.586±13.8 (p-value <0.001). In group B, preintervention mean for WOMAC was 40.87±8.33, and after four weeks of intervention, mean was 30.47±7.22 (p-value=0.001); while preintervention mean for Y-balance test was 0.583±7.8 and after four weeks of intervention, mean was 0.645±7.0 (p-value=0.001). Between groups, analysis showed p-value=0.051 for both groups post four weeks of intervention. Conclusion: The study concluded that CKC exercises are more effective than OKC exercises in improving dynamic balance and decrease in pain, stiffness, and improving physical function in knee osteoarthritis.