Abstract

BackgroundKnee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities. High prevalence (60–80%) has been reported for KI amongst the patients with knee osteoarthritis (KOA). In this line, the present study targeted the effect of two interventions on self-reported KI and affected factors.MethodsIn this single blind, randomized, and controlled trial, 36 patients with radiographic grading (Kellgren–Lawrence ≥ II) of KOA were selected. Patients were divided into three groups namely, aquatic (n = 12), Total Resistance exercises (TRX) (n = 12) and control (n = 12) by random. Then both 8-week TRX and aquatic exercises were carried out by experimental groups. The following measure were taken before and after interventions: Pain by visual analog scale (VAS), balance by Berg Balance Scale (BBS), quadriceps strength by dynamometer, knee flexion range of motion (ROM) by inclinometer, knee stiffness with Western Ontario and McMaster Universities Osteoarthritis (WOMAC), and self-reported KI with Felson’s questionnaire.ResultsThe results demonstrated that KI, VAS, BBS improved over time both in TRX and aquatic groups significantly (p < 0.05), but WOMAC(stiffness), knee flexion ROM, and quadriceps strength were significantly improved over time only for TRX (p < 0.05). Post hoc test, also, showed that there were significant differences between interventions and control groups (p < 0.05) for the VAS, KI, BBS, but for WOMAC(stiffness), a significant difference was observed only between TRX and control groups (p = 0.05).ConclusionsAlthough TRX and aquatic interventions had a similar effect on the patients’ balance, pain and KI, TRX had more effect on WOMAC(stiffness), quadriceps strength, and knee flexion ROM than aquatic exercises.Trial registrationThis study was registered in the Iranian Clinical Trial Center with the number IRCT20181222042070N1, http://www.irct.ir/trial/36221, registered 02 February 2019.

Highlights

  • Knee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities

  • The results of one-way analysis of variance (ANOVA) and Tukey’s test indicated that there were no significant differences between the treatment and control groups in the baseline characteristics

  • A significant improvement in instability scores was detected from 8 weeks compared to the baseline (t0 vs. t1, P = 0.0001 in Total Resistance exercises (TRX); t0 vs. t1, P = 0.0001 in aquatic exercises), but this was not significant in control (t0 vs. t1, P = 0.45)

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Summary

Introduction

Knee Instability (KI) is described as a sense of knee buckling, shifting, or giving way during the weight bearing activities. Knee instability (KI) is the most common problem amongst patients with knee osteoarthritis (KOA) which can affect weight bearing or walking. Knee instability may result in increasing joint’s movements in sagittal and frontal planes while walking and weight bearing, and altering the loading on the knee joint [1, 8]. This problem can affect the patients’ quality of life by reducing trust in the joint, and abstaining from daily activities [9, 10]. The emergence of KI as an accelerator in the arthritis symptoms recovery has recently caught the attention of specialists and researchers

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