Comparisons of Neuromuscular Training Versus Quadriceps Training on Gait and WOMAC Index in Patients With Knee Osteoarthritis and Varus Malalignment

Abstract

Objective: The purpose of this study was to compare the effects of neuromuscular training (NMT) and quadriceps training (QT) on the altered gait patterns and Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index in patients with knee osteoarthritis (OA) and varus malalignment. Methods: Sixty-six patients with knee pain ≥2 on 100-mm visual analog scale, radiographic knee OA changes ≥2 on Kellgren-Lawrence grading scale, and genu varum were allocated randomly into either the neuromuscular training group or quadriceps training group. Twelve weeks of supervised exercise protocol was given to the participants of both groups, which included 3 sessions per week. Primary outcomes were gait variables and self-reported physical function (WOMAC index). Results: Of 66 knee OA patients, only 31 (94%) in the NMT group and 28 (84.8%) in the QT group completed the exercise protocol and were included in the analysis. There was a significant improvement in gait velocity (P = .022), stride length (P = .009), and global WOMAC index (P = .011) in the NMT group compared to the QT group. However, the scores of cadence (P = .226), gait cycle (P = .332), and double limb support (P = .054) were not found significant in the NMT group compared with the QT group. Conclusion: The NMT group showed improvement in some of the gait parameters as well as improvement in pain, stiffness, and functional limitation compared with conventional QT. No additional improvement was found in cadence, gait cycle, and double limb support in patients who received NMT.

Contribution of hip and knee muscles to lateral knee stability during gait

“…The strengthening of these muscles would help reduce the load in the medial knee compartment and help prevent the progression of knee OA. In addition, neuromuscular training, which encourages correct knee alignment under weight-bearing conditions, is beneficial in facilitating motor learning associated with inter-muscle coordination in the knee and hip joint 29,30) .…”

The effect of Total resistance exercise vs. aquatic training on self-reported knee instability, pain, and stiffness in women with knee osteoarthritis: a randomized controlled trial

“…3.1, Heinrich Heine University, Düsseldorf, Germany) software was used to estimate the minimum sample size. According to the reported results of previous researches and based on the test power of 0.90, the effect size of 0.63 and the significance level of 0.05, the minimum sample size was determined to be 36 [21]. Finally, the participants were randomly distributed into three groups, including TRX (n = 12), aquatic exercises (n = 12), and control (n = 12) ( Fig.…”

The Effect of TRX vs. Aquatic Exercises on Self-Reported Knee Instability and Affected Factors in Women with Knee Osteoarthritis: A Randomized Controlled Trial

“…3.1, Heinrich Heine University, Düsseldorf, Germany) software was used to estimate the minimum sample size. According to the reported results of previous researches and based on the test power of 0.90, the effect size of 0.63 and the significance level of 0.05, the minimum sample size was determined to be 36 [22]. Finally, the participants were randomly distributed into three groups, including TRX (n=12), aquatic exercises (n=12), and control (n=12) ( Table 2).…”