Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial

Dantas, Glauko André Figueirêdo; Sacco, Isabel de Camargo Neves; Santos, Ademir dos; Watari, Ricky; Matias, Alessandra B.; Serrão, Paula Regina Mendes da Silva; Pott-Júnior, Henrique; Salvini, Tania F.

doi:10.1136/bmjopen-2020-039279

Cited by 5 publications

(7 citation statements)

References 49 publications

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“…Many patients with knee arthritis have unsatisfactory treatment results because they do not pay attention to foot and ankle function. Studies have shown that foot and ankle function have an impact on knee joint disease [ 39 ]. However, the impact of FMJC has not been defines.…”

Section: Discussionmentioning

confidence: 99%

Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking

Zuo

et al. 2021

Med Sci Monit

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Background We analyzed the effect of limitation of movement of the first metatarsophalangeal joint (FMJ) on the biomechanics of the lower limbs during walking. Material/Methods Eight healthy college students completed walking under barefoot (BF) and FMJ constraint (FMJC) conditions. We synchronously collected kinematics and dynamics data, and calculated the torque, power, and work of hip, knee, and ankle joints. Results Compared with normal conditions, when the FMJ is restricted from walking, the maximum ankle dorsiflexion angle is significantly increased ( P <0.001), the maximum plantar flexion angle is significantly reduced ( P <0.001), the maximum plantar flexion torque ( P <0.001) and the maximum dorsiflexion torque ( P <0.05) increased significantly, the maximum power increased significantly ( P <0.001), the minimum power decreased significantly ( P <0.001), and the negative work increased significantly ( P <0.001). The torque of hip and knee joints increased significantly ( P <0.05). Conclusions After the movement of the FMJ is restricted, the human body mainly compensates and transfers compensation by increasing the angle of dorsiflexion, increasing work and the activity level of surrounding muscles through the ankle joint, thereby increasing the torque load of the knee and hip joints to maintain the dynamic balance of kinematics. FMJC condition increases the energy consumption of the human ankle, knee, and hip joints during walking. The load is compensated by the gradual attenuation of the ankle, knee, and hip. Long-term limitation may cause damage to the posterior calf muscles and increase the incidence of knee arthritis.

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Section: Discussionmentioning

confidence: 99%

Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking

Zuo

et al. 2021

Med Sci Monit

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“…The sample size was calculated to estimate the equality between the therapeutic programme of muscular resistance, balance, and gait exercises with and without the use of low-cost flexible shoes and the treatment according to Osteoarthritis Research Society International Clinical Trials recommendations, based on the mean difference (pretreatment and post-treatment) in the WOMAC pain domain immediately after treatment. Previous studies evaluating therapeutic exercises for knee OA reported a post-treatment mean difference of 2.12 points between the intervention and control groups on the WOMAC pain subscale 44. Thus, based on an average intergroup difference of 2.12 points and assuming an SD of 3.3 points, we calculated a total of 36 participants (12 per group) required to provide an 80% power at a significance level of 5% and detect this difference, assuming a 10% dropout rate after randomisation.…”

Section: Methods and Analysismentioning

confidence: 96%

“…Previous studies evaluating therapeutic exercises for knee OA reported a post-treatment mean difference of 2.12 points between the intervention and control groups on the WOMAC pain subscale. 44 Thus, based on an average intergroup difference of 2.12 points and assuming an SD of 3.3 points, we calculated a total of 36 participants (12 per group) required to provide an 80% power at a significance level of 5% and detect this difference, assuming a 10% dropout rate after randomisation.…”

Section: Methods and Analysismentioning

confidence: 99%

“…During the intervention protocol, all the older women will receive a notepad and guidelines for recording the use of analgesics for the knee, when necessary, for pain management at home. On completion of the study, all subjects will receive an educational kit on the benefits of knee exercise and guidelines for performing daily activities at home 24 44…”

Section: Methods and Analysismentioning

confidence: 99%

“…42 As exclusion criteria, present isolated knee OA (grade II and III) in the lateral compartment due to specific biomechanical changes in this compartment, asymptomatic knee OA in one or both knees, use of an assistive device or any other daily orthosis for the lower limbs (including insoles), physical therapy, acupuncture, or other physical treatment in the previous 3 months and during the study period, wearing any minimalist footwear for more than 6 hours daily, having received intra-articular steroid and hyaluronic acid injections within the previous 3 months and 6 months, a history of hip, knee, and ankle surgery within the past 2 years, neurological disorders, diabetic neuropathy, and rheumatoid arthritis, as well as severe valgus and varus alignment requiring the use of an assistive device and the inability to walk independently, and changes in pharmacological treatment. 44 The evaluation of eligibility criteria, written informed consent, data collection and statistical analyses will be performed by researchers blinded to the allocation of patients in the groups. Participants will receive oral and written instructions on the risks and benefits of the study and will provide written informed consent.…”

Section: Eligibility Criteriamentioning

confidence: 99%

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Effect of a programme of muscular endurance, balance and gait exercises with and without the use of flexible and minimalist shoes in older women with medial knee osteoarthritis: study protocol for a randomised controlled trial

et al. 2022

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IntroductionStudies have indicated that gait intervention programmes with minimalist shoes are effective for reducing pain, improving functionality and reducing knee joint overload in older women with knee osteoarthritis (OA). Other clinical trials with knee and foot muscle strength training and/or dynamic balance training have also shown clinical and functional effectiveness. Despite promising strategies, there is no evidence of the combination of shoes with gait intervention programmes. Thus, the objective of this randomised clinical trial is to investigate the effects of therapeutic programme of muscular resistance, balance and gait exercises with and without the use of low-cost, flexible shoes on the clinical, functional and biomechanical aspects of older women with medial knee OA.Methods and analysisThis randomised controlled trial with blinded evaluators will involve 36 older women. Twenty-four older women with knee OA (medial compartment) will be randomised to the intervention groups with minimalist shoes (GIC; n=12) or in a barefoot condition (GID; n=12), and 12 older women to the control group (n=12). The intervention protocol will consist of knee-foot muscle resistance and static balance training, reactive and proactive dynamic balance training, and gait training with visual feedback. The intervention will have a duration of two consecutive months, twice a week, totalling 16 sessions. The primary outcomes will be walking pain measured by Visual Analogue Scale and questionnaires: Western Ontario McMaster Universities Osteoarthritis Index and Lequesne Algofunctional. The secondary outcomes will be: 6-min walk test, Falls Risk Awareness Questionnaire, Timed Up and Go Test, and distribution of plantar load during gait and balance by pressure platform. Data will be analysed according to an intention-to-treat approach.Ethics and disseminationThis study involves human participants and was approved by the ethics committee of the Universidade Santo Amaro, School Medicine, São Paulo/SP, Brazil (N°4.091.006). Participants gave informed consent to participate in the study before taking part. Investigators will communicate trial results to participants and healthcare professionals through scientific databases, social media, publications and conferences.Trial registration numberRBR-10j4bw25 in Brazilian Clinical Trial Registry.

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Effects of a foot-ankle muscle strengthening program on pain and function in individuals with knee osteoarthritis: a randomized controlled trial

Dantas,

Sacco,

Ferrari

et al. 2023

Brazilian Journal of Physical Therapy

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Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial

Cited by 5 publications

References 49 publications

Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking

Effects of Short-Term Limitation of Movement of the First Metatarsophalangeal Joint on the Biomechanics of the Ipsilateral Hip, Knee, and Ankle Joints During Walking

Effect of a programme of muscular endurance, balance and gait exercises with and without the use of flexible and minimalist shoes in older women with medial knee osteoarthritis: study protocol for a randomised controlled trial

Effects of a foot-ankle muscle strengthening program on pain and function in individuals with knee osteoarthritis: a randomized controlled trial

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