Efficacy of leg swing versus quadriceps strengthening exercise among patients with knee osteoarthritis: study protocol for a randomized controlled trial

Abstract

Background Knee osteoarthritis (OA) is a leading cause of global disability. According to current guidelines, exercise is the most recommended and important non-surgical treatment for knee OA. However, the best type of exercise for this condition remains unclear. Evidence has shown that traditional Chinese exercises may be more effective. Therefore, the current prospective, two-armed, single-center randomized controlled trial (RCT) aimed to identify an effective physiotherapy for knee OA. Methods/design In total, 114 patients with painful knee OA will be recruited from the orthopedic outpatient department of Shanghai Jiao Tong University Affiliated Sixth People’s Hospital. To compare the therapeutic effect of two different home-based exercise programs, the participants will be randomly assigned into the experimental group (leg swing exercise) or the control group (quadriceps strengthening exercise). Each participant in both groups will be required to attend five individual sessions with a physiotherapist who will teach the exercise program and monitor progress. Participants will be instructed to perform the exercises at home every day for 12 weeks. Clinical outcomes will be assessed at baseline and 12 and 24 weeks after starting the intervention. The primary outcomes are average overall knee pain and physical function in daily life. The secondary outcomes include other measures of knee pain, physical function, patient-perceived satisfactory improvement, health-related quality of life, physical activity and performance, muscle strength of the lower limb, and adherence. Discussion This study will provide more evidence on the effects of traditional Chinese exercise on improving physical function and relieving joint pain among patients with knee OA. If proven effective, leg swing exercise can be used as a non-surgical treatment for knee OA in the future. Trial registration Chinese Clinical Trial Registry ChiCTR2000039005. Registered on 13 October 2020.

The efficacy of the leg swing and quadriceps strengthening exercises versus platelet-rich plasma and hyaluronic acid combination therapy for knee osteoarthritis: A retrospective comparative study

“…Some scholars have suggested that quadriceps strengthening exercises may be an effective way to prevent and treat KOA, which could reduce pain and restore stability and function. [3,19,20,27] Meanwhile, some recent studies have found that leg swing exercise can reduce pain and improve the overall function of patients with All values are expressed as mean ± standard deviation or numbers (%). BMI = body mass index, K-L = Kellgren-Lawrence.…”

“…KOA by strengthening the hip abductor muscle strength and reducing knee joint loading. [19] In patients with KOA, pain and muscle wasting are associated with limited knee function. Chronic pain causes behavioral avoidance and increases muscle wasting.…”

“…Some scholars have suggested that quadriceps strengthening exercises may be an effective way to prevent and treat KOA, which could reduce pain and restore stability and function. [ 3 , 19 , 20 , 27 ] Meanwhile, some recent studies have found that leg swing exercise can reduce pain and improve the overall function of patients with KOA by strengthening the hip abductor muscle strength and reducing knee joint loading. [ 19 ] In patients with KOA, pain and muscle wasting are associated with limited knee function.…”

“…2 ). [ 19 ] For the quadriceps strengthening exercise, the ankle joint of the affected side was held in plantar flexion in a neutral position, the knee joint was extended to 0°, and then the leg was slowly raised until the heel was 25 to 30 cm away from the bed, held for 5 to 10 seconds and then slowly lowered to the supine position. They were required to raise their leg approximately 200 times per day (Fig.…”

“…The primary outcome measures were the Visual Analogue Scale (VAS) and the Western Ontario and McMaster Universities (WOMAC) scores. [ 3 , 19 , 20 ] Secondary outcomes included the single leg stance test (SLS) and functional activity using the 2-minute walk test (2MWT) and the time up and go test (TUGT). [ 13 , 15 ] All outcomes were assessed at baseline and at 1, 3, 6, and 12 months.…”