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

Abstract

Background: Knee 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. Methods: In 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. Results: The 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). Conclusions: Although 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.

Post-exercise Stretching Protects Strain of Knee Joint Movement System by Relieving Knee Pain and Iliotibial Band Tension

“…Continuous tension of the iliotibial band can cause Iliotibial Band Friction Syndrome and cause knee pain. Studies have reported that exercise therapy has a certain effect on knee pain and knee joint function [4,23] . However, there are few studies comparing the effects of stretching and non-stretching after exercise on the improvement of the two.…”

Effect of aqua walking exercise on knee joint angles, muscular strength, and visual analogue scale for patients with limited range of motion of the knee

“…Application of CPM therapy in the initial rehabilitation of patient with limited ROM of the knee joint positively affected in the change of ROM and pain during the knee extension and flexion as well as reduced length of stay in hospital (Bakirhan et al, 2015;Liao et al, 2016;Yang et al, 2019). Also, recent studies reported that aquatic exercise for the treatment of knee osteoarthritis could be safe and improve pain, disability, and quality of life (Assar et al, 2020). The results of these previous studies support the importance of aquatic walking exercise in therapeutic strategy for developing the knee ROM.…”

The effect of self-reported knee instability on plantar pressure and postural sways in women with knee osteoarthritis

“…In addition, it is unclear whether instability is the cause of imbalance or poor balance is the cause of instability. Knee instability is a multifactorial condition, which may occur due to increased capsular-ligament laxity, damage to the knee structures, decreased muscle strength, altered muscle activity patterns, and altered neuromuscular control, Therefore, insufficient joint stability is provided during daily activities and this leads to pain, swelling, and decreased mobility, and ultimately affects the patient's posture control and balance [3,4,37,38]. In a systematic review in this regard, Wallace et al (2019) reported that knee instability may occur due to the proprioception impairment or lack of posture control as the patient is unable to be clearly positioned and control the joint movement.…”