The efficacy of balance and proprioception exercises in female patients with knee osteoarthritis: A randomized controlled study

Abstract

Objective Loss of proprioception and balance disorders are commonly observed in patients with knee osteoarthritis. In this study, we aimed to investigate the effects of balance and proprioception exercises in patients with knee osteoarthritis. Design A single-center randomized trial with three parallel arms. Setting A tertiary health care facility in Turkey. Participants Female patients with knee osteoarthritis aged 40–70 years. Interventions Ten-week exercise program in Biodex training, classical balance training and isometric strengthening groups. Main measures Dynamic balance (overall stability index and the modified Clinical Test of Sensory Interaction and Balance), pain (visual analogue scale), physical function (30-s chair stand test and 40-meter fast-paced walk test) and quality of life (Knee Injury and Osteoarthritis Outcome Score). Results Eighty-nine patients enrolled in the study. The Biodex training group, the classical training group, and the control group had overall stability index values of 1.0 ± 0.07, 1.4 ± 0.07 and 1.4 ± 0.07, and the Modified Clinical Test of Sensory Interaction and Balance – Condition-3 values of 0.7 ± 0.04, 0.9 ± 0.04 and 0.9 ± 0.04 respectively, at the end of treatment. In terms of pain scores on movement, each group showed significant improvement compared to their baseline, and the classical balance training group had better scores than the control group. No other significant difference was found between the groups. Physical function and quality of life outcomes showed significant main effects only in the time factor. Conclusions Balance and proprioception exercises may have positive effects on dynamic balance and pain. The effects on physical function and quality of life should be investigated in further studies with larger sample.

Knee stability training exercise versus Biodex balance training on dynamic balance indices in individuals with knee osteoarthritis: A Randomized clinical trial

“…Participants were selected and enrolled into the study according to the criteria performed by Kellgren & Lawrence class (II), pain around the knee, and limitation of ROM within the past 6 months [15]. Participants who underwent assessment were excluded from the study if they had: demonstrated any other types of arthritis, swelling around the knee, used of oral or intraarticular corticosteroids (currently or within 6 months), taken physiotherapy treatment for knee OA within 6 months prior to inclusion, uncontrolled hyper-tension, serious cardiovascular problems, a patient with body mass index (BMI) greater than 30, a history of nonsteroidal antiinflammatory drugs (NSAIDs) or consumption of symptomoriented slowacting drugs for OA (e.g., hyaluronic acid or diacerein) a month prior to the assessment date, as well as a diseases that might impact balance [16].…”

“…Patients in both groups (A and B) received the same strengthening exercise, which consisted of isometric quadriceps exercise that was performed in 10 repetitions of 6 seconds of contractions each and two seconds of rest periods [16]. In addition, participants in group A received knee stability training exercises, while participants in group B received Biodex Balance training exercises.…”

“…For group A, the participants received knee stability training. The exercises included singleleg standing, the participants stand with one foot close to a backing for stability, while bent the other knee for 3 second, then the procedures repeated for the other leg [16]. The next exercise involved 30 repetitions of stepping forward, backward, and sideways for each limb [16].…”

“…The exercises included singleleg standing, the participants stand with one foot close to a backing for stability, while bent the other knee for 3 second, then the procedures repeated for the other leg [16]. The next exercise involved 30 repetitions of stepping forward, backward, and sideways for each limb [16]. The following exercise was heeltotoe walking in tandem, the participants standing in upright posture with extend arms outside body, while Keep their eyes on the horizon.…”

“…The participants walking by placing one foot directly in front of the other. After 8 steps forward, step backwards and return to the starting position [16]. The last exercises were training on a balancing board which start by standing on the balance board with both feet distance apart while keeping posture upright then shift weight on balancing board without touching the ground by the edges of the board with arms in front of the bo-dy.…”