Different Modalities of Aquatic Physiotherapy in Patients With Knee Osteoarthrosis

NCT ID: NCT05610696

Last Updated: 2023-01-20

Basic Information

• Recruitment Status: UNKNOWN
• Clinical Phase: NA
• Total Enrollment: 15 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-03-30
• Study Completion Date: 2024-01-31

Brief Summary

The aim of this study is to evaluate the effects of different modalities of aquatic physiotherapy on the biochemical and functional behavior of patients with knee's Osteoarthritis.

Detailed Description

The subjects will be informed about the study and its potentials risks and sign the informed consent. The sample will be submitted to three different modalities of AF interventions: (a) low impact immersion, (b) conventional aquatic physiotherapy and (c) high intensity aquatic physiotherapy. The functional variables of flexibility, pain, joint volume will be evaluated before and immediately after each intervention whereas the biochemical variables will be evaluated from the analysis of peripheral blood following times: baseline moment (immediately before the intervention), moment 1 (immediately after the intervention), and moment 2 (24 hours after the intervention).

Conditions

Osteoarthritis of the Knee

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Low impact immersion

This intervention will use the principles of Ai Chi, a model defined as a low-intensity aquatic exercise strategy

Group Type: EXPERIMENTAL

Low impact immersion

Intervention Type: OTHER

Consists of a sequence of shoulder, trunk and hip movements. In this modality, the aim will be to understand the physiological effects of immersion in heat water. Resisted movements (either by turbulence or by floats) or interventional maneuvers in the knee joints will not be performed. Considering the period of 5 minutes for acclimatization to the liquid environment, the program will last approximately 47 minutes.

Conventional aquatic physiotherapy

In this intervention, medium impact exercises will be performed, with a comfortable movement speed.

Group Type: EXPERIMENTAL

Conventional aquatic physiotherapy

Intervention Type: OTHER

include warm-up, strengthening and calming down activities. Aquatic steppes will be used to ensure that all participants will maintain the waterline level approximately in the xiphoid appendix. For strengthening activities, the exercises must be performed at an adequate speed, which ensures a comfortable level for the activity. For this purpose, a subjective feedback will be extracted from the participants constantly. The warm-up sequence consists of six different active hip and knee movements performed at maximum range of motion and contributes to neuromuscular activation. For strengthening, each movement should be performed for 1 minute (30 seconds for each lower limb) followed by a period of 30 seconds of rest between each movement.

High intensity aquatic physiotherapy

In this intervention, high-impact exercises will be performed, with maximum movement speed, twice time of the medium-intensity protocol

Group Type: EXPERIMENTAL

High intensity aquatic physiotherapy

Intervention Type: OTHER

In this modality subjects will perform the same sequence of exercises of the Conventional Aquatic Physiotherapy program will be respected. However the work load and speed will be adjusted to the maximum level. For strengthening, each movement should be performed for 2 minutes (1 minute for each lower limb) followed by a period of 30 seconds of rest between each movement. To guarantee the maximum effort of the participants, verbal stimuli will be constantly provided. The program will last approximately 68 minutes.

Interventions

Low impact immersion

Consists of a sequence of shoulder, trunk and hip movements. In this modality, the aim will be to understand the physiological effects of immersion in heat water. Resisted movements (either by turbulence or by floats) or interventional maneuvers in the knee joints will not be performed. Considering the period of 5 minutes for acclimatization to the liquid environment, the program will last approximately 47 minutes.

Intervention Type: OTHER

Conventional aquatic physiotherapy

include warm-up, strengthening and calming down activities. Aquatic steppes will be used to ensure that all participants will maintain the waterline level approximately in the xiphoid appendix. For strengthening activities, the exercises must be performed at an adequate speed, which ensures a comfortable level for the activity. For this purpose, a subjective feedback will be extracted from the participants constantly. The warm-up sequence consists of six different active hip and knee movements performed at maximum range of motion and contributes to neuromuscular activation. For strengthening, each movement should be performed for 1 minute (30 seconds for each lower limb) followed by a period of 30 seconds of rest between each movement.

Intervention Type: OTHER

High intensity aquatic physiotherapy

In this modality subjects will perform the same sequence of exercises of the Conventional Aquatic Physiotherapy program will be respected. However the work load and speed will be adjusted to the maximum level. For strengthening, each movement should be performed for 2 minutes (1 minute for each lower limb) followed by a period of 30 seconds of rest between each movement. To guarantee the maximum effort of the participants, verbal stimuli will be constantly provided. The program will last approximately 68 minutes.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Patients over 50 years old and diagnosed with OA in at least one knee
• Presence of pain and at least one functional dysfunction for at least 6 months
• Absence of physical limitation that prevents the exercise protocol from being performed
• Kellgren and Lawrence ranking between I and IV
• walk independently and without auxiliary device

Exclusion Criteria

• Inflammatory, rheumatic or autoimmune conditions
• Use of psychotropic, immunosuppressive and steroid medications
• Antioxidant consumption
• Alcohol and tobacco consumption
• Progressive ankylosis states
• neurological injuries
• Infections or skin diseases that contraindicate swimming pool immersion
• Surgical procedures on the knee joint in the last 12 months (excluding meniscectomy or arthroscopy)
• Lower Limb Joint Prosthesis
• Presence of inflammatory or infectious diseases, uncontrolled systemic arterial hypertension, uncontrolled diabetes, chronic obstructive pulmonary disease and history of ischemic heart disease
• Self-report of aquatic phobia and chlorine allergies

• Minimum Eligible Age: 50 Years
• Maximum Eligible Age: 95 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Federal University of Health Science of Porto Alegre

OTHER

Sponsor Role: lead

Responsible Party

Fernanda Cechetti

Sponsor-Investigator

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Fernanda Cechetti

Role: CONTACT

nandacecheti@gmail.com

3303-8700

A Teixeria

Role: CONTACT

References

Augusto Teixeira C, Haas L, Frata B, Fiori Bortoli A, Scalco Acco F, de Castro G, Cechetti F. Effects of a low, medium, and high-intensity aquatic physiotherapy protocol on functional and biochemical parameters in individuals with knee osteoarthritis: protocol for a crossover randomized controlled trial. F1000Res. 2024 Sep 16;12:1605. doi: 10.12688/f1000research.140342.4. eCollection 2023.

Reference Type: DERIVED

PMID: 39296351 (View on PubMed)

Other Identifiers

FUHSPortoAlegreCesar

Identifier Type: -

Identifier Source: org_study_id