Hip Abductor Strengthening Exercises in Knee Osteoarthritis

NCT ID: NCT06845657

Last Updated: 2025-03-11

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 40 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-03-03
• Study Completion Date: 2026-03-26

Brief Summary

The aim of this randomized controlled trial is to find the effect of hip abductor strengthening exercises on pain, range of motion, functional disability and balance in patient with knee osteoarthritis.

Detailed Description

Osteoarthritis (OA) is a chronic disease affecting the joint and its tissues, primarily leading to progressive damage to articular cartilage and, subsequently, to the subchondral bone and surrounding synovial structures. This chronic degenerative disease affects approximately one-third of adults, and its prevalence increasing with advancing age. The knee is one of the most common joints affected by the OA. Systematic reviews indicate a global prevalence of knee osteoarthritis (KOA) is 22.9% among individuals aged 40 and older, affecting an estimated 654.1 million people worldwide, with variations across countries and increasing with age.

Knee osteoarthritis (KOA) is a multi etiological, chronic disabling disease that affects the entire knee joint, which is the most common site of involvement in OA. KOA patients mostly suffer from progressive stiffness and knee pain. Gradually, they have some difficulties in performing daily activities, such as walking, squatting, and climbing and doing housework, as the disease progresses. Ultimately, pain and disability associated with the disease lead to a loss of functional independence and a profound reduction in quality-of- life. Impairments that are caused by KOA include knee pain, limited ROM of the knee, muscle weakness and knee instability.

The hip abductor muscles influence knee joint loading through their control of the pelvis in the frontal plane. Researchers have proposed that during the single-limb stance phase of gait, weakness of the stance-limb hip abductor muscles may lead to drop of the pelvis toward the contralateral limb, shifting the body's center of mass away from the stance limb toward the swing side. These adjustments, theoretically, could lead to higher knee adduction moments and greater medial knee joint loading.

Knee adduction moment is the moment that acts on the joint in the frontal plane. The knee adduction moment is generated by the combination of the ground reaction force, which passes medial to the centre of the knee joint during gait, and the perpendicular distance of this force from the centre of the joint. . This moment tends to adduct the tibiofemoral joint, causing an increase in medial compartment pressure, and people with knee OA have demonstrated larger than normal peak knee adduction moments in their gait patterns.

OA of the knee is characterized by changes in gait kinematics. High dynamic loads of the medial knee, as assessed by the external peak knee adduction moment, have been associated with tibiofemoral OA severity progression, and knee pain. The aging process impairs postural control more in a medial-lateral (ML) direction than in an anterior-posterior (AP) direction, which is linked with increased falling risk. Postural control stability in the ML direction, in orthostatic stance and during compensatory step, is dependent on hip abductor-adductor muscle torque .The hip abductor muscles are also needed to stabilize the lumbar-pelvic joint during gait and during balance recovery after external disturbance (postural responses of hip and step) This study aims to find the effect of hip abductor strengthening exercises on improving range of motion, functional activities, balance and minimizing pain in individuals affected by the knee OA.

Conditions

Knee Osteoarthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Hip Abductor Strengthening Exercises+ Conventional PT

Group Type: ACTIVE_COMPARATOR

Hip Abductor Strengthening Exercises

Intervention Type: OTHER

Hip Abductor Strengthening Exercises .1.side lying leg raise 2.clam shell(Frequency: 3 sets 10 reps in session 1-5) 3.standing hip abduction.4.pelvic lift training (Frequency: 3 sets 10 reps in session 6-9) .Conventional PT including 1-ROM 2- Stretching of hamstrings,calf,,rectus femoris (30 sec hold,15 sec relaxation period,3 rep) 3.knee isometrics (2 sets 10 rep in first 5 sessions and 3 sets 10 rep in next 4 sessions).total duration is 3 sessions per week for 3 consecutive weeks.

Conventional PT

Group Type: OTHER

Conventional Treatment

Intervention Type: OTHER

Conventional PT including 1-ROM 2- Stretching of hamstrings,calf,rectus femoris (30 sec hold,15 sec relaxation period,3 rep) 3.knee isometrics (2 sets 10 rep in first 5 sessions and 3 sets 10 rep in next 4 sessions). Total duration is 3 sessions per week for 3 consecutive weeks

Interventions

Hip Abductor Strengthening Exercises

Hip Abductor Strengthening Exercises .1.side lying leg raise 2.clam shell(Frequency: 3 sets 10 reps in session 1-5) 3.standing hip abduction.4.pelvic lift training (Frequency: 3 sets 10 reps in session 6-9) .Conventional PT including 1-ROM 2- Stretching of hamstrings,calf,,rectus femoris (30 sec hold,15 sec relaxation period,3 rep) 3.knee isometrics (2 sets 10 rep in first 5 sessions and 3 sets 10 rep in next 4 sessions).total duration is 3 sessions per week for 3 consecutive weeks.

Intervention Type: OTHER

Conventional Treatment

Conventional PT including 1-ROM 2- Stretching of hamstrings,calf,rectus femoris (30 sec hold,15 sec relaxation period,3 rep) 3.knee isometrics (2 sets 10 rep in first 5 sessions and 3 sets 10 rep in next 4 sessions). Total duration is 3 sessions per week for 3 consecutive weeks

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• • Age group 40-60

• Both genders male and female
• Have had knee pain for 3 months or more
• Report a minimum average overall pain severity of 4 on an 11-point numeric rating scale (NPRS) over the previous week
• grade II and III on X-ray (Kellgren and Lawrence classification);
• For participants with bilateral knee osteoarthritis, the more seriously affected side (as identified by the Kellgren-Lawrence grade of knee osteoarthritis and the pain intensity) was selected as the affected leg.
• willing to participate in intervention program

Exclusion Criteria

• • history of surgery of lower limb

• Past knee fracture or malignancy
• individuals with known hip OA and/or previous trauma affecting one or both hips
• Intraarticular corticosteroid injection into the knee within previous 3 months.
• Pregnancy

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

KINZA ANWAR, MS-OMPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

National Institute Of Rehabilitation Medicine G-8/2, Islamabad

Islamabad, Punjab Province, Pakistan

Site Status: RECRUITING

Countries

Pakistan

Central Contacts

KINZA ANWAR, MS-OMPT

Role: CONTACT

kinza.anwar@riphah.edu.pk

+92-3239735427

Facility Contacts

KINZA ANWAR, MS-OMPT

Role: primary

kinza.anwar@riphah.edu.pk

+92-3239735427

Fouzia Kousar, MS-OMPT*

Role: backup

Other Identifiers

Fouzia Kousar

Identifier Type: -

Identifier Source: org_study_id