Different Hold Durations in Isometric Exercises

NCT ID: NCT07198204

Last Updated: 2025-09-30

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 50 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-11-30
• Study Completion Date: 2026-04-30

Brief Summary

this stuy tries to evaulate the best contraction (hold time) during isometric effort that can provide the best therapeutic effects on muscular performance in patients with knee osteoarthritis

Detailed Description

Knee osteoarthritis (KOA) is a common degenerative disease characterized by the gradual degeneration and loss of joint cartilage, accompanied by bone proliferation. These pathological changes lead to joint pain, stiffness, and limited mobility in affected individuals (Sharma, 2021). The development of KOA, usually associated with various risk factors including age, gender, obesity, genetics, and joint injuries, severely affects patients' quality of life and imposes a heavy economic burden on society (Katz et al., 2021). Research indicates that the global prevalence of KOA has increased significantly since 1990 and is expected to continue rising until 2050, posing a major challenge to global public health.(Steinmetz et al., 2023) Currently, there are various treatment methods for KOA, including pharmacotherapy, surgical treatment, and physical therapy (Duong et al., 2023). Although pharmacotherapy can effectively alleviate symptoms, long-term use may lead to a series of side effects.

Due to its low impact and reduced joint stress, isometric exercise may be more suitable for patients sensitive to joint stress or at higher risk; however, the optimal duration for isometric exercises remains controversial and varies. For instance, Folland et al. compared the strength gains produced by isometric training (with contraction duration of 2 seconds) at four joint angles with conventional dynamic training(Folland et al., 2005). In another study, Kubo et al. investigated the effects of static and dynamic training on the stiffness and blood volume of the human tendon, using a training regimen of 10 contractions of 15-s duration for isometric knee extensions (Kubo et al., 2009). Additionally, Anwer & Alghadir utilized a 5-second duration for isometric quadriceps contractions and hip adduction exercises. In contrast, the Straight Leg Raising (SLR) exercise was maintained for a contraction time of 10 seconds to assess the effects of isometric quadriceps exercises on individuals with knee osteoarthritis.

Understanding the isometric exercise parameters, such as duration, that achieve a desired adaptive response in muscle and tendon would benefit optimizing results. Therefore, the purpose of this study is to compare the effect of isometric exercise duration on muscle strength, pain, and function in patients with KOA.

Conditions

Knee Arthritis Osteoarthritis

Study Design

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

Study Groups

group 1

The subjects in this group will perform isometric exercises, including isometric quadriceps, straight-leg raising, and isometric hip adduction exercises for 5 seconds.

All exercises will be performed in sets of 12 repetitions: one set twice a day for the 1st week, which will be progressed weekly until three sets twice a day by 3th week. Allow 5 seconds of rest between each repetition and 3 minutes of rest between sets, with a total contraction time of 60 to 180 seconds per session at 30 to 50% of maximum voluntary contraction (MVC).

Group Type: EXPERIMENTAL

isometric exercises

Intervention Type: OTHER

Isometric quadriceps exercise: Patients lie in a supine position. A rolled-up towel was put beneath the knee. They were instructed to maximally activate their thigh muscles to straighten their knee and hold the contraction for 5 seconds (Group A), 10 seconds (Group B), or 20 seconds (Group C).

therapeutic ultrasound

Intervention Type: OTHER

all patients will reciece ultrasound for 5 minutes using 1MHz frequency, 0.8 wc2, 5cm2 head with adequate gel as a coupling medium

Transcutanous electrical nerve stimulation

Intervention Type: OTHER

all participants will recieve TENS for 30 minutes per session. the parameters will be Burst TENS, with main frequency of 100Hz, burst frequency of 4 Hz, intensity to the comfortable muscle twitch, electrodes size according to the size of the patients knee.

group 2

The subjects in this group will perform isometric exercises, including isometric quadriceps, straight leg raising, and isometric hip adduction exercise for 10 sec.

All exercises will be performed in sets of 6 repetitions: one set twice a day for the 1st week, which will be progressed weekly until three sets twice a day by 3th week. Allow 10 seconds of rest between each repetition and 3 minutes of rest between sets, with a total contraction time of 60 to 180 seconds per session at 30 to 50% of MVC.

Group Type: EXPERIMENTAL

isometric exercises

Intervention Type: OTHER

Isometric quadriceps exercise: Patients lie in a supine position. A rolled-up towel was put beneath the knee. They were instructed to maximally activate their thigh muscles to straighten their knee and hold the contraction for 5 seconds (Group A), 10 seconds (Group B), or 20 seconds (Group C).

therapeutic ultrasound

Intervention Type: OTHER

all patients will reciece ultrasound for 5 minutes using 1MHz frequency, 0.8 wc2, 5cm2 head with adequate gel as a coupling medium

Transcutanous electrical nerve stimulation

Intervention Type: OTHER

all participants will recieve TENS for 30 minutes per session. the parameters will be Burst TENS, with main frequency of 100Hz, burst frequency of 4 Hz, intensity to the comfortable muscle twitch, electrodes size according to the size of the patients knee.

group 3

The subjects in this group will perform isometric exercises, including isometric quadriceps, straight leg raising, and isometric hip adduction exercise for 20 sec.

All exercises will be performed in sets of 3 repetitions: one set twice a day for the 1st week, which will be progressed weekly until three sets twice a day by 3th week. Allow 20 seconds of rest between each repetition and 3 minutes of rest between sets, with a total contraction time of 60 to 180 seconds per session at 30 to 50% of MVC.

Group Type: EXPERIMENTAL

isometric exercises

Intervention Type: OTHER

Isometric quadriceps exercise: Patients lie in a supine position. A rolled-up towel was put beneath the knee. They were instructed to maximally activate their thigh muscles to straighten their knee and hold the contraction for 5 seconds (Group A), 10 seconds (Group B), or 20 seconds (Group C).

therapeutic ultrasound

Intervention Type: OTHER

all patients will reciece ultrasound for 5 minutes using 1MHz frequency, 0.8 wc2, 5cm2 head with adequate gel as a coupling medium

Transcutanous electrical nerve stimulation

Intervention Type: OTHER

all participants will recieve TENS for 30 minutes per session. the parameters will be Burst TENS, with main frequency of 100Hz, burst frequency of 4 Hz, intensity to the comfortable muscle twitch, electrodes size according to the size of the patients knee.

control group

The control group will receive ultrasound therapy and TENS only.

Group Type: ACTIVE_COMPARATOR

therapeutic ultrasound

Intervention Type: OTHER

all patients will reciece ultrasound for 5 minutes using 1MHz frequency, 0.8 wc2, 5cm2 head with adequate gel as a coupling medium

Transcutanous electrical nerve stimulation

Intervention Type: OTHER

all participants will recieve TENS for 30 minutes per session. the parameters will be Burst TENS, with main frequency of 100Hz, burst frequency of 4 Hz, intensity to the comfortable muscle twitch, electrodes size according to the size of the patients knee.

Interventions

isometric exercises

Isometric quadriceps exercise: Patients lie in a supine position. A rolled-up towel was put beneath the knee. They were instructed to maximally activate their thigh muscles to straighten their knee and hold the contraction for 5 seconds (Group A), 10 seconds (Group B), or 20 seconds (Group C).

Intervention Type: OTHER

therapeutic ultrasound

all patients will reciece ultrasound for 5 minutes using 1MHz frequency, 0.8 wc2, 5cm2 head with adequate gel as a coupling medium

Intervention Type: OTHER

Transcutanous electrical nerve stimulation

all participants will recieve TENS for 30 minutes per session. the parameters will be Burst TENS, with main frequency of 100Hz, burst frequency of 4 Hz, intensity to the comfortable muscle twitch, electrodes size according to the size of the patients knee.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• prediagnosed case of knee OA as per the American College of Rheumatology (ACR) and radiological evidence of primary osteoarthritis of grade 3 or less on the Kellgren Lawrence scale;
• age between 40-65 years, including both men and women.
• unilateral or bilateral involvement (in the case of bilateral involvement, the more symptomatic knee was included).

Exclusion Criteria

• Other knee joint pathologies, eg, Chondromalacia patella, plica syndrome,
• Neurological disorders.
• Patients having lower extremity injury/surgeries in the past 6 months,
• Hip or knee fractures or deformity,
• joint infections and inflammatory joint disease,
• physical therapy on the knee within the last 3 months or steroid injections,

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 65 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Hail

OTHER

Sponsor Role: lead

Responsible Party

Hisham Mohamed Hussein

Associate Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Central Contacts

Hisham Hussein, PhD

Role: CONTACT

drhisham3000@cu.edu.eg

+966543704108

Other Identifiers

FPTBSUREC/1207/14925

Identifier Type: -

Identifier Source: org_study_id