Randomized Controlled Trial of Dynamic Balance Training in People With Knee Osteoarthritis

University of British Columbia

Status: Completed

Conditions: Knee Osteoarthritis

Treatments: Other: Targeted dynamic balance training

Study type: Interventional

Funder types: Other

Identifiers

NCT02103907

H14-00587

AHPA-TAS- 14-001 (Other Grant/Funding Number)

Details and patient eligibility

About

There is a high prevalence of falls in those with knee osteoarthritis (OA) compared to healthy older adults. Balance is a key element of function that allows individuals to maintain posture and respond to perturbations, and poor balance control, a risk factor for falls, has been noted in those with knee OA. There is a lack of research guiding treatment for balance deficits in knee OA, with interventions aimed at improving balance deficits in those with knee OA having mixed results. Targeted dynamic balance interventions in other patient populations have been shown to significantly improve dynamic balance control and physical function. If results similar to such populations can be achieved, such a program may produce a significant reduction in functional disability in the knee OA population and improve quality of life. The purpose of this study is to examine the effect of a 10-week targeted dynamic balance intervention on dynamic balance and physical function in people with knee OA. This will be a randomized controlled trial (RCT).

Enrollment: 40 patients

Sex: All

Ages: 50 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• age 50 - 80 years (to meet the American College of Rheumatology clinical definition of OA)
• radiographically confirmed knee OA in the medial compartment of the tibiofemoral joint
• predominance of pain/tenderness over the medial (inside) region of the knee

Exclusion criteria

• articular cartilage degradation in the lateral tibiofemoral compartment greater than the medial
• inflammatory arthritic condition
• history of knee or hip replacement surgery
• recent use of corticosteroids (oral or via injection, within last 6 months)
• pain originating predominantly from the patellofemoral joint
• inability to ambulate without a gait aid
• non-English speaking
• recent (within 6 months) arthroscopic knee surgery
• significant hip or back pain (limits the ability to perform the testing)
• Neurological, musculoskeletal or other condition that affects movement ability or balance (i.e. stroke, diabetes, Parkinson's, heart attack, multiple sclerosis, fibromyalgia)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 2 patient groups

Wait list

No Intervention group

Description:

Wait list control group. Participants will be placed on the wait list and asked to maintain their current routine and level of activity during the 10 week period. Control group participants will receive the dynamic balance training program in a single training session after the followup (second testing session at 10 weeks).

Treatment (balance training)

Experimental group

Description:

Targeted dynamic balance training. Dynamic balance training will consist of progressive exercise training over three phases, with exercises emphasising dynamic balance control, muscle strength and proprioception. Exercises will be performed four times per week for ten weeks. Exercises will be taught and supervised by a trained kinesiologist. Difficulty of exercises will be increased progressively over time by increasing resistance, time of timed exercises, and distance of walking exercises. Exercises will be progressed to different exercises in each new phase (total 3 phases). Participants will complete six treatment sessions at the university (during weeks 1, 2, 3, 5, 7, and 9) that will be included in the total number of sessions per week. All other sessions will be performed at home.

Treatment:

Other: Targeted dynamic balance training