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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.
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).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low impact immersion | Experimental | This intervention will use the principles of Ai Chi, a model defined as a low-intensity aquatic exercise strategy |
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| Conventional aquatic physiotherapy | Experimental | In this intervention, medium impact exercises will be performed, with a comfortable movement speed. |
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| High intensity aquatic physiotherapy | Experimental | In this intervention, high-impact exercises will be performed, with maximum movement speed, twice time of the medium-intensity protocol |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low impact immersion | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Biochemical variables over time | Variations in the concentration of and Glutathione perioxidase in peripheral blood resulting from three aquatic physical therapy interventions evaluated comparatively between the different interventions in U/L | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions |
| Biochemical variables over time | Variations in the concentration of Metalloproetinase | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions in mg/mL |
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain over time | Performed using the visual analogue pain scale, from a scale graduated from zero to 10, in which zero corresponds to cases without pain and 10 corresponds to the worst imaginable pain. | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Fernanda Cechetti | Contact | 3303-8700 | nandacecheti@gmail.com | |
| A Teixeria | Contact |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39296351 | Derived | 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. |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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Randomized clinical trial, of the crossover type
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| Conventional aquatic physiotherapy | 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. |
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| High intensity aquatic physiotherapy | 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. |
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| Edema over time | Performed based on the measurement of the circumference of the affected knee. Result expressed in centimeters | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) |
| Flexibility over time | Assessed by measuring the amplitude of the active and passive movement for the knee flexion and, for that, a conventional goniometer will be used. Result expressed in degrees | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions. |
| Muscle strength over time | Measured by dynamometer to assess knee extension strength. Results expressed in kg of force. | Baseline moment (immediately before the intervention), moment 1 (immediately after the intervention) measured in all interventions. |