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The primary objective of the study is to determine the effects of Feldenkrais Exercises on Pain, Range of Motion, and Disability in Patients with Knee osteoarthritis. Knee osteoarthritis poses significant challenges in pain management, mobility improvement, and disability reduction among middle-aged to older adults. Feldenkrais Method offers benefits comparable to back school lessons or core stability exercises. This study, conducted as a Randomized Controlled Trial at RIPHAH Rehabilitation Clinic, aims to assess the efficacy of Feldenkrais exercises compared to conventional physical therapy in addressing pain, range of motion, and disability in knee osteoarthritis patients aged 40-60 years. A non-probability convenience sampling method will recruit 32 participants meeting specific criteria for osteoarthritis severity and functional ability. Participants will be randomly assigned to Group A (Feldenkrais exercises) or Group B (conventional therapy), with interventions delivered over four weeks. Group A will engage in Feldenkrais exercises targeting pelvic and lower limb mobility, while Group B will receive standard treatments including knee isometrics, mobilization, transcutaneous electric nerve stimulation, and heating pad applications. Pain severity will be measured using the Numeric Pain Rating Scale, Range of Motion assessed via goniometry, and disability evaluated using the Western Ontario McMaster Universities Osteoarthritis Index. Statistical analysis using SPSS will compare outcomes between groups at baseline, post-treatment, and follow-up assessments.
Osteoarthritis (OA) is one of the most prevalent rheumatic diseases in the elderly, being a frequent cause of incapacity among this population. It is more common in the knee and is characterized by pain, stiffness, and function loss. OA is a major public health problem. The prevalence of knee OA is 34-45% in the Indian population with clinical symptoms of pain, reduced muscle strength, and knee function. That is the most common form of degenerative joint disease affecting 15 to 40% of people aged 40 and above. One hundred fifty-one million people worldwide experienced OA, and it was ranked sixth as a leading cause of moderate and severe disability. The knee is the joint most frequently affected by osteoarthritis. The Feldenkrais Method has the potential to help older people with OA. Developed by Dr. Moshe Feldenkrais, the method is a gentle form of exercise which has been shown to be acceptable for older people who have limited movement. The Feldenkrais Method is taught in two parallel forms, Awareness Through Movement (conducted as a group exercise) and Functional Integration (one-on one approach). This study explores the effectiveness of Awareness Through Movement lessons in helping older people with OA. The method aims for improved functioning, where the entire body cooperates efficiently with minimal effort. This study aims to explore the potential benefits of Feldenkrais exercises as an alternative, non-invasive treatment for knee osteoarthritis. Medical conventional treatments for knee OA, such as pharmacotherapy and surgical interventions, often come with limitations including potential side effects, high costs, and sometimes limited long-term effectiveness. These constraints necessitate the exploration of alternative, non-invasive treatment options that can be both effective and accessible. Feldenkrais exercises focus on improving movement patterns and body awareness, which may help reduce pain, enhance range of motion, and decrease disability.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group-A (Feldenkrais exercises) | Experimental | This group of participants will engage in Feldenkrais exercises focused on pain, improved mobility, and disability. Each session will last 30 minutes, conducted twice a week for 4 weeks. The exercises include Pelvic Clock Exercise, Knee Rolling, Ankle Circles, Knee Flexion and Extension and Leg Slides. |
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| Group-B (Standard Physicaltherapy interventions) | Active Comparator | Participants will receive standard physical therapy interventions for knee osteoarthritis. Protocol:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Feldenkrais exercises | Other | Feldenkrais exercises focused on pain, improving mobility, and disability. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Numeric Pain Rating Scale | The NPRS is a segmented numeric scale in which the respondent selects a whole number (0-10 integers) that best reflects the intensity of his/her pain. The common format is a horizontal bar or line. NPRS is anchored by terms describing pain severity extremes. | upto 4 weeks |
| Western Ontario and McMaster Universities Arthritis Index (WOMAC) | WOMAC is a disease-specific measure of health status (pain, stiffness, and function) in OA sufferers. It is widely used for evaluating hip and knee osteoarthritis. It is a self-administered questionnaire consisting of 24 items divided into 3 subscales | upto 4 weeks |
| Universal Goniometer (UG) | A universal goniometer is a crucial tool in orthopedics used to precisely measure joint angles. It exists in two primary forms: the short-arm version is ideal for smaller joints such as the wrist, elbow, or ankle, while the long-arm version is more accurate for joints with longer levers like the knee and hip. It highlighting its role in quantifying joint mobility and aiding in treatment planning and assessment in medical practice. | upto 4 weeks |
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Inclusion Criteria:
Exclusion Criteria:
• Tuberculosis, carcinoma, heart disease, and osteoporosis
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Imran Amjad, PHD* | Contact | 03324390125 | imran.amjad@riphah.edu.pk | |
| Imran Amjad, PHD* | Contact | 051-5481826 | imran.amjad@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Ghulam Fatima, PhD* | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| RIPHAH Rehabilitation Clinic, Punjab, Pakistan | Recruiting | Lahore | Punjab Province | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 16609823 | Background | Brooks PM. The burden of musculoskeletal disease--a global perspective. Clin Rheumatol. 2006 Nov;25(6):778-81. doi: 10.1007/s10067-006-0240-3. Epub 2006 Apr 12. | |
| 20699159 | Background | Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010 Aug;26(3):355-69. doi: 10.1016/j.cger.2010.03.001. |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| Standard physical therapy interventions | Other |
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| 22632702 | Background | Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. PM R. 2012 May;4(5 Suppl):S45-52. doi: 10.1016/j.pmrj.2012.01.019. |
| 16285189 | Background | Salaffi F, Carotti M, Stancati A, Grassi W. Health-related quality of life in older adults with symptomatic hip and knee osteoarthritis: a comparison with matched healthy controls. Aging Clin Exp Res. 2005 Aug;17(4):255-63. doi: 10.1007/BF03324607. |
| 24078825 | Background | Webb R, Cofre Lizama LE, Galea MP. Moving with ease: feldenkrais method classes for people with osteoarthritis. Evid Based Complement Alternat Med. 2013;2013:479142. doi: 10.1155/2013/479142. Epub 2013 Sep 3. |
| 29035179 | Background | Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. Perm J. 2017;21:16-183. doi: 10.7812/TPP/16-183. |
| D012216 |
| Rheumatic Diseases |