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| Name | Class |
|---|---|
| Les Mills International | INDUSTRY |
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This will be a clinical trial of a standardized group exercise intervention, Les Mills Thrive, and determine if it alters muscle activation patterns and improves strength, balance, and symptoms in those with knee osteoarthritis (OA). Muscle activation patterns will be assessed using surface electromyography, strength will be assessed using isokinetic dynamometry, balance will be measured using the Community Balance and Mobility Scale (CB&M), and symptoms and typical activity will be measured using two questionnaires: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Physical Activity Scale for the Elderly (PASE). These outcome measures will be measured at baseline and after a 12-week group exercise intervention (Les Mills Thrive) for 42 older adults with knee OA. Results of this study will be disseminated via a report to Les Mills International, in community presentations, at relevant academic (e.g. Osteoarthritis Research Society International (OARSI) annual conference) and industry (e.g. Medical Fitness Association annual meeting) conferences, in an academic journal publication (e.g. Arthritis Care & Research), and through press releases or other media publications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Exercise program | Experimental | Les Mills Thrive is a 45-minute class that consists of flexibility, strength, and coordination exercises designed to be delivered in a group fitness environment. Participants will have the option to attend group fitness classes in person, or do the exercise program at home on their own asynchronously, using recorded classes as guidance. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exercise | Behavioral | Les Mills Thrive is a 45-minute class that consists of flexibility, strength, and coordination exercises. This program aims to improve sensorimotor control and strength via functional weight-bearing exercises and floor exercises to isolate targeted hip and core muscles. In each class (whether in person or online), a certified Les Mills Thrive instructor will provide options to either increase or decrease the intensity of each exercise to cater to varying fitness levels and fluctuating symptoms. Each exercise has an assisted (using a chair for balance), body weight, and resisted (weight or exercise tubing) option. Participants will have the option to attend group fitness classes or do the classes asynchronously at home using a link to access a recorded class. |
| Measure | Description | Time Frame |
|---|---|---|
| Quadriceps amplitude (Quadriceps PC1) | Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The first pattern extracted from quadriceps EMG waveforms (Quadriceps PC1) captures the overall magnitude (i.e. amplitude) of quadriceps activity. | From initial data collection to the end of treatment at 12 weeks |
| Quadriceps co-activation ( Quadriceps PC2) | Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The second pattern extracted from quadriceps EMG waveforms (Quadriceps PC2) captures prolonged quadriceps activity (i.e. co-activation). | From baseline data collection to the end of the intervention at 12 weeks. |
| Hamstrings amplitude (Hamstrings PC1) | Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The first pattern extracted from hamstrings EMG waveforms (Hamstrings PC1) captures the overall magnitude (i.e. amplitude) of hamstrings activity. | From baseline data collection to the end of the intervention at 12 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Balance (Community Balance & Mobility Scale) | The Community Balance and Mobility Scale (CB&M) was developed to assess community-level functional deficits in dynamic balance (locomotor stability during movement) and mobility. It assesses advanced balance and mobility activities such as rapid direction changes and dual tasking. This tool has been found to be valid and reliable in adults with knee OA , and avoids the ceiling effects of other balance tests like the Berg Balance Scale in individuals who can ambulate independently in the community. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gillian Hatfield, PhD | University of the Fraser Valley | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of the Fraser Valley | Chilliwack | British Columbia | V2R0N3 | Canada |
Primary and secondary outcome measures: EMG data, balance scores, WOMAC scores, knee extensor and flexor strength, PASE scores
Also participant age, sex, gender
Approximately June 2026 until June 2031 (five years).
Academics at other universities will be able to access the data by contacting the Primary Investigator via email.
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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| Hamstrings co-activation (Hamstrings PC2) | Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The second pattern extracted from hamstrings EMG waveforms (Hamstrings PC2) captures prolonged hamstrings activation (i.e. co-activation). | From baseline data collection to the end of the intervention at 12 weeks. |
| From baseline data collection to the end of the intervention at 12 weeks. |
| Knee extensor strength | Isometric knee extensor strength will be measured at 45 degrees of knee flexion using an isokinetic dynamometer. The participant will push as hard as they can against the dynamometer for 3 seconds. This will be repeated twice, with at least 2 minutes of rest between contractions. | From baseline data collection until the end of the intervention at 12 weeks. |
| Knee flexor strength | Isometric knee flexor strength will be measured at 55 degrees of knee flexion using an isokinetic dynamometer. The participant will push as hard as they can against the dynamometer for 3 seconds. This will be repeated twice, with at least 2 minutes of rest between contractions. | From baseline data collection until after the 12 week intervention. |
| Symptoms (WOMAC) | Knee symptoms will be assessed using the Western Ontario & MacMaster Universities Osteoarthritis Index (WOMAC). This questionnaire assesses pain, stiffness, and function. | From baseline data collection until after the 12 week intervention. |
| Physical activity | Self-reported physical activity will be assessed using the Physical Activity Scale for the Elderly (PASE). | From baseline until after the 12 week intervention. |