Cross-Education From Unilateral Strength and Balance Training in Older Adults With Bilateral Knee Osteoarthritis

Cross-Education of Combined Unilateral Strength and Balance Training on Motor Function in Older Adults With Bilateral Knee Osteoarthritis

Kinesitherapy is one of the main tools in the rehabilitation of knee osteoarthritis, but is often limited due to pain, reduced functionality, and fear of falling in older adults. This study will, through three sub-studies, examine the effects of unilateral training programs on strength, movement control, balance, and pain in the contralateral leg, as well as on functionality, fall risk, and kinesiophobia in older adults with bilateral knee osteoarthritis through three sub-studies. A total of 45 participants (aged 60-80 years) with bilateral knee osteoarthritis will be randomly assigned to one of three groups: 1. combined unilateral strength and balance training; 2. unilateral balance training; 3. unilateral strength training. Strength will be measured with maximal voluntary contraction, balance using a single leg stance test on an unstable surface, movement control with an active joint position reproduction test, and functionality using the six-minute walk test and the Western Ontario and McMaster Osteoarthritis Index questionnaire. Pain will be assessed with the Visual Analog Scale and the Intermittent and Constant Osteoarthritis Pain questionnaire, fall risk with the Timed Up and Go test and the Falls Efficacy Scale-International questionnaire, and kinesiophobia using the TAMPA questionnaire. This study will expand knowledge on cross-transfer and its effects on symptoms in the rehabilitation of older adults with bilateral knee osteoarthritis.

This research is a part of a doctoral thesis conducted under the supervision of assoc. prof. Tatjana Trošt, PhD.

Inclusion Criteria:

• age 60-80 years,
• bilateral knee osteoarthritis of grade II-III according to the Kellgren-Lawrence classification

Exclusion Criteria:

• acute lower extremity injuries in the past year,
• taking nonsteroidal anti-inflammatory drugs within the past month,
• involvement in physical therapy within the past 6 months,
• undergoing intra-articular injections and/or knee surgery within the past year,
• rheumatoid arthritis, septic arthritis, uncontrolled diabetes, other systemic inflammatory and autoimmune diseases, and severe cardiovascular, renal, and hepatic comorbidities