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This study aims to examine the effects of moderate-intensity strength training, performed with or without an unloading knee orthosis (valgus-corrective or sham mode), on muscle function, motor unit behavior, and force modulation in patients with moderate knee osteoarthritis
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| controls group | Sham Comparator |
| |
| Group A with the corrective knee orthosis | Experimental | patients with moderate knee osteoarthritis (Kellgren-Lawrence grade II-III) who will receive a valgus-corrective knee orthosis. |
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| Group B without the corrective knee orthosis | Placebo Comparator | patients with moderate knee osteoarthritis (Kellgren-Lawrence grade II-III) who will not receive a valgus-corrective knee orthosis. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| the strengthening program | Behavioral | The isometric knee-extension strengthening program from session 1 to session 9 as follows:
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| Measure | Description | Time Frame |
|---|---|---|
| maximal voluntary isometric contraction (MVC) | Baseline and 3 weeks | |
| The Western Ontario and McMaster Universities Turkish (WOMAC) index | a self-administered questionnaire that assesses three aspects of a patient's health status -pain, stiffness, and physical function - in those with lower limb Osteoarthritis. WOMAC consists of 24 questions, with a total score ranging from 0 to 96 points. there are three subscales: pain (5 questions), stiffness (2 questions), and physical function (17 questions). a five-tier classification of symptomatic severity: minimal or no symptoms (≤24 score), mild (25-41 score), moderate (42-69 score), severe (70-86 score), and extreme (≥87 score). | baseline, 3 weeks |
| The Knee Injury and Osteoarthritis Outcome Score (KOOS) | a knee-specific instrument, developed to assess the patients' opinion about their knee and associated problems. Knee Injury and Osteoarthritis Outcome Score (KOOS) has five subscales: pain (9 questions), symptoms (7 questions), activities of daily living (17 questions), sport/recreation (5 questions), knee-related quality of life (4 questions). The total score of each question (0-4 points) is converted into a score of 0-100, where 100 points represents the best knee health and 0 points represents the worst. | Baseline and 3 weeks |
| Motor Unit Recruitment (amplitude relative to recruitment threshold) | surface EMG decomposition | Baseline and 3 weeks |
| Motor Unit Recruitment (firing rate relative to recruitment threshold) | surface EMG decomposition | Baseline and 3 weeks |
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Inclusion Criteria:
- 1. age 55 to 75 years.
2. Diagnosed with moderate knee traumatic arthritis (Kellgren-Lawrence classification II or III)(experimental group).
The control group must not have a diagnosis of osteoarthritis of the knee and must have normal knee joint function.
3. Physical Health Status: Able to perform basic movements requiring isometric knee contraction tests and electromyography recording.
4. Able to wear knee orthotics.
Exclusion Criteria:
1. Knee or lower extremity injury: Recent (within the past 6 months) history of severe injury, fracture, or surgery to the knee or lower extremity.
2. Other joint disorders: Coexisting joint disorders (such as rheumatoid arthritis or gouty arthritis).
3. Neuromuscular disorders: Presence of neuromuscular dysfunction, such as stroke, Parkinson's disease, or peripheral neuropathy.
4. Uncontrolled cardiovascular disease, hypertension, diabetes, or other medical conditions.
Taking medications that affect neuromuscular function.
5. Allergy or intolerance: Allergy to laboratory equipment (such as electromyography electrode gel) or knee brace materials.
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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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| D012216 |
| Rheumatic Diseases |