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This clinical trial will evaluate the effects of High-Intensity Laser Therapy (HILT) on femoral cartilage thickness and other clinical outcomes in people with knee osteoarthritis. Participants aged 40 to 60 years with grade II or III knee osteoarthritis will be randomly assigned to receive either HILT plus conventional physiotherapy or conventional physiotherapy alone. Both groups will receive 12 treatment sessions on alternate days for 4 weeks. The study will assess changes in cartilage thickness using ultrasound, as well as improvements in pain, knee movement, muscle strength, and daily function. Findings from this research may help improve physiotherapy treatment strategies for patients with knee osteoarthritis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| High-Intensity Laser Therapy (HILT) + Conventional Physiotherapy | Experimental | Participants in this group will receive High-Intensity Laser Therapy (HILT) using a Class IV laser (1064 nm wavelength) applied at eight standardized knee points according to WALT guidelines, along with conventional physiotherapy including hot moist pack, joint mobilization, and strengthening exercises. Treatment will be given on alternate days for 4 weeks (12 sessions total). |
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| Conventional Physiotherapy | Active Comparator | Participants in this group will receive only conventional physiotherapy, including hot moist pack, patellofemoral and tibiofemoral joint mobilization, and a structured exercise program for quadriceps and hamstrings. Treatment will be given on alternate days for 4 weeks (12 sessions total). |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High-Intensity Laser Therapy (HILT) + Conventional Physiotherapy | Device | HILT will be administered using a Class IV laser applied perpendicularly at eight standardized knee points. Both analgesic and biostimulation modes will be used.. Sessions will be conducted on alternate days for 4 weeks (12 sessions total). |
| Measure | Description | Time Frame |
|---|---|---|
| Femoral Cartilage Thickness | Mean change in femoral cartilage thickness (mm) measured by high-frequency musculoskeletal ultrasound at three standardized sites - medial femoral condyle, intercondylar notch, and lateral femoral condyle. The measurement will be performed using a 7-12 MHz linear probe following standardized scanning protocol | Baseline, Week 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Intensity | Change in pain intensity will be measured using the Visual Analogue Scale (VAS), a 10-centimeter horizontal scale ranging from 0 to 10, where 0 will represent 'no pain' and 10 will represent the 'worst imaginable pain.' Higher scores will indicate worse pain. | Baseline, Week 2, Week 4 |
| Western Ontario and McMaster Universities Arthritis Index (WOMAC) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Iqra Waseem, Ph.D Scholar | Contact | +923347779399 | iqra.waseem91@gmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| London Aesthetics and Rejuvenation Center | Lahore | Punjab Province | 55000 | Pakistan |
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| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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Participants will be randomly assigned into two parallel groups: one receiving High-Intensity Laser Therapy (HILT) plus conventional physiotherapy, and the other receiving conventional physiotherapy alone. Each group will receive 12 treatment sessions on alternate days for 4 weeks.
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This is a single-blind study. The outcome assessor will be blinded to group allocation, while the participants and treating physiotherapist will be aware of the intervention assigned
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| Conventional Physiotherapy | Other | Conventional physiotherapy includes hot moist pack application, manual joint mobilization, stretching, and strengthening exercises for quadriceps and hamstrings. Sessions will be held on alternate days for 4 weeks (12 sessions total). |
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The Western Ontario and McMaster Universities Arthritis Index measures pain and functional disability and contains 24 questions: 5 for pain, 2 for joint stiffness, and 17 for physical function. Each item is scored qualitatively as none, low, moderate, severe, or very severe, with equivalent numerical scores of 0, 1, 2, 3, and 4. Higher scores indicate a greater negative effect on quality of life |
| Baseline, Week 2, Week 4 |
| Knee Range of Motion (ROM) | Active knee flexion and extension measured using a universal goniometer. Flexion is normally up to approximately 135 degrees. Higher degrees of motion indicate better knee mobility. | Baseline, Week 2, Week 4 |
| One-Leg Stance Test | The participant will stand on one leg with hands on hips and the opposite knee flexed to approximately 90°, and the time maintained in this position will be recorded in seconds. Maintaining the stance for at least 10 seconds will be considered the minimum threshold for functional balance. A longer time will indicate better balance performance. | Baseline, Week 2, Week 4 |
| Quadriceps Muscle Strength | Change in quadriceps strength will be measured using Manual Muscle Testing (Oxford/MRC scale). Muscle strength will be graded on a scale from 0 to 5, where 0 represents no muscle contraction and 5 represents normal strength against full resistance. Higher scores will indicate better quadriceps strength | Baseline, Week 2, Week 4 |