Effects of Different Walking Exercises on Pain, Physical Performance and Balance in Knee Osteoarthritis

Condition(s) studied

Investigational drug(s) / intervention(s)

Backward-treadmill Walking: A backward walking program will be applied on the treadmill. To be done 3 times a week / 8 weeks. Before the walking exercises, 5 minutes of warm-up and 5 minutes of cool-down exercises will be performed. While walking on the treadmill, the participant can hold onto the railings. Each participant will start at the speed they choose and gradually increase their perceived exertion rate to 11-13 on the Borg scale, and it is planned to walk for 10 minutes in the first week and gradually for 20-30 minutes in the following weeks.

Forward-treadmill Walking: A forward walking program will be applied on the treadmill. To be done 3 times a week / 8 weeks. Before the walking exercises, 5 minutes of warm-up and 5 minutes of cool-down exercises will be performed. While walking on the treadmill, the participant can hold onto the railings. Each participant will start at the speed they choose and gradually increase their perceived exertion rate to 11-13 on the Borg scale, and it is planned to walk for 10 minutes in the first week and gradually for 20-30 minutes in the following weeks.

Traditional physiotherapy: Traditional physiotherapy is a treatment method that includes exercise training, hotpack, ultrasound and TENS (electrotherapy) applications. To be done 3 times a week / 8 weeks. 20 min hotpack + 7 min ultrasound + 20 min TENS and knee osteoarthritis exercises (hip knee flexion extension, knee extension while sitting on a chair, quadriceps isometric exercise in the supine position, straight leg raise exercises) are planned to be applied in the clinic with the physiotherapist. The exercises are planned to be started with 5 repetitions in the first week and the intensity of the exercise is planned to be increased with 10 repetitions, 15 repetitions and 20 repetitions depending on the patient's tolerance.

Study summary

The aim of this study is to investigate and compare the effects of forward and backward walking exercises on treadmill in addition to traditional physiotherapy interventions on pain, physical performance and balance in patients with knee osteoarthritis. Secondarily, it is aimed to investigate the effects of walking on spatio-temporal parameters, knee joint position sense, range of motion, quadriceps, hamstring and hip adductors muscle strength, Q angle, quality of life and kinesiophobia.

Eligibility

Primary outcome measure(s)

• Pain — 8 weeks
  It will be evaluated with the visual analog scale (VAS). VAS consists of a horizontal 10 cm long line, where "0" (zero) indicates no pain and "10" indicates unbearable pain. The patient is asked to indicate where their condition fits on this line by drawing a line, putting a dot or pointing.
• Physical Function and Performance Measures — 8 weeks
  Western Ontario and McMaster Üniversiteleri Osteoartrit İndeksi (WOMAC) WOMAC is a self-reported health status measure developed to assess pain, joint stiffness, and function in patients with hip and knee osteoarthritis. It questions patients on three separate clinical dimensions: pain, joint stiffness, and function. It contains a total of 24 questions. The three subdimensions that make up the scale can be scored individually or as a total. Higher scores represent worse pain, physical function, and stiffness.
• Physical Function and Performance Measures — 8 weeks
  30 second Chair test A test that evaluates the patient's sit-to-stay activity, lower extremity strength and dynamic balance. The number of times the patient sits down and stands up in 30 seconds gives the test score.
• Physical Function and Performance Measures — 8 weeks
  40 meter fast paced walk test This test evaluates the speed and direction change activity of short-distance walking, especially in individuals with hip and knee osteoarthritis.
• Physical Function and Performance Measures — 8 weeks
  Stair climb test A test that evaluates the patient's stair climbing and descending activity, lower extremity strength and dynamic balance. Ideally, the desired time to go up and down 9 steps gives the result of the test.
• Physical Function and Performance Measures — 8 weeks
  6 minute walk test A test that evaluates functional capacity in individuals. The test is performed in a closed and uncrowded space. The distance between the starting and finishing points in a closed space should be 30 meters on a flat surface. The distance an individual can walk in this area in 6 minutes is evaluated in meters. Before the test begins, the patient is rested and information about the test is given to the patient. The patient is asked to walk between the starting and finishing points at their own walking pace. The test is monitored with a stopwatch. The purpose of the test is to measure the maximum distance they can walk during this time
• balance — 8 weeks
  Timed up and go test This test measures the dynamic balance and functional mobility. It is a test that measures the time in seconds for the individual to stand up from a standard chair (seat height of approximately 44 cm, arm height 65 cm), walk a distance of 3 meters, turn around and sit on the chair.
• balance — 8 weeks
  Functional Reach Test A test developed to examine forward stability. During the test, participants' ability to reach forward while standing with their feet fixed is recorded as a distance and their balance performance is evaluated.

Trial sites (1)

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