Objective: This randomized controlled trial was designed to investigate and compare the effectiveness of twelve-week open, closed and combined kinetic-chain exercises (OKCEs, CKCEs and CCEs) on pain and physical function (PF) in the management of knee osteoarthritis. Method: Ninety-six consecutive patients with knee OA were randomly assigned to one of OKCE, CKCE and CCE groups. Participants' average daily pain (ADP), pain before and after walking (PBW and PAW), were evaluated using Visual Analogue Scale while PF was assessed using Ibadan Knee/Hip Osteoarthritis Outcome Measure. Results: Seventy-nine participants completed the study but data of another 4 participants who completed only 8-week treatment were included in data analysis (total=83; mean age = 61.10±13.75 years). The groups' demographic and dependent variables were comparable at baseline but CCE group demonstrated significantly more reductions (p < 0.05) in ADP, PBW and PAW than OKCE and CKCE groups at weeks 4, 8 and 12 of the study. However, there were significant within group improvements (p < 0.05) in all four variables for the three groups. Conclusion: CCEs are better than OKCEs and CKCEs for pain reduction in though all three exercise regimens are singly effective. CCEs are recommended for improving treatment outcome for pain in patients with knee osteoarthritis.

No abstract

BackgroundThe study was designed to evaluate and compare the effectiveness of 12-week open, closed and combined kinetic-chain exercises (OKCE, CKCE and CCE) on quadriceps muscle strength and thigh girth of patients with knee osteoarthritis (OA).MethodThe randomized clinical trial involved ninety-six consecutive patients with knee OA who were randomly assigned to one of OKCE, CKCE or CCE groups. Participants’ static quadriceps muscle strength (SQS), dynamic quadriceps muscle strength (DQS) and thigh girth (TG) were assessed using cable tensiometer, one repetition method and inelastic tape measure respectively at baseline and at the end of weeks 4, 8 and 12 of study.ResultsThe three groups were comparable regarding their demographic and dependent variables at baseline; there was significant time effect (p < 0.001each) as all three measures significantly increased over time from baseline to week 12 [mean difference: SQS: 3.30 (95% CI: 2.52–4.08) N; DQS: 0.74 (95% CI: 0.45–1.02) N; TG: 1.32 (95% CI: 0.93–1.71) cm]. The effect of intervention-time interaction was not significant (p > 0.05) for all three measures. Changes in SQS, DQS and TG between baseline and week 12 were also not significantly different (p > 0.05) among the three groups.ConclusionAll three exercise regimens are effective and demonstrate similar effects on quadriceps muscle strength and muscular trophism.Trial registration NHREC/05/01/2008a. Registered 20th March, 2014 Retrospectively.

Forward stair climbing (FSC) is associated with cardiovascular fitness benefits, but the training effects of backward stair climbing (BSC) have not been reported in the literature. This study compared the effects of 8 weeks of FSC and BSC on the cardiovascular parameters of apparently healthy young adults. Forty apparently healthy young adults, aged 18-30 years were recruited consecutively and assigned to FSC and BSC training groups. Thirty-one subjects (16 FSC and 15 BSC) completed the study. The FSC subjects climbed a stepladder in the forward direction while the BSC subjects did so in the backward direction. Each paced ascent and descent lasted 8 seconds for both FSC and BSC groups. Systolic blood pressure (SBP) and diastolic blood pressure (DPB), heart rate (HR) and cardiovascular endurance (CE) were evaluated at baseline, and at the end of the 4 and 8 weeks of the study. Data was analysed using mean, standard deviation, percentages, one-way th th of variance (ANOVA) and independent t-test. Level of significance was set at 0.05. The groups were not significantly different (p> 0.05) in their cardiovascular parameters at weeks 0, 4, and 8. The FSC group had significant improvement (p = 0.045) in CE. The percentage change in CE by FSC (11.06 ± 11.44%) was significantly greater (p = 0.006) than that by BSC (-0.60 ± 10.41%). Both interventions had no significant effect on the participants' systolic blood pressure, diastolic blood pressure and heart rate. Forward stair climbing is more effective in improving the CE of apparently healthy young adults and, hence, for improving cardiovascular endurance in rehabilitation and athletic training.

Background: Lumbar stabilisation exercise has been shown to reduce pain and disability in patients with low back pain but information on its potential benefits in term of back muscle endurance is scarce. Objective: This study was aimed at investigating the effects of augmenting conventional physiotherapy with lumbar stabilization exercises on selected variables of patients with non-specific chronic low back pain (NSCLBP). Methods: Forty individuals with NSCLBP aged 20-60 years were assigned to one of experimental or control groups (20 in each). The experimental group had lumbar stabilisation exercises in addition to conventional therapy (transcutaneous electrical nerve stimulator and infrared) which was the only treatment for the control group. Both groups were treated thrice weekly. Participants’ pain intensity, disability index, kinesiophobia level and back muscle endurance were evaluated at baseline and after 8 weeks. Results: There was significant reduction in pain intensity (experimental: 6.74±1.37; 3.48±1.09; control: 6.57±1.40; 2.96±1.13) and disability index (experimental: 46.60±16.67; 26.55±14.78; control: 32.10±16.16; 24.60±15.27) and increase in back muscle endurance (experimental: 11.05±8.39; 14.30±19.24s; control: 10.85±9.79; 13.90±11.63s) for both groups. Experimental group had significantly greater reduction (p < 0.05) in disability index than the controls (p = 0.048). Conclusion: Augmenting conventional physiotherapy with lumbar stabilisation exercises achieved better reduction in disability than conventional therapy alone in patients with NSCLBP. Bangladesh Journal of Medical Science Vol.19(3) 2020 p.467-474