Comparison of Mini-squats and Straight Leg Raises in Patients with Knee Osteoarthritis: A Randomized Controlled Clinical Trial

Abstract

Amaç: Bu çalışmada diz osteoartritli (OA) hastalarda ağrı şiddeti, performans, kas kuvveti, fiziksel fonksiyon ve denge üzerine düz bacak kaldırma egzersizi (DBKE) ve mini çömelme egzersizinin (MÇE) etkinliği karşılaştırıldı. Hastalar ve yöntemler:Şubat 2009-Şubat 2010 tarihleri arasında iki taraflı diz OA yakınması ile Başkent Üniversitesi Hastanesi'ne başvuran, 40 kadın hasta (ort. yaş 59.93±10.61 yıl; dağılım 30-65 yıl) bu randomize kontrollü, çift-kör klinik çalışmaya dahil edildi. Hastalar DBKE ve MÇE olmak üzere iki gruba ayrıldı. Her iki egzersiz grubu haftada beş seanstan oluşan toplam üç haftalık bir programa dahil edildi. İki grup da her seansta elektroterapi programı aldı. Görsel analog ölçeği (GAÖ) ile diz ağrısı, Zamanlı Kalk-Yürü (ZKY) testi ile fiziksel performans, Cybex II ile izokinetik kuadriseps ve hamstring kas kuvveti, Spor KAT 3.0 ile statik denge, Diz İncinme ve Osteoartrit Sonuç Skoru-Fiziksel Fonksiyon Kısa Formu (KOOS-PS) ile fiziksel fonksiyon başlangıçta, tedavi sonrasında ve tedaviden bir ay sonra değerlendirildi. Bulgular: Statik denge parametreleri göz önünde bulundurulduğunda egzersiz programı (EP) sonrası (p=0.659) ve takip döneminde (p=0.327) gruplar arası anlamlı fark bulunmadı. Egzersiz programı sonrası (p=0.398) ve takip döneminde (p=0.201) DBKE ve MÇE grupları arasında KOOS-PS skorları açısından anlamlı fark bulunmadı. Ayrıca GAÖ skorları açısından EP sonrasında (p=0.149) DBKE ve MÇE grupları arası anlamlı fark bulunmamasına rağmen takip döneminde (p=0.030) anlamlı fark bulundu. Mini çömelme egzersiz grubu, DBKE grubuna kıyasla, EP sonunda anlamlı düzeyde yüksek ZKY testi skorları ve 60°/sn (p=0.024), 90°/ sn (p=0.003), 120°/sn (p=0.005) ve 180°/sn'de (p=0.017) daha yüksek sağ izokinetik diz ekstansör kas kuvvetine sahipti.Sonuç: Uzun dönemli takipleri içeren ve bu periyottan sonra DBKE ve MÇE'nin etkinliğini değerlendirebilecek kriterleri kapsayan başka çalışmalara gereksinim vardır.Anahtar sözcükler: Diz; mini çömelme egzersizi; osteoartrit; düz bacak kaldırma egzersizi. Objectives:In this study, we aimed to compare the effects of the straight leg raise exercise (SLRE) and mini squat exercise (MSE) on pain intensity, performance, muscle strength, physical function and balance in patients with knee osteoarthritis (OA). Patients and methods:Forty female patients (mean age 59.93±10.61 years; range 30-65 years) who were admitted to Başkent University Hospital between February 2009 and February 2010 with bilateral knee OA were included in this randomized controlled double-blind clinical trial. The patients were assigned into two groups, including SLRE and MSE. Both exercise groups were scheduled for a threeweek program of five sessions per week. Both groups also received an electrotherapy program in each session. Knee pain using the visual analog scale (VAS), physical performance using Timed Up and Go (TUG) Test, isokinetic quadriceps and hamstring muscle strengths using Cybex II, static balance using SportKAT 3000, physical function using Knee Injury and Osteoarhtritis Outcome...

Effectiveness of combined chain exercises on pain and function in patients with knee osteoarthritis

“…The findings of this study regarding significantly more reduction in pain for the CCE group appears consistent with the reports of Minoonejad et al 73 who also reported significantly more reduction in pain intensity for participants with PPS in the CCE group than the controls although the extent to which their findings can be compared with the results of this study is limited because the controlsdid not undergo any exercise training. Mikkelsen et al 72 found that addition of isokinetic OKCEs to CKCEs for one study group at the sixth week after both groups commenced CKCEs produced significantly higher isokinetic quadriceps strength than the group that had CKCEs alone; their finding are not really comparable with that of this study because pain was not assessed by Mikkelsen et al 72 Unlike CCEs, the comparative effects of OKCE and CKCE exercises on pain in knee OA have been largely studied in the past two decades 38,39,40,41,52,63,65 although some of the authors did not report significant difference in the effect s of OKCEs and CKCEs. The result of this study on ADP is hence consistent with the reports of this aforementioned authors.…”

“…Stability of the knee joint which is enhanced by increased quadriceps muscle strength following resistance exercises has been opined to improve function in patients with OA 59 . Similarly, Alnahdi et al 64 in a review of literature also identified muscle strength especially quadriceps as a major determinant of both performance -based and self-reported physical function and further submitted that exercise therapy, including global and targeted resistance training, is 40,53,65,66 . The similarity between the findings of these researchers and that of the present study may be attributed to significant pain reduction observed in present study which was also reported by these authors; a significant inverse relationship between pain and physical function has been previously reported in literature 67 .…”

Effects of Open Versus Closed Kinetic Chain Exercises in Patients with Knee Osteoarthritis

“…They suggested that exercise type should be selected according to each patient's clinical characteristics, limitations, needs, and interests. 4 Gbiri et al compared the effects of OKCE and CKCE on proprioception, muscles strength, and func-tional performance in individuals with knee OA. 15 They found that the CKCE group showed significantly better improvement than the OKCE group in physical function, energy, role limitation, pain, and osteoarthritis severity.…”

“…3 Active modalities such as muscle strengthening exercises have been found to be effective is reducing pain, stiffness of joints and disability as well as in improving the quality of life and performance of functional tasks in patients with knee OA. 4 Different exercise programs such as strengthening and aerobic exercises, walking programs, aquatic exercise, jogging in water, yoga, and Tai Chi exercise are applied in knee OA. However, the intensity, duration and type of physical activity that is necessary to produce improvement is still unknown.…”

Effect of Whole Body Vibration on Lower Body Strength and Balance in Osteoarthritis Knee

“…Decrease of disability along with an increase in knee ranges, as seen in the study, shows the reduction of pain with conventional exercise protocol. This helps to restore an optimal function in the joint [14].…”