Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Lower Extremity Strengthening Exercise Combined with Balance Exercise on Lower Extremity Function, Range of Motion, Muscle Strength, and Balance in Patients with Knee Osteoarthritis

균형운동을 동반한 하지 근력강화운동이 슬관절골관절염 환자의 하지 기능수준과 관절가동범위, 근력, 균형 수준에 미치는 영향

  • 박지은 (대전보훈병원 물리치료실) ;
  • 김선엽 (대전대학교 물리치료학과)
  • Received : 2017.10.09
  • Accepted : 2017.10.26
  • Published : 2017.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

PURPOSE: Balance exercise as well as lower extremity strengthening exercise (LESE) is known to be effective in patients with knee osteoarthritis (KOA). The purpose of this study was to investigate the effectiveness of performing LESE in conjunction with balance exercise on lower extremity function, range of motion, muscle strength, and balance in patients with KOA. METHODS: The subjects of this study were 25 patients with KOA who were recruited and randomly divided into two groups: 1) those who performed LESE with balance exercise; and 2) those who performed only LESE. Both the groups also received general physical therapy and performed aerobic exercise. The interventions were performed 3 times a week for 4 weeks. To determine the effectiveness of the interventions, we measured Western Ontario and MacMaster Universities Arthritis Index (WOMAC) score, numerical rating scale (NRS) score, passive range of motion (PROM), chair stand test (CST), and Berg Balance Scale (BBS) score at the initiation of the interventions and again after 4 weeks, at the time of completion of the interventions. RESULTS: After 4 weeks of the interventions, both the groups showed significantly improved WOMAC (p<.01), NRS (p<.01), PROM (p<.05), CST (p<.05), and BBS (p<.01) scores. However, there was no significant difference between the groups in terms of the clinical outcomes observed. CONCLUSION: These results suggest that the addition of balance exercise to a LESE regimen in patients with KOA did not provide any additional benefit.

Keywords

References

  1. Ahmed AF. Effect of sensorimotor training on balance in elderly patients with knee osteoarthritis. J Adv Res. 2011;2(4):305-11. https://doi.org/10.1016/j.jare.2011.02.001
  2. Al-khlaifat L, Herrington LC, Tyson SF, et al. The effectiveness of an exercise programme on dynamic balance in patients with medial knee osteoarthritis: A pilot study. Knee. 2016;23(5):849-56. https://doi.org/10.1016/j.knee.2016.05.006
  3. Astephen JL, Deluzio KJ, Caldwell GE, et al. Biomechanical changes at the hip, knee, and ankle joints during gait are associated with knee osteoarthritis severity. J Orthop Res. 2008;26(3):332-41. https://doi.org/10.1002/jor.20496
  4. Bae SC, Lee HS, Yun HR, et al. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage. 2001;9(8):746-50. https://doi.org/10.1053/joca.2001.0471
  5. Bartholdy C, Juhl C, Christensen R, et al. The role of muscle strengthening in exercise therapy for knee osteoarthritis: A systematic review and meta-regression analysis of randomized trials. Semin Arthritis Rheum. 2017; 55(0):779-85.
  6. Bogle Thorbahn LB, Newton RA. Use of the Berg balance test to predict fall in elderly persons. Phys Ther. 1996;76(6):576-85. https://doi.org/10.1093/ptj/76.6.576
  7. Cho IS. The effects of visual feedback balance training on pain, physical function, gait, balance in chronic knee osteoarthritis patients. Doctor's Degree. Daegu University. 2016.
  8. Clarkson HM. Musculoskeletal assessment: joint range of motion and manual muscle strength (2nd ed). Philadelphia. Lippincott Williams & Wilkins. 1999.
  9. Gogia PP, Braatz JH, Rose SJ, et al. Reliability and validity of goniometric measurements at the knee. Phys Ther. 1987;67(2):192-5. https://doi.org/10.1093/ptj/67.2.192
  10. Gstoettner M, Raschner C, Dirnberger E, et al. Preoperative proprioceptive training in patients with total knee arthroplasty. Knee. 2011;18(4):265-70. https://doi.org/10.1016/j.knee.2010.05.012
  11. Han TR, Bang MS. Rehabilitation medicine (3rd ed). Seoul. Kunja. 2008.
  12. Hawker G, Mian S, Kendzerska T, et al. Measures of adult pain: Visual analog scale for pain (VAS pain), numeric rating scale for pain (NRS pain), McGill pain questionnaire (MPQ), short-form McGill pain questionnaire (SF-MPQ), chronic pain grade scale (CPGS), short form-36 bodily pain scale (SF-36 BPS), and measure of intermittent and constant osteoarthritis pain (ICOAP). Arthritis Care Res. 2011;63(S11): S240-52. https://doi.org/10.1002/acr.20543
  13. Hinman RS, Bennell KL, Metcalf BR, et al. Balance impairments in individuals with symptomatic knee osteoarthritis: A comparison with matched controls using clinical tests. Rheumatology (Oxford). 2002;4:1388-94.
  14. Ho SC, Woo J, Chan SS, et al. Risk factors for falls in the Chinese elderly population. J Gerontol A Biol Sci Med Sci. 1996;51(5):M195-8.
  15. Hwang SJ, Lee SY. Effects of balance control and functional activities during gym ball exercise in elderly people. Phys Ther Korea. 2004;11(3):25-32.
  16. Iwamoto J, Takeda T, Sato Y. Effect of muscle strengthening exercises on the muscle strength in patients with osteoarthritis of the knee. Knee. 2007;14(3):224-30. https://doi.org/10.1016/j.knee.2007.03.002
  17. Jang WS, Bae SS, Ju MY, et al. Influence of lower extremity strengthening exercise on sway area of knee osteoarthritis. J Korean Soc Phys Med. 2006;1(1): 13-21.
  18. Jang WS, Bae SS, Jung YW. Effect of balance ability of knee osteoarthritis with lower extremity strengthening exercise. J Korean Soc Phys Med. 2007;2(1):31-9.
  19. Jones CJ, Rikli RE, Beam WC. A 30-s chair-stand test as a measure of lower body strength in communityresiding older adults. Res Q Exerc Sport. 1999;70: 113-9. https://doi.org/10.1080/02701367.1999.10608028
  20. Kim DH, Jang HJ, Cheon JG, et al. Relationship between the severity of radiographic features and degree of pain and dysfunction in patients with knee osteoarthritis. J Korean Soc Phys Med. 2016;11(1): 23-34. https://doi.org/10.13066/kspm.2016.11.1.23
  21. Kim SY. Muscle strength ratio and Q-angle in patients with osteoarthritis of the knee: A comparative study with healthy persons. Phys Ther Korea. 2005;12(1):45-54.
  22. KISS (Korea Institute of Sports Science). Latest exercise prescription for professionals. Seoul. 21 st Publishing. 1998.
  23. Koh EK, Yi CH. Rasch analysis of the Korean Western Ontario McMaster(KWOMAC): In the out-patients over 65 years with osteoarthritis of the knee. Phys Ther Korea. 2007;14(1)82-9.
  24. Kutlay S, Kucukdeveci AA, Elhan AH, et al. Validation of the world health organization disability assessment schedule II (WHODAS-II) in patients with osteoarthritis. Rheumatol Int. 2011;31(3):339-46. https://doi.org/10.1007/s00296-009-1306-8
  25. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol. 1994;49:M72-84. https://doi.org/10.1093/geronj/49.2.M72
  26. Moon EM. Effect of elastic band for resistance training and balance training on walking ability in elderly women. Master's Degree. Kookmin University. 2006.
  27. O'Reilly SC, Jones A, Muir KR, et al. Quadriceps weakness in knee osteoarthritis: The effect on pain and disability. Ann Rheum Dis. 1998;57:588-94. https://doi.org/10.1136/ard.57.10.588
  28. Peat G, McCarney R, Croft P. Knee pain and osteoarthritis in older adults: A review of community burden and current use of primary health care. Ann Rheum Dis. 2001;60(2):91-7. https://doi.org/10.1136/ard.60.2.91
  29. Rikli RE, Jones CJ. Senior Fitness Test Manual. Champaign. Human Kinetics Publishers. 2001.
  30. Salaffi F, Stancati A, Silvestri CA, et al. Minimal clinically important changes in chronic musculoskeletal pain intensity measured on a numerical rating scale. Eur J Pain. 2004;8(4):283-91. https://doi.org/10.1016/j.ejpain.2003.09.004
  31. Scopaz KA, Piva SR, Gil AB, et al. Effect of baseline quadriceps activation on changes in quadriceps strength after exercise therapy in subjects with knee osteoarthritis. Arthritis Rheum. 2009;61:951-7. https://doi.org/10.1002/art.24650
  32. Sung NJ. The effects of isokinetic and isokinetic plus balance exercise on the change of functional status, pain and postural control in patients with osteoarthritis of the knee. Master's Degree. Konyang University. 2006.
  33. Takacs J, Carpenter MG, Garland SJ, et al. Factors associated with dynamic balance in people with knee osteoarthritis. Arch Phys Med Rehabil. 2015;96: 1873-9. https://doi.org/10.1016/j.apmr.2015.06.014
  34. Takacs J, Krowchuk NM, Garland SJ, et al. Dynamic balance training improves physical function in individuals with knee osteoarthritis: A pilot randomized controlled trial. Arch Phys Med Rehabil. 2017;98(8):1586-93. https://doi.org/10.1016/j.apmr.2017.01.029
  35. Zhang W, Doherty M, Peat G, et al. EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis. 2010;69(3):483-9. https://doi.org/10.1136/ard.2009.113100

Cited by

  1. Effects of Multipath Electrical Stimulation on the Functional Recovery of Early Stage Patients of Total Knee Arthroplasty vol.13, pp.1, 2018, https://doi.org/10.13066/kspm.2018.13.1.107
  2. Designing Intervention Arthritis Self-Management Program with Tai Chi for Older Adults with Osteoarthritis in Rural Korea vol.7, pp.2, 2017, https://doi.org/10.7236/ijasc.2018.7.2.55