Effect of Downhill-uphill Walking Exercises on Functional Level and Muscle Strength in Patients With Knee Arthroplasty.

NCT03421938 | Withdrawn

• 1 other identifier: 3243-GOA
• Study Type: interventional
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

This study is planned for investigating effect of downhill-uphill walking exercises on functional level and muscle strength in patients with knee arthroplasty. Patients who have had primary knee arthroplasty and has gone 3 months after surgery will be included in this study. The patients will be divided into two groups by randomization. Totally, 22 patients will be included in this study. Every patients will have same standart post-operative rehabilitation programme. In addition,group 1 will have downhill walking exercises with %10 slope; group 2 uphill walking exercises on the treadmill with %10 slope. Assessments will be made before and after treatment.

Conditions

Knee Arthroplasty

Keywords

total knee arthroplasty; walking exercises; uphill-downhill walking exercises; functional level

Outcome Measures

Primary Outcomes (4)

• Change of Iowa Level of Assistance Scale

  This test assesses the patient's ability to perform four functional activities, namely, supine to sitting on the edge of the bed,sitting on the edge of the bed to standing, walking 4.57 metres. The scoring of these activities is done as independent 6 points, observational aid 5 points, minimum help 4 points, medium help 3 points, maximum help 2 points, fail 1 point and untest 0 points. Higher values represent a better outcome. Speed scoring is done by evaluating the walking speed at a distance of 13.4 meters (44 steps). 20 seconds (sec) and below are recorded as 0, 21-30 sec 1, 31-40 sec 2, 41-50 3, 51-60 sec 4, 61-70 sec 5 and 70 sec. Higher values represent a worse outcome

  Change from Baseline Patient's Functional Level at 4 weeks

• Change of Hospital For Special Surgery Knee Score

  Hospital for Special Surgery knee score. A scoring system evaluation of pain, mobility, range of motion and deforming of the knee giving 0-100 points

  Change from Baseline Patient's Functional Level at 4 weeks

• Change of 10 meter walk speed test

  Individual walks without assistance 10 meters and the time is measured for the intermediate 6 meters to allow for acceleration and deceleration, start timing when the toes of the leading foot crosses the 2-meter mark, stop timing when the toes of the leading foot crosses the 8-meter mark,assistive devices can be used but should be kept consistent and documented from test to test, if physical assistance is required to walk, this should not be performed can be performed at preferred walking speed or fastest speed possible documentation should include the speed tested (preferred vs. fast) collect three trials and calculate the average of the three trials

  Change from Baseline Patient's Functional Level at 4 weeks

• Change of Timed Up and Go (TUG)

  To determine fall risk and measure the progress of balance, sit to stand, and walking.The patient starts in a seated position. The patient stands up upon therapist's command walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. The subject is allowed to use an assistive device.

  Change from Baseline Patient's Functional Level at 4 weeks

Secondary Outcomes (4)

• SF-12

  Change from Baseline SF-12 score Level at 4 weeks

• Numeric Pain Scale

  Change from Baseline Patient's Pain Level at 4 weeks

• Range of Motion

  Change from Baseline Patient's Range of Motion 4th week

• Muscle Strength

  Change from Baseline Patient's Muscles Strengths at 4 weeks

Study Arms (2)

Group 1 (Downhill Exercise Group)

EXPERIMENTAL

This group will have downhill walking exercises with %10 slope.

Other: Walking Exercise

Group 2 ( Uphill Exercise Group)

EXPERIMENTAL

This group will have uphill walking exercises on the treadmill with %10 slope.

Other: Walking Exercise

Interventions

Walking Exercise OTHER

Group 1 will have downhill walking exercises with %10 slope; group 2 uphill walking exercises on the treadmill with %10 slope..

Group 1 (Downhill Exercise Group); Group 2 ( Uphill Exercise Group)

Eligibility Criteria

• Age: 30 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Preoperative diagnosis have to be knee osteoarthritis.
• Patients with primary knee arthroplasty after 3 months surgery.

You may not qualify if:

• BMI \>40 kg/m2
• Having orthopedic or neurologic disorders which cause walking disorders.
• Revision total knee arthroplasty

Sponsors & Collaborators

• Dokuz Eylul University: lead

Study Sites (1)

Dokuz Eylul University

Izmir, 35340, Turkey (Türkiye)

Location

Related Publications (16)

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  PMID: 15083429 BACKGROUND

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  PMID: 17596949 BACKGROUND

• Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009 Feb 15;61(2):174-83. doi: 10.1002/art.24167.

  PMID: 19177542 BACKGROUND

• Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol). 2008 Mar;23(3):320-8. doi: 10.1016/j.clinbiomech.2007.10.008. Epub 2007 Dec 3.

  PMID: 18060669 BACKGROUND

• Rossi MD, Hasson S. Lower-limb force production in individuals after unilateral total knee arthroplasty. Arch Phys Med Rehabil. 2004 Aug;85(8):1279-84. doi: 10.1016/j.apmr.2003.11.034.

  PMID: 15295753 BACKGROUND

• Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005 Jul;35(7):424-36. doi: 10.2519/jospt.2005.35.7.424.

  PMID: 16108583 BACKGROUND

• Meier WA, Marcus RL, Dibble LE, Foreman KB, Peters CL, Mizner RL, LaStayo PC. The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatr Phys Ther. 2009;32(2):79-82.

  PMID: 20039587 BACKGROUND

• Berth A, Urbach D, Awiszus F. Improvement of voluntary quadriceps muscle activation after total knee arthroplasty. Arch Phys Med Rehabil. 2002 Oct;83(10):1432-6. doi: 10.1053/apmr.2002.34829.

  PMID: 12370881 BACKGROUND

• Mizner RL, Petterson SC, Stevens JE, Axe MJ, Snyder-Mackler L. Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol. 2005 Aug;32(8):1533-9.

  PMID: 16078331 BACKGROUND

• LaStayo P, Marcus R, Dibble L, Frajacomo F, Lindstedt S. Eccentric exercise in rehabilitation: safety, feasibility, and application. J Appl Physiol (1985). 2014 Jun 1;116(11):1426-34. doi: 10.1152/japplphysiol.00008.2013. Epub 2013 Jul 3.

  PMID: 23823152 BACKGROUND

• Rodio A, Fattorini L. Downhill walking to improve lower limb strength in healthy young adults. Eur J Sport Sci. 2014;14(8):806-12. doi: 10.1080/17461391.2014.908958. Epub 2014 Apr 23.

  PMID: 24754630 BACKGROUND

• Samaei A, Bakhtiary AH, Hajihasani A, Fatemi E, Motaharinezhad F. Uphill and Downhill Walking in Multiple Sclerosis: A Randomized Controlled Trial. Int J MS Care. 2016 Jan-Feb;18(1):34-41. doi: 10.7224/1537-2073.2014-072.

  PMID: 26917996 BACKGROUND

• Langhammer B, Stanghelle JK. Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke. Clin Rehabil. 2010 Jan;24(1):46-54. doi: 10.1177/0269215509343328. Epub 2009 Dec 21.

  PMID: 20026572 BACKGROUND

• Wiik AV, Aqil A, Tankard S, Amis AA, Cobb JP. Downhill walking gait pattern discriminates between types of knee arthroplasty: improved physiological knee functionality in UKA versus TKA. Knee Surg Sports Traumatol Arthrosc. 2015 Jun;23(6):1748-55. doi: 10.1007/s00167-014-3240-x. Epub 2014 Aug 27.

  PMID: 25160471 BACKGROUND

Study Officials

• Abdurrahman Nalbant, PT,MSc

  Dokuz Eylul University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: January 17, 2018
• First Posted: February 5, 2018
• Study Start: October 11, 2017
• Primary Completion: March 20, 2018
• Study Completion: March 20, 2018
• Last Updated: August 23, 2021

Record last verified: 2021-08

Locations

TU (1)