Effect of Exercise on Muscle Activity, Strength, and Balance in People With Knee Osteoarthritis

NCT07073911 | Active Not Recruiting

• 1 other identifier: 101801
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

This will be a clinical trial of a standardized group exercise intervention, Les Mills Thrive, and determine if it alters muscle activation patterns and improves strength, balance, and symptoms in those with knee osteoarthritis (OA). Muscle activation patterns will be assessed using surface electromyography, strength will be assessed using isokinetic dynamometry, balance will be measured using the Community Balance and Mobility Scale (CB\&M), and symptoms and typical activity will be measured using two questionnaires: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Physical Activity Scale for the Elderly (PASE). These outcome measures will be measured at baseline and after a 12-week group exercise intervention (Les Mills Thrive) for 42 older adults with knee OA. Results of this study will be disseminated via a report to Les Mills International, in community presentations, at relevant academic (e.g. Osteoarthritis Research Society International (OARSI) annual conference) and industry (e.g. Medical Fitness Association annual meeting) conferences, in an academic journal publication (e.g. Arthritis Care \& Research), and through press releases or other media publications.

Conditions

Osteo Arthritis Knee and Hip

Keywords

muscle activity; gait; balance; strength

Outcome Measures

Primary Outcomes (4)

• Quadriceps amplitude (Quadriceps PC1)

  Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The first pattern extracted from quadriceps EMG waveforms (Quadriceps PC1) captures the overall magnitude (i.e. amplitude) of quadriceps activity.

  From initial data collection to the end of treatment at 12 weeks

• Quadriceps co-activation ( Quadriceps PC2)

  Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The second pattern extracted from quadriceps EMG waveforms (Quadriceps PC2) captures prolonged quadriceps activity (i.e. co-activation).

  From baseline data collection to the end of the intervention at 12 weeks.

• Hamstrings amplitude (Hamstrings PC1)

  Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The first pattern extracted from hamstrings EMG waveforms (Hamstrings PC1) captures the overall magnitude (i.e. amplitude) of hamstrings activity.

  From baseline data collection to the end of the intervention at 12 weeks.

• Hamstrings co-activation (Hamstrings PC2)

  Surface electromyography (EMG) will be used to assess muscle activation patterns from the quadriceps and hamstrings. We will assess overall magnitude of activity as well as co-activation. These outcomes will be extracted from the EMG data using principal component analysis (PCA). PCA is a pattern recognition technique that extracts the main patterns in waveform data. It has previously identified patterns of quadriceps and hamstrings activity that are correlated with knee osteoarthritis progression. The second pattern extracted from hamstrings EMG waveforms (Hamstrings PC2) captures prolonged hamstrings activation (i.e. co-activation).

  From baseline data collection to the end of the intervention at 12 weeks.

Secondary Outcomes (5)

• Balance (Community Balance & Mobility Scale)

  From baseline data collection to the end of the intervention at 12 weeks.

• Knee extensor strength

  From baseline data collection until the end of the intervention at 12 weeks.

• Knee flexor strength

  From baseline data collection until after the 12 week intervention.

• Symptoms (WOMAC)

  From baseline data collection until after the 12 week intervention.

• Physical activity

  From baseline until after the 12 week intervention.

Study Arms (1)

Exercise program

EXPERIMENTAL

Les Mills Thrive is a 45-minute class that consists of flexibility, strength, and coordination exercises designed to be delivered in a group fitness environment. Participants will have the option to attend group fitness classes in person, or do the exercise program at home on their own asynchronously, using recorded classes as guidance.

Behavioral: Exercise

Interventions

Exercise BEHAVIORAL

Les Mills Thrive is a 45-minute class that consists of flexibility, strength, and coordination exercises. This program aims to improve sensorimotor control and strength via functional weight-bearing exercises and floor exercises to isolate targeted hip and core muscles. In each class (whether in person or online), a certified Les Mills Thrive instructor will provide options to either increase or decrease the intensity of each exercise to cater to varying fitness levels and fluctuating symptoms. Each exercise has an assisted (using a chair for balance), body weight, and resisted (weight or exercise tubing) option. Participants will have the option to attend group fitness classes or do the classes asynchronously at home using a link to access a recorded class.

Also known as: Les Mills Thrive

Exercise program

Eligibility Criteria

• Age: 19 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participants must have received a diagnosis of knee OA from a physician and/or meet the American College of Rheumatology Clinical Classification Criteria for Osteoarthritis of the knee. The American College of Rheumatology criteria specify that a participant needs to have pain and fulfill three of the following six items: 1) aged 50 years or older, 2) no early morning stiffness or morning stiffness less than 30 minutes, 3) crepitus, 4) bony tenderness, 5) bony enlargement, 6) no palpable warmth
• They must pass the Get Active Questionnaire to ensure that they are safe to begin an exercise program (determined via recruitment email).

You may not qualify if:

• i) severe knee trauma, knee surgery, or intraarticular knee joint injections in the previous six months, ii) active synovitis, iii) concurrent neurological (i.e. Parkinson's disease, Alzheimer's dementia, or polyneuropathy), endocrine (i.e., diabetes mellitus) and/or vestibular disorders which may affect balance, iv) chronic disease that may put them at risk during the exercise classes (i.e., history of heart failure, stroke, chronic obstructive lung disease), v) uncorrected visual impairment which may affect balance, or vi) an inflammatory rheumatic disease (i.e., rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and chronic reactive arthritis).

Sponsors & Collaborators

• Gillian Hatfield: lead
• Les Mills International: collaborator

Study Sites (1)

University of the Fraser Valley

Chilliwack, British Columbia, V2R0N3, Canada

Location

MeSH Terms

Interventions

Exercise

Intervention Hierarchy (Ancestors)

Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Gillian Hatfield, PhD

  University of the Fraser Valley

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Associate Professor

Study Record Dates

• First Submitted: July 16, 2025
• First Posted: July 20, 2025
• Study Start: August 26, 2025
• Primary Completion (Estimated): June 19, 2026
• Study Completion (Estimated): June 19, 2026
• Last Updated: May 1, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ICF
• Time Frame: Approximately June 2026 until June 2031 (five years).
• Access Criteria: Academics at other universities will be able to access the data by contacting the Primary Investigator via email.

Locations

CA (1)