Evaluation of Muscle Oxygenation and Recovery Dynamics in Individuals With Knee Osteoarthritis

NCT07471204 | Completed

• 1 other identifier: MONO1
• Study Type: observational
• Target: 34
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis (OA) is a degenerative joint disease characterized by pain, muscle weakness, and functional limitations that significantly affect lower limb muscle performance. Structural and physiological alterations in the quadriceps muscle, particularly in the vastus medialis obliquus (VMO), have been reported in individuals with knee OA, including reductions in muscle cross-sectional area, intramuscular fat infiltration, vascular changes, and impaired neuromuscular activation. Muscle oxygenation (SmO₂) is an objective indicator of the metabolic status and circulatory capacity of skeletal muscle. However, the oxygenation dynamics of the quadriceps muscle before and after exercise in individuals with knee OA have not been sufficiently investigated. The aim of this study is to evaluate VMO muscle oxygenation at rest, during exercise, and during the recovery period in individuals with knee OA and to compare these parameters with age- and sex-matched healthy individuals. In addition, the study will examine the relationship between muscle oxygenation parameters, muscle strength, functional performance, and pain levels. Understanding these physiological responses may provide insight into the metabolic mechanisms underlying muscle dysfunction in knee OA and may contribute to the development of more individualized rehabilitation strategies.

Conditions

Healthy Participants; Osteoarthritis of Knee

Keywords

Osteoarthritis of Knee; Muscle oxygenation; Muscle Strength; Pain

Outcome Measures

Primary Outcomes (1)

• Muscle Oxygenation

  Muscle oxygenation (SmO₂) of the vastus medialis obliquus will be measured using near-infrared spectroscopy (Moxy Monitor, Fortiori Design LLC, USA). SmO₂ values will be recorded at rest (baseline), immediately after the mini-squat exercise, and throughout the recovery period. The primary outcome will include the magnitude of SmO₂ change following exercise and the recovery time required for SmO₂ to return to its baseline value.

  Measured during the single assessment session

Secondary Outcomes (3)

• Maximal Isometric Quadriceps Strength

  Measured during the single assessment session

• Functional Performance - 30-Second Sit-to-Stand Test

  Measured during the single assessment session

• Pain Intensity

  Measured before the assessment session

Study Arms (2)

Knee Osteoarthritis

Participants diagnosed with bilateral knee osteoarthritis according to the American College of Rheumatology criteria and classified as Kellgren-Lawrence grade 2-3.

Other: No intervention

Healthy Controles

Age- and sex-matched healthy individuals without knee osteoarthritis or lower extremity musculoskeletal disorders.

Other: No intervention

Interventions

No intervention OTHER

15-repetition mini-squat exercise is used only as an assessment task.

Healthy Controles; Knee Osteoarthritis

Eligibility Criteria

• Age: 45 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of adults aged 45-65 years, including individuals diagnosed with knee osteoarthritis (Kellgren-Lawrence grade 2-3) according to the American College of Rheumatology criteria and age- and sex-matched healthy controls. All participants will meet the predefined eligibility criteria and provide written informed consent prior to participation.

You may qualify if:

• Age between 45 and 65 years
• Body mass index (BMI) below 30 kg/m²
• Willingness to participate in the study
• Additional criteria for the knee osteoarthritis group:
• Diagnosis of knee osteoarthritis confirmed by a physician according to the American College of Rheumatology diagnostic criteria
• Bilateral knee osteoarthritis classified as Kellgren-Lawrence grade 2 or 3

You may not qualify if:

• Presence of another orthopedic or rheumatologic condition affecting the lower extremity
• Uncontrolled hypertension
• Presence of lower extremity arterial or venous disorders
• Presence of a neurological disease
• Cognitive, learning, or perception impairments
• Knee extension deficit
• Physical activity level exceeding 600 MET-min/week according to the International Physical Activity Questionnaire Short Form (IPAQ-SF)
• Participation in a physiotherapy and rehabilitation program for knee osteoarthritis within the last 6 months
• Intra-articular knee injection within the past 6 months

Sponsors & Collaborators

• Bahçeşehir University: lead
• Istanbul University - Cerrahpasa: collaborator
• Istanbul Aydın University: collaborator

Study Sites (1)

Istanbul University-Cerrahpaşa, Faculty of Health Sciences, Physiotherapy and Rehabilitation Lab.

Istanbul, Büyükçekmece, 34000, Turkey (Türkiye)

Location

Related Publications (11)

• Daşkapan, A., KÜLÜNKOĞLU, B., Özünlü Pekyavaş, N., Tüzün, E., Nur Coşar, S., & Karataş, M.; Comparison of mini-squats and straight leg raises in patients with knee osteoarthritis: A randomized controlled clinical trial; Turkish Journal of Rheumatology; 2013; 28(1); 016-026.

  BACKGROUND

• Earl JE, Schmitz RJ, Arnold BL. Activation of the VMO and VL during dynamic mini-squat exercises with and without isometric hip adduction. J Electromyogr Kinesiol. 2001 Dec;11(6):381-6. doi: 10.1016/s1050-6411(01)00024-4.

  PMID: 11738950 BACKGROUND

• Edwards MH, van der Pas S, Denkinger MD, Parsons C, Jameson KA, Schaap L, Zambon S, Castell MV, Herbolsheimer F, Nasell H, Sanchez-Martinez M, Otero A, Nikolaus T, van Schoor NM, Pedersen NL, Maggi S, Deeg DJ, Cooper C, Dennison E. Relationships between physical performance and knee and hip osteoarthritis: findings from the European Project on Osteoarthritis (EPOSA). Age Ageing. 2014 Nov;43(6):806-13. doi: 10.1093/ageing/afu068. Epub 2014 Jun 10.

  PMID: 24918169 BACKGROUND

• Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018 Apr 26;11:851-856. doi: 10.2147/JPR.S158847. eCollection 2018.

  PMID: 29731662 BACKGROUND

• Jun, I., Lee, Y., Shin, C.; The effects of isometric extension at different knee angles on vastus medialis electromyographic activity in patients with knee joint osteoarthritis; Journal of Physical Therapy Science; 2012; 24 (9), 855-857.

  BACKGROUND

• Carpenter MR, Carpenter RL, Peel J, Zukley LM, Angelopoulou KM, Fischer I, Angelopoulos TJ, Rippe JM. The reliability of isokinetic and isometric leg strength measures among individuals with symptoms of mild osteoarthritis. J Sports Med Phys Fitness. 2006 Dec;46(4):585-9.

  PMID: 17119524 BACKGROUND

• Feldmann A, Schmitz R, Erlacher D. Near-infrared spectroscopy-derived muscle oxygen saturation on a 0% to 100% scale: reliability and validity of the Moxy Monitor. J Biomed Opt. 2019 Nov;24(11):1-11. doi: 10.1117/1.JBO.24.11.115001.

  PMID: 31741352 BACKGROUND

• Crum EM, O'Connor WJ, Van Loo L, Valckx M, Stannard SR. Validity and reliability of the Moxy oxygen monitor during incremental cycling exercise. Eur J Sport Sci. 2017 Sep;17(8):1037-1043. doi: 10.1080/17461391.2017.1330899. Epub 2017 May 30.

  PMID: 28557670 BACKGROUND

• Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019 Apr 27;393(10182):1745-1759. doi: 10.1016/S0140-6736(19)30417-9.

  PMID: 31034380 BACKGROUND

• Taniguchi M, Fukumoto Y, Yagi M, Hirono T, Yamagata M, Asayama A, Okada S, Nakai R, Kobayashi M, Ichihashi N. A higher intramuscular fat in vastus medialis is associated with functional disabilities and symptoms in early stage of knee osteoarthritis: a case-control study. Arthritis Res Ther. 2023 Apr 14;25(1):61. doi: 10.1186/s13075-023-03048-0.

  PMID: 37060080 BACKGROUND

• Noehren B, Kosmac K, Walton RG, Murach KA, Lyles MF, Loeser RF, Peterson CA, Messier SP. Alterations in quadriceps muscle cellular and molecular properties in adults with moderate knee osteoarthritis. Osteoarthritis Cartilage. 2018 Oct;26(10):1359-1368. doi: 10.1016/j.joca.2018.05.011. Epub 2018 May 23.

  PMID: 29800621 BACKGROUND

Related Links

• The Moxy sensor will be placed at the midpoint of the vastus medialis obliquus muscle, based on anatomical reference points according to SENIAM guidelines.

MeSH Terms

Conditions

Osteoarthritis, Knee; Pain

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Ayşem Ecem Özdemir, PT, Msc

  Bahçeşehir University

  PRINCIPAL INVESTIGATOR

• Yıldız Analay Akbaba, PT, PhD

  Istanbul University - Cerrahpasa

  STUDY CHAIR

• Gökhan Özkoçak, MD, PhD

  Istanbul Aydın University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Msc. PT.

Study Record Dates

• First Submitted: March 10, 2026
• First Posted: March 13, 2026
• Study Start: March 1, 2026
• Primary Completion: June 5, 2026
• Study Completion: June 5, 2026
• Last Updated: June 15, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)