Perturbation Based Balance Training Versus Progressive Neuromuscular Training as an Adjunct to Conventional Physiotherapy for Pain Reduction and Functional Improvement in Knee Osteoarthritis

NCT07653841 | Recruiting

• 1 other identifier: IIUI/RERC/ADT/2026/05/259
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

This is an RCT aims to explore Perturbation-Based Balance Training versus Progressive Neuromuscular Training as an Adjunct to Conventional Physiotherapy for Pain Reduction and Functional Improvement in Knee Osteoarthritis.

Conditions

Knee Arthritis, Osteoarthritis

Outcome Measures

Primary Outcomes (1)

• Pain & Functional Ability

  Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

  Baseline to Week 6

Secondary Outcomes (3)

• Functional Mobility

  Baseline to Week 6

• Muscle strength

  Baseline to week 6

• Balance

  Baseline to week 6

Study Arms (2)

Perturbation-Based Balance Training (PBBT)

EXPERIMENTAL

Perturbation-Based Balance Training (PBBT) Static standing with manual perturbations: Therapist gives gentle pushes at pelvis/shoulders (anterior/posterior) Double-leg stance on foam: Maintain balance on a soft surface Tandem stance: Heel-to-toe standing with minimal support Supported balance board: Controlled weight shifting Weight-shift training: Side-to-side and forward-backward shifts

Other: Perturbation-Based Balance Training

Progressive Neuromuscular Training (NMT)

ACTIVE COMPARATOR

Progressive Neuromuscular Training (NMT) Mini squats: Partial range knee flexion (0-30°) Sit-to-stand: From chair, controlled movement Double-leg stance balance: Eyes open → progress to reduced support Tandem walking: Straight line walking Heel-to-toe walking: Improves gait control Basic coordination drills: Marching in place

Other: Progressive Neuromuscular Training

Interventions

Perturbation-Based Balance Training OTHER

3 sessions/week 20-25 min (2 sets × 30 sec/activity) Starts with Low-Moderate (slow, predictable external perturbations) progress to Moderate-High (fast, unpredictable perturbations) 30-35 min (3 sets × 45-60 sec)

Also known as: (PBBT)

Perturbation-Based Balance Training (PBBT)

Progressive Neuromuscular Training OTHER

3 sessions/week 20-25 min (2 sets × 10-12 reps) starts with Low-Moderate (RPE 9-11) then proceeds to Moderate (RPE 11-13)

Also known as: (NMT)

Progressive Neuromuscular Training (NMT)

Eligibility Criteria

• Age: 40 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male and female, aged between 40-70 years Diagnosed with knee osteoarthritis Grades I-III based on the Kellgren-Lawrence classification Chronic knee pain for ≥3 months Ability to walk independently

You may not qualify if:

• Grade IV osteoarthritis Previous knee surgery or joint replacement Rheumatoid arthritis or inflammatory joint disease Recent intra-articular injection (\<6 months) Severe systemic illness, Neurological disorders and Vestibular disorders

Sponsors & Collaborators

• Ibadat International University, Islamabad: lead

Study Sites (1)

Institute of Medical Rehabilitation (IMR)

Islamabad, ICT, Pakistan

RECRUITING

MeSH Terms

Conditions

Osteoarthritis

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases

Central Study Contacts

Rashid Nawaz, DPT, MSPT MSK

CONTACT

+923160534195; nawazrashid158@gmail.com

Sidra Hanif, DPT, MSNMPT, PhD PT

CONTACT

+923335985631; sidra.hanif@uipt.iiui.edu.pk

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: SPONSOR

Model Details: Two-arm parallel group randomized controlled trial

Study Record Dates

• First Submitted: May 21, 2026
• First Posted: June 17, 2026
• Study Start: May 18, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): September 20, 2026
• Last Updated: June 17, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)