Effect of Core Versus Hip Strengthening on Knee Function in Adults With Knee Osteoarthritis: A Randomized Controlled Trial

TL;DR

This study compares core and hip strengthening exercises for knee osteoarthritis and finds both are equally effective in improving knee function and quality of life.

Contribution

The study provides a direct comparison of core versus hip strengthening exercises for knee osteoarthritis, an area with limited prior research.

Findings

Both core and hip strengthening exercises significantly improved KOOS scores, muscle strength, and chair stand test performance.

Improvements in functional outcomes were statistically similar between the core and hip exercise groups.

Both exercise types enhanced pain relief, quality of life, and daily living activities in knee osteoarthritis patients.

Abstract

Background

Osteoarthritis (OA) is a prevalent condition characterized by joint pain, functional limitation, and reduced quality of life, particularly affecting older adults, with a higher prevalence in women. OA impacts daily activities, such as walking, climbing stairs, and driving, and is one of the leading causes of pain and disability worldwide. This further affects a person's ability to carry out their activities of daily living and reduces quality of life as a consequence. Exercise remains a core recommendation for managing knee osteoarthritis (OA), and structured exercise programs have been shown to improve knee-related and overall health outcomes. Existing literature supports the effectiveness of core stability and hip strengthening exercises when added to knee strengthening for the management of OA knee. However, there is limited research comparing these two approaches. This study aims to evaluate the effect of supervised core stability versus hip strengthening exercises, alongside conventional occupational therapy, on improving functional outcomes, mobility, and strength in OA knee patients.

Methodology

Patients diagnosed with unilateral osteoarthritis of the knee, grades 1, 2, and 3 according to the Kellgren-Lawrence( KL) grading system, managed conservatively, with no history of trauma or surgery of symptomatic knee after taking approval from the Institutional Ethics Committee of Seth GS Medical College and KEM Hospital were categorized into group A (Core) and group B (Hip) using convenient sampling. A total of 34 patients, both males and females, between 40 and 60 years of age were allocated into group A or B, and were evaluated at baseline, 2 weeks, 4 weeks, and 6 weeks on the knee osteoarthritis outcome score (KOOS), 30-second chair stand test, and the modified Oxford manual muscle grading system. Both groups were given conventional occupational therapy treatment.

Results

Both the Core and Hip groups showed a statistically significant improvement in KOOS, muscle strength of knee flexors and extensors, and the number of repetitions on the 30-second chair stand test. When the Core and Hip groups were compared, the improvement in these parameters was statistically insignificant.

Conclusion

Both hip and core strengthening exercises are equally effective in improving muscle strength, pain, quality of life, and activities of daily living, leading to improvement in KOOS scores in patients with OA knee.

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