Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial

Introduction Studies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has...

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Main Authors: Tania F Salvini, Glauko Dantas, Isabel C N Sacco, Ana F dos Santos, Ricky Watari, Alessandra B Matias, Paula R M S Serrao, Henrique Pott-Junior
Format: Article
Language:English
Published: BMJ Publishing Group 2020-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/9/e039279.full
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author Tania F Salvini
Glauko Dantas
Isabel C N Sacco
Ana F dos Santos
Ricky Watari
Alessandra B Matias
Paula R M S Serrao
Henrique Pott-Junior
author_facet Tania F Salvini
Glauko Dantas
Isabel C N Sacco
Ana F dos Santos
Ricky Watari
Alessandra B Matias
Paula R M S Serrao
Henrique Pott-Junior
author_sort Tania F Salvini
collection DOAJ
description Introduction Studies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has shown that strengthening the foot-ankle muscles improved function in diabetic patients and reduced patellofemoral pain. The aim of this paper is to investigate whether an 8-week therapeutic foot-ankle exercise programme improves pain, functionality, foot strength, foot kinematics and knee joint overload during gait, and decreases medication intake in individuals with KOA.Methods and analysis This two-arm, prospectively registered, randomised controlled trial with blinded assessors will involve 88 patients with medial tibiofemoral osteoarthritis. Subjects will be randomly allocated to a control group that will receive no specific foot intervention and will follow treatment recommended by the medical team; or an intervention group that will undergo an 8-week physiotherapist-supervised strengthening programme for extrinsic and intrinsic foot muscles, three times a week. The primary outcome will be the pain domain of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The secondary outcomes include WOMAC stiffness and function domains, total WOMAC score, physical function, foot muscle isometric strength, foot kinematics and knee kinetics during gait, and medication intake. Data will be analysed on intention-to-treat principles and a per protocol basis.Ethics and dissemination Investigators and sponsors will communicate trial results to participants and healthcare professionals through scientific databases and social media. In addition, findings will be reported in peer-review publications, and at national and international conference presentations. Ethics approval: Ethics Committee of the Universidade Federal de São Carlos, São Carlos, SP, Brazil (N° 3.488.466).Trial registration number NCT04154059.
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spelling doaj-art-d746a4e2db2f43e690408227933e517f2025-01-08T04:05:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-039279Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trialTania F Salvini0Glauko Dantas1Isabel C N Sacco2Ana F dos Santos3Ricky Watari4Alessandra B Matias5Paula R M S Serrao6Henrique Pott-Junior7Department of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, BrazilDepartment of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, BrazilSchool of Medicine, Physical Therapy, Speech and Occupational Therapy Dept, University of São Paulo, São Paulo, BrazilUNA University Center, Pouso Alegre, BrazilDepartment of Physical Therapy, Speech, and Occupational Therapy, USP, Sao Paulo, BrazilDepartment of Physical Therapy, Speech, and Occupational Therapy, USP, Sao Paulo, BrazilDepartment of Physical Therapy, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, BrazilDepartment of Medicine, Universidade Federal de São Carlos (UFSCar), São Carlos, São Paulo, BrazilIntroduction Studies have indicated that hip and knee muscle strengthening are effective in reducing pain, improving self-reported function and increasing lower limb strength, without, however, decreasing knee joint overload during gait in patients with knee osteoarthritis (KOA). Recent research has shown that strengthening the foot-ankle muscles improved function in diabetic patients and reduced patellofemoral pain. The aim of this paper is to investigate whether an 8-week therapeutic foot-ankle exercise programme improves pain, functionality, foot strength, foot kinematics and knee joint overload during gait, and decreases medication intake in individuals with KOA.Methods and analysis This two-arm, prospectively registered, randomised controlled trial with blinded assessors will involve 88 patients with medial tibiofemoral osteoarthritis. Subjects will be randomly allocated to a control group that will receive no specific foot intervention and will follow treatment recommended by the medical team; or an intervention group that will undergo an 8-week physiotherapist-supervised strengthening programme for extrinsic and intrinsic foot muscles, three times a week. The primary outcome will be the pain domain of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC). The secondary outcomes include WOMAC stiffness and function domains, total WOMAC score, physical function, foot muscle isometric strength, foot kinematics and knee kinetics during gait, and medication intake. Data will be analysed on intention-to-treat principles and a per protocol basis.Ethics and dissemination Investigators and sponsors will communicate trial results to participants and healthcare professionals through scientific databases and social media. In addition, findings will be reported in peer-review publications, and at national and international conference presentations. Ethics approval: Ethics Committee of the Universidade Federal de São Carlos, São Carlos, SP, Brazil (N° 3.488.466).Trial registration number NCT04154059.https://bmjopen.bmj.com/content/10/9/e039279.full
spellingShingle Tania F Salvini
Glauko Dantas
Isabel C N Sacco
Ana F dos Santos
Ricky Watari
Alessandra B Matias
Paula R M S Serrao
Henrique Pott-Junior
Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
BMJ Open
title Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
title_full Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
title_fullStr Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
title_full_unstemmed Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
title_short Effects of a foot-ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis: protocol for a randomised controlled trial
title_sort effects of a foot ankle strengthening programme on clinical aspects and gait biomechanics in people with knee osteoarthritis protocol for a randomised controlled trial
url https://bmjopen.bmj.com/content/10/9/e039279.full
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