Short-Term Effects of Strengthening Exercises of Lower Limb Rehabilitation Protocol on Pain, Stiffness, Physical Function and Body Mass Index among Knee Osteoarthritis Participants Who Were Overweight or Obese: A Clinical Trial

Abstract BackgroundOsteoarthritis (OA) of the knee is defined as a progressive disease of the synovial joints and is characterized by wear and tear of cartilage and underlying bone. This study aimed to determine the short-term effects of the lower limb rehabilitation protocol (LLRP) on pain, stiffness, physical function, and body mass index (BMI) among knee OA participants who were overweight or obese. MethodologySingle blinded randomized controlled trial of one-month duration was conducted at Rehmatul-Lil-Alameen Postgraduate Institute, Lahore, Pakistan. Fifty overweight or obese participants with knee OA were randomly divided into two groups by a computer-generated number. Participants in the Rehabilitation Protocol Group (RPG) were provided with leaflets explaining the strengthening exercises of the LLRP and instruction of daily care (IDC), while the participants in the Control Group (CG) were provided with leaflets explaining IDC only for a duration of four weeks. The primary outcome measures were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores for pain, stiffness, and physical function. The secondary outcome measures were BMI, exercise adherence, and patients’ satisfaction by the numeric rating scale ranging from 0 to 10. Paired Samples t-test was used to analyze the differences within groups from baseline to post-test evaluations. The analysis of variance 2 × 2 factor was used to analyze the difference of BMI, knee pain, stiffness, and physical function between the groups. ResultsParticipants in the RPG and CG reported a statistically significant reduction in knee pain, and stiffness (p ≤ 0.05) within group. The reduction in the scores of knee pain was higher in participants of the RPG than the CG (p = 0.001). Additionally, participants in the RPG reported greater satisfaction (p = 0.001), higher self-reported exercise adherence (p = 0.010) and coordinator-reported exercise adherence (p = 0.046) compared to the participants in the CG. ConclusionShort-term effects of the LLRP appear to reduce knee pain and stiffness only, but not physical function and BMI. TRIAL REGISTRATIONName: Iranian Registry of Clinical TrialsNumber: IRCT20191221045846N2Date of registration: June 28, 2020Registration timing: prospective