Comparison of effectiveness of an etiologic-based exercise and conventional exercises on knee loading, pain and functional activity in individuals with Knee osteoarthritis: A randomized clinical trials.

This study is designed to compare the effectiveness of a reduction knee adduction moment exercise (etiologic-based exercise) and conventional exercises on biomechanical and clinical measures in individuals with Knee osteoarthritis.

This study was a randomized, double-blind, parallel-design clinical trial.

This study compares three methods of exercise therapy in patients with knee osteoarthritis.Patients at Djavad Mowafaghian research center of intelligent neuro-rehabilitation technologies are treated for one month with one of the exercise methods. All measurements will be performed by a blind assessor to the groups of study before and after intervention and one month after intervention.Patients and data analysts were also blind.

Inclusion criteria included having mild to moderate chronic osteoarthritis of tibiofemoral joint and 45-76 years old. Reporting other diseases and use of invasive treatments in the lower extremities consider as exclusion criteria.

1. Intervention group 1: treated by education, ultrasound therapy, hot pack, electrostimulator (TENS) and yoga exercise and medial thrust gait training For 4 weeks and 3 sessions per week 2. Intervention group 2: treated by education, ultrasound therapy, hot pack, TENS and quadriceps and hamstring strength training For 4 weeks and 3 sessions per week 3. Intervention group 3: treated by education, ultrasound therapy, hot pack, TENS and walking exercise For 4 weeks and 3 sessions per week

Anterior knee pain; functional activity during gait; knee joint loading during gait.

Adding a new treatment group; Following the publication of the study protocol, experts suggested that a new treatment group with only normal walking exercise be added to the study to ensure control of the results of the study.

Ahvaz Jundishapur University of Medical Sciences

The volunteers were divided among the treatment groups by using the closed envelopes.The closed were only available to a technician at the research center who was not a part of the research team.After the pre-treatment evaluation, patients were asked to select one envelope from a box containing several envelopes. After opening the envelope, the patient was referred to the therapist based on the patient's group number to begin treatment. Than the covariate adaptive randomization technique was used for group assignment ensuring a balanced assignment of participants over the covariates of pain severity, the K-L score, age and body mass index.

Results were evaluated by a person who was not involved in the study design. She was only aware of the participants' illnesses and the consequences that need to be measured. So outcome assessor were blinded to the study purpose, number of groups, and treatment differences. She was also unaware of any patient group. The data analyzer was entered into the research group after completing the study. He was blind to all aspects of the study including purpose, groups, and treatments and he identified treatment groups as groups 1, 2 and 3 without recognizing the differences.