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Knee ArthroplastyNCT03421938

Effect of Downhill-uphill Walking Exercises on Functional Level and Muscle Strength in Patients With Knee Arthroplasty.

A study testing Walking Exercise in people with Knee Arthroplasty, run by Dokuz Eylul University at 1 site in Turkey (Türkiye).

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This study is planned for investigating effect of downhill-uphill walking exercises on functional level and muscle strength in patients with knee arthroplasty. Patients who have had primary knee arthroplasty and has gone 3 months after surgery will be included in this study. Read more about this study

Who is it for?
Ages 30 years and older
Conditions the study is for
Knee Arthroplasty
What is being tested?
Walking Exercise
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
1 siteTurkey (Türkiye)
Study dates
11 Oct 2017to 20 Mar 2018
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 30 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Preoperative diagnosis have to be knee osteoarthritis.
  • Patients with primary knee arthroplasty after 3 months surgery.

Who cannot join

  • BMI >40 kg/m2
  • Having orthopedic or neurologic disorders which cause walking disorders.
  • Revision total knee arthroplasty

Trial locations and contacts

1 site in 1 country.

Turkey (Türkiye)1 site
  • Dokuz Eylul University

    Izmir, 35340

Other trials in Turkey (Türkiye)

About this study

Official title: Investigation of the Effect of Downhill-uphill Walking Exercises on Functional Level and Muscle Strength in Patients With Knee Arthroplasty.

This study is planned for investigating effect of downhill-uphill walking exercises on functional level and muscle strength in patients with knee arthroplasty. Patients who have had primary knee arthroplasty and has gone 3 months after surgery will be included in this study. The patients will be divided into two groups by randomization. Totally, 22 patients will be included in this study. Every patients will have same standart post-operative rehabilitation programme. In addition,group 1 will have downhill walking exercises with %10 slope; group 2 uphill walking exercises on the treadmill with %10 slope. Assessments will be made before and after treatment.

Read the detailed description

This study is planned for investigating effect of downhill-uphill walking exercises on functional level and muscle strength in patients with knee arthroplasty. Patients who have had primary knee arthroplasty and has gone 3 months after surgery will be included in this study. The patients will be divided into two groups by randomization. Totally, 22 patients will be included in this study. Every patients will have same standart post-operative rehabilitation programme. Assessments will be made before and after treatment. Rehabilitation programme after knee arthroplasty has included muscle strength and endurance, balance and proprioceptive sensation, increasing functional level and providing independence in daily life activities.For this purpose, a standard physiotherapy program will be implemented in accordance with the goals and objectives stated for all patients. In addition,group 1 will have downhill walking exercises with %10 slope; group 2 uphill walking exercises on the treadmill with %10 slope. It takes 30 minutes for one session.

Exercise intensity was measured before treatment; will be determined using the Karvonen formula depending on the heart rate. Walking intensity during exercise; 55% of the maximum heart rate will be determined at the beginning of the treatment and 85% towards the end of the treatment. Walking exercise on the treadmill will be performed in conjunction with a qualified physiotherapist in this area for 4 weeks(3 session in 1 week).

Within the scope of the assessments, patients' pain levels will be determined using the Numeric Pain Scale (NAS). For the knee joint, the normal range of motion will be determined by universal goniometer. For the determination of functional level, Iowa functional activity scale, Iowa ambulatory speed scale and Hospital For Special Surgery (HSS) knee scoring, 10-meter walking speed, Timed Up and Go (TUG) test, SF-12(12-Item Short Form Survey) quality of life scale will be used. Hand dynamometer will be used to evaluate muscle strength.These assessments will be made before and after treatment.

Being tested
Walking Exercise
Keywords
total knee arthroplasty, walking exercises, uphill-downhill walking exercises, functional level

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Walking ExerciseOther

    Group 1 will have downhill walking exercises with %10 slope; group 2 uphill walking exercises on the treadmill with %10 slope..

Study groups in NCT03421938
Study groupRoleWhat they receive
Group 1 (Downhill Exercise Group)ExperimentalThis group will have downhill walking exercises with %10 slope.
Receives: Other: Walking Exercise
Group 2 ( Uphill Exercise Group)ExperimentalThis group will have uphill walking exercises on the treadmill with %10 slope.
Receives: Other: Walking Exercise

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change of Iowa Level of Assistance Scale

    This test assesses the patient's ability to perform four functional activities, namely, supine to sitting on the edge of the bed,sitting on the edge of the bed to standing, walking 4.57 metres. The scoring of these activities is done as independent 6 points, observational aid 5 points, minimum help 4 points, medium help 3 points, maximum help 2 points, fail 1 point and untest 0 points. Higher values represent a better outcome.

    Speed scoring is done by evaluating the walking speed at a distance of 13.4 meters (44 steps). 20 seconds (sec) and below are recorded as 0, 21-30 sec 1, 31-40 sec 2, 41-50 3, 51-60 sec 4, 61-70 sec 5 and 70 sec. Higher values represent a worse outcome

    Measured: Change from Baseline Patient's Functional Level at 4 weeks

  2. Change of Hospital For Special Surgery Knee Score

    Hospital for Special Surgery knee score. A scoring system evaluation of pain, mobility, range of motion and deforming of the knee giving 0-100 points

    Measured: Change from Baseline Patient's Functional Level at 4 weeks

  3. Change of 10 meter walk speed test

    Individual walks without assistance 10 meters and the time is measured for the intermediate 6 meters to allow for acceleration and deceleration, start timing when the toes of the leading foot crosses the 2-meter mark, stop timing when the toes of the leading foot crosses the 8-meter mark,assistive devices can be used but should be kept consistent and documented from test to test, if physical assistance is required to walk, this should not be performed can be performed at preferred walking speed or fastest speed possible documentation should include the speed tested (preferred vs. fast) collect three trials and calculate the average of the three trials

    Measured: Change from Baseline Patient's Functional Level at 4 weeks

  4. Change of Timed Up and Go (TUG)

    To determine fall risk and measure the progress of balance, sit to stand, and walking.The patient starts in a seated position. The patient stands up upon therapist's command walks 3 meters, turns around, walks back to the chair and sits down. The time stops when the patient is seated. The subject is allowed to use an assistive device.

    Measured: Change from Baseline Patient's Functional Level at 4 weeks

Secondary outcomes (4)
  1. SF-12

    SF-12 Health Survey is a shorter version of the SF-36 Health Survey that uses just 12 questions to measure functional health and well-being from the patient's point of view. The SF-12 is a practical, reliable and valid measure of physical and mental health and is particularly useful in large population health surveys or for applications that combine a generic and disease-specific health survey.

    Measured: Change from Baseline SF-12 score Level at 4 weeks

  2. Numeric Pain Scale

    Severity of pain was rated by each patient marking their current level of pain on a 10cm visual analogue scale (VAS), where 0 represented no pain and 10 was the worst pain imaginable.Higher values represent a worse outcome.

    Measured: Change from Baseline Patient's Pain Level at 4 weeks

  3. Range of Motion

    Each patient's active (unassisted) range of knee extension and flexion will be measured, using a goniometer with the patient in the supine position.

    Measured: Change from Baseline Patient's Range of Motion 4th week

  4. Muscle Strength

    Strength of knee muscles will be evaluated by hand-held dynamometer.

    Measured: Change from Baseline Patient's Muscles Strengths at 4 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Feb 2018
  2. Study start11 Oct 2017
  3. Primary completion20 Mar 2018 (estimated)
  4. Study completion20 Mar 2018 (estimated)

Why it stopped: I changed my PhD thesis

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03421938
Sponsor's protocol ID
3243-GOA
Status last verified
Aug 2021
First submitted
17 Jan 2018
Last updated
23 Aug 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Shields RK, Enloe LJ, Leo KC. Health related quality of life in patients with total hip or knee replacement. Arch Phys Med Rehabil. 1999 May;80(5):572-9. doi: 10.1016/s0003-9993(99)90202-2.

    PubMed 10326924
  • Moffet H, Collet JP, Shapiro SH, Paradis G, Marquis F, Roy L. Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: A single-blind randomized controlled trial. Arch Phys Med Rehabil. 2004 Apr;85(4):546-56. doi: 10.1016/j.apmr.2003.08.080.

    PubMed 15083429
  • Noble PC, Gordon MJ, Weiss JM, Reddix RN, Conditt MA, Mathis KB. Does total knee replacement restore normal knee function? Clin Orthop Relat Res. 2005 Feb;(431):157-65. doi: 10.1097/01.blo.0000150130.03519.fb.

    PubMed 15685070
  • Wylde V, Dieppe P, Hewlett S, Learmonth ID. Total knee replacement: is it really an effective procedure for all? Knee. 2007 Dec;14(6):417-23. doi: 10.1016/j.knee.2007.06.001. Epub 2007 Jun 26.

    PubMed 17596949
  • Petterson SC, Mizner RL, Stevens JE, Raisis L, Bodenstab A, Newcomb W, Snyder-Mackler L. Improved function from progressive strengthening interventions after total knee arthroplasty: a randomized clinical trial with an imbedded prospective cohort. Arthritis Rheum. 2009 Feb 15;61(2):174-83. doi: 10.1002/art.24167.

    PubMed 19177542
  • Yoshida Y, Mizner RL, Ramsey DK, Snyder-Mackler L. Examining outcomes from total knee arthroplasty and the relationship between quadriceps strength and knee function over time. Clin Biomech (Bristol). 2008 Mar;23(3):320-8. doi: 10.1016/j.clinbiomech.2007.10.008. Epub 2007 Dec 3.

    PubMed 18060669
  • Rossi MD, Hasson S. Lower-limb force production in individuals after unilateral total knee arthroplasty. Arch Phys Med Rehabil. 2004 Aug;85(8):1279-84. doi: 10.1016/j.apmr.2003.11.034.

    PubMed 15295753
  • Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. J Orthop Sports Phys Ther. 2005 Jul;35(7):424-36. doi: 10.2519/jospt.2005.35.7.424.

    PubMed 16108583
  • Meier WA, Marcus RL, Dibble LE, Foreman KB, Peters CL, Mizner RL, LaStayo PC. The long-term contribution of muscle activation and muscle size to quadriceps weakness following total knee arthroplasty. J Geriatr Phys Ther. 2009;32(2):79-82.

    PubMed 20039587
  • Berth A, Urbach D, Awiszus F. Improvement of voluntary quadriceps muscle activation after total knee arthroplasty. Arch Phys Med Rehabil. 2002 Oct;83(10):1432-6. doi: 10.1053/apmr.2002.34829.

    PubMed 12370881
  • Mizner RL, Petterson SC, Stevens JE, Axe MJ, Snyder-Mackler L. Preoperative quadriceps strength predicts functional ability one year after total knee arthroplasty. J Rheumatol. 2005 Aug;32(8):1533-9.

    PubMed 16078331
  • LaStayo P, Marcus R, Dibble L, Frajacomo F, Lindstedt S. Eccentric exercise in rehabilitation: safety, feasibility, and application. J Appl Physiol (1985). 2014 Jun 1;116(11):1426-34. doi: 10.1152/japplphysiol.00008.2013. Epub 2013 Jul 3.

    PubMed 23823152
  • Rodio A, Fattorini L. Downhill walking to improve lower limb strength in healthy young adults. Eur J Sport Sci. 2014;14(8):806-12. doi: 10.1080/17461391.2014.908958. Epub 2014 Apr 23.

    PubMed 24754630
  • Samaei A, Bakhtiary AH, Hajihasani A, Fatemi E, Motaharinezhad F. Uphill and Downhill Walking in Multiple Sclerosis: A Randomized Controlled Trial. Int J MS Care. 2016 Jan-Feb;18(1):34-41. doi: 10.7224/1537-2073.2014-072.

    PubMed 26917996
  • Langhammer B, Stanghelle JK. Exercise on a treadmill or walking outdoors? A randomized controlled trial comparing effectiveness of two walking exercise programmes late after stroke. Clin Rehabil. 2010 Jan;24(1):46-54. doi: 10.1177/0269215509343328. Epub 2009 Dec 21.

    PubMed 20026572

Questions about this trial

What is this clinical trial studying?

A study testing Walking Exercise in people with Knee Arthroplasty, run by Dokuz Eylul University at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 23 Aug 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change of Iowa Level of Assistance Scale (time frame: Change from Baseline Patient's Functional Level at 4 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03421938, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Aug 2021.

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