Tag: choroba zwyrodnieniowa stawu kolanowego

Efficacy of different doses of high intensity laser and traditional exercise on pain and function in chronic knee osteoarthritis

Dina Samy Abd-Alkareem Kassem, Bassem Galal Eldein El Nahass, Mona Mohamed Ibrahim

Dina Samy Abd-Alkareem Kassem, Bassem Galal Eldein El Nahass, Mona Mohamed Ibrahim – Efficacy of different doses of high intensity laser and traditional exercise on pain and function in chronic knee osteoarthritis –  Fizjoterapia Polska 2025; 25(4); 163-168

DOI: https://doi.org/10.56984/8ZGA431DVRB

Abstract
Introduction. High-intensity laser therapy (HILT) appears to be effective for knee osteoarthritis (KOA). However, no recommendations exist for the optimal dosage of HILT in chronic KOA.
Aim of the study. This study examined how different dosages of HILT affect KOA pain and function.
Materials and methods. Fifty-one patients with third-degree knee osteoarthritis, aged 50–70 years, were randomly assigned to three equal groups. Group A received exercises and a dose of 1500 J of HILT. Group B received exercises and a dose of 3000 J of HILT. Group C received sham laser treatment along with exercises. Pain and function were evaluated using the numerical pain rating scale (NPRS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Groups were evaluated before and after a six-week treatment period.
Results. A mixed design multivariate analysis of variance (MANOVA) showed that pain and function significantly improved in all three groups after treatment (p < 0.001). Significant differences were observed between both active groups (A and B) and the control group. Between groups A and B, no significant differences were found (p > 0.05). However, descriptive analysis revealed that group B achieved greater improvements than group A.
Conclusion. In patients with chronic KOA, HILT at either 1500 J or 3000 J combined with exercises effectively reduced pain and improved function. To save time and energy, a dosage of 1500 J may be recommended.
Key words
high intensity laser therapy, knee osteoarthritis, pain, function, high power laser
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Effectiveness of adding neuromuscular taping to ultrasound therapy and exercise therapy in increasing physical activity in older adults with knee osteoarthritis

Siti Muawanah, Azliyana Azizan, Zarina Zahari, Susi Endrini, Nova Relida Samosir, Suci Wahyu Ismiyasa, Rezky Guna Putra

Siti Muawanah, Azliyana Azizan, Zarina Zahari, Susi Endrini, Nova Relida Samosir, Suci Wahyu Ismiyasa et al. – Effectiveness of adding neuromuscular taping to ultrasound therapy and exercise therapy in increasing physical activity in older adults with knee osteoarthritis –  Fizjoterapia Polska 2025; 25(3); 392-402

DOI: https://doi.org/10.56984/8ZG7D19623K

Abstract
Introduction. Knee osteoarthritis (KOA) is a common degenerative condition that causes pain, swelling, limited range of motion, reduced leg muscle strength, restricted walking and stair climbing ability, and decreased quality of life.
Aim. This study aimed to evaluate the effectiveness of ultrasound therapy, exercise therapy, and neuromuscular taping (NMT) on pain, balance, and physical activity in older adults with knee osteoarthritis.
Materials and methods. An experimental design was used to compare two groups: a control group of KOA patients receiving ultrasound therapy and exercise, and an intervention group receiving a combination of neuromuscular taping, ultrasound therapy, and exercise. The effectiveness was assessed using core outcome measures: the visual analogue scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM), and the timed up and go (TUG) test, measured before and after a 4-week intervention (3 sessions per week) in a sample of 20 participants. Data were analyzed using parametric tests (independent samples t-test) as normality was confirmed (p > 0.05).
Results. Both groups showed a significant reduction in pain and improvements in balance and daily function, with superior outcomes in the intervention group (NMT + ultrasound + exercise). In the intervention group, VAS decreased by 2.60 (p < 0.000), WOMAC by 18.00 (p < 0.004), and TUG time by 10.86 seconds (p < 0.004). In the control group, VAS decreased by 3.20 (p < 0.000), WOMAC by 23.40 (p < 0.000), and TUG time by 14.40 seconds (p < 0.001).
Conclusions. The combination of ultrasound therapy, exercise, and neuromuscular taping is an effective therapeutic approach for improving pain, balance, and physical activity in older adults with knee osteoarthritis.
Key words
ultrasound therapy, exercise, neuromuscular taping, knee osteoarthritis, physical activity
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Effect of plyometric training in unilateral knee osteoarthritis

Prasanna Kumar R, Kotteeswaran K, Kamalakannan M, Hariharan J, Supriya P, Priyanga Seemathan, Dinesh S

 

Prasanna Kumar R et al.– Effect of plyometric training in unilateral knee osteoarthritis –  Fizjoterapia Polska 2025; 25(3); 100-103

DOI: https://doi.org/10.56984/8ZG7D19PD06

Abstract
Background. Osteoarthritis is a degenerative condition that begins with the onset of pain and gradually leads to decreased functional movement and activities. It is a complex, progressive disorder resulting in loss of articular cartilage, reduction of joint space, pain, loss of function, and physical incapacity, which together deteriorate quality of life. Plyometrics can be effective in improving joint awareness, balance, and neuromuscular properties, helping to enhance proprioception, kinaesthesia, and muscle performance.
Materials and methods. One hundred and four subjects with unilateral knee osteoarthritis were included in the study. Subjects with rheumatoid arthritis, polyarthritis, other joint complaints, systemic inflammatory arthropathies, previous knee replacement surgery, or intra-articular corticosteroid injections in either knee in the past 12 weeks were excluded. Participants were divided into two groups of 52 each: a control group (conventional exercises) and an experimental group (plyometric training along with conventional exercises) for 4 weeks. Pre- and post-tests were conducted using the knee injury and osteoarthritis outcome score (KOOS), which assesses pain, daily activities, and quality of life.
Results. The post-test values of both groups were compared to determine the difference in improvement due to the interventions. Based on all the data, the results show that the experimental group demonstrated greater improvement in KOOS components compared to the control group that received only conventional treatment.
Conclusion. It is concluded that plyometric training is an effective intervention for improving pain and functional outcomes among individuals with unilateral knee osteoarthritis.
Key words
conventional exercises, knee injury and osteoarthritis outcome score (KOOS), knee osteoarthritis, plyometric exercises
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Correlation of demographic factors on pain, stiffness and functional impairment in patients with chronic osteoarthritis of knee

Makesh Babu Subramanian, Preethi Rajesh, Annie Thomas

Makesh Babu Subramanian, Preethi Rajesh, Annie Thomas – Correlation of demographic factors on pain, stiffness and functional impairment in patients with chronic osteoarthritis of knee –  Fizjoterapia Polska 2025; 25(2); 104-110

DOI: https://doi.org/10.56984/8ZG7D19RTWM

Abstract
Introduction. Osteoarthritis (OA) is the most prevalent arthritis that presents as joint pain or disability, mainly affecting knee joints. This study evaluates pain severity, stiffness, and functional impairment in chronic knee OA. In addition, it also explores the key factors that influence symptoms such as age, gender, body mass index, and joint stress. Moreover, the aim of this study is to explain the connection between these aspects and OA symptom intensity.
Aim and objectives. To analyze the level of pain, stiffness and the physical function in patients with chronic osteoarthritis of knee and its correlation with the demographic factors.
Method. This cross-sectional study evaluated the chronic knee osteoarthritis severity. WOMAC index was used to determine the level of pain, stiffness, and physical function among persons diagnosed with chronic osteoarthritis of knee. It also examined the relation with demographic factors such as age, BMI and occupation.
Result. The study indicates a higher prevalence of osteoarthritis in older females, with a mean age of 57.13 years. BMI significantly correlates with osteoarthritis severity, showing strong positive associations with both overall symptoms (P < 0.001) and pain (P < 0.001). While age also positively impacts pain (P = 0.010) and physical function (P = 0.002), it does not significantly affect stiffness (P = 0.335). Educational and occupational status notably influence the WOMAC scores, affecting overall severity, pain, and physical function (P < 0.05), while gender and stiffness remain unaffected by these factors.
Conclusion. The study has concluded that higher age and BMI are strongly associated with increased severity of pain and functional impairment in individuals with chronic knee osteoarthritis, while stiffness is unaffected by these factors.
Key words
pain, stiffness, functional impairment, knee osteoarthritis, knee pain
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Assessing the relationship between vitamin D, magnesium, and functional outcomes in knee osteoarthritis

Aisyah, Yose Waluyo, Nuralam Sam, Andi Alfian Zainuddin, Rumaisah Hasan, Anshory Sahlan

 

Aisyah, Yose Waluyo, Nuralam Sam, Andi Alfian Zainuddin, Rumaisah Hasan, Anshory Sahlan – Assessing the relationship between vitamin D, magnesium, and functional outcomes in knee osteoarthritis –  Fizjoterapia Polska 2025; 25(2); 86-91

DOI: https://doi.org/10.56984/8ZG7D19FZ3A

Abstract
Introduction. Knee osteoarthritis (KOA) is the most common degenerative joint disease and a major contributor to disability, highlighting the need to assess functional status alongside clinical findings. Despite the growing incidence of KOA, no simple therapy has significantly improved its functional impairments. Identifying modifiable risk factors, such as micronutrient levels, is necessary. While current research explores the relationship between vitamin D and magnesium with KOA severity, their association with specific functional status remains unclear. This study investigates the relationship between serum vitamin D and magnesium levels with functional status in KOA patients, using total and subscale Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
Methods. Data from clinical assessments and laboratory tests were analyzed against total WOMAC scores using Fisher’s exact test, independent t-test, and Mann-Whitney test. Subscale correlations were evaluated with Pearson and Spearman tests.
Results. The mean vitamin D level was 20.59 ± 5.43 ng/ml, while the median magnesium level was 1.90 mmol/L. Vitamin D showed a significant negative correlation with total WOMAC scores (p < 0.05), whereas magnesium did not. Vitamin D was significantly negatively correlated with the pain and function subscales (p < 0.01), and magnesium was negatively correlated with the stiffness subscale (p < 0.05). Cut-off points for differentiating mild-moderate and severe WOMAC scores were 18.42 ng/ml for vitamin D (AUC 0.833, sensitivity 88.9%, specificity 69.2%) and 1.945 mmol/L for magnesium (AUC 0.634, sensitivity 88.9%, specificity 40.4%).
Conclusion. Compared to magnesium, vitamin D showed a significant negative correlation with total WOMAC scores, as well as the pain and function subscales, indicating a stronger association with functional outcomes in KOA. Its identified cut-off point effectively differentiates mild-moderate from severe WOMAC classifications. However, magnesium had a correlation with the stiffness subscale, a relationship not observed with vitamin D.

Keywords
vitamin D, magnesium, functional outcomes, knee osteoarthritis, WOMAC score

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Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha

 

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha – Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis –  Fizjoterapia Polska 2025; 25(2); 23-27

DOI: https://doi.org/10.56984/8ZG7D19CE52

Abstract
Introduction. Knee osteoarthritis (OA) is a common and debilitating condition, particularly affecting the medial compartment of the tibiofemoral joint, leading to pain, stiffness, and functional limitations. Exercise therapy, including muscle strengthening, is a primary conservative treatment for managing OA symptoms. The vastus medialis oblique (VMO) plays a crucial role in patellar stability, and its dysfunction is frequently associated with knee OA, contributing to altered joint mechanics and increased pain. Lumbopelvic hip-core exercises focus on improving control of trunk and pelvic movements, which may influence lower limb alignment and reduce knee joint load. Conventional quadriceps strengthening exercises primarily target the knee extensors, with an emphasis on enhancing VMO function.
Aim. The aim of the study was to determine which exercise approach is more effective in enhancing VMO activation, improving knee stability, and optimizing rehabilitation outcomes.
Materials and methods. Based on inclusion and exclusion criteria, 104 individuals diagnosed with knee osteoarthritis were recruited from Saveetha Hospital. Each group completed five exercise sessions per week over a four-week period. Electromyographic (EMG) analysis was used to assess muscle activation patterns and determine which intervention more effectively enhanced VMO activation.
Results. The post-test mean value for the experimental group was 60.29, while the control group had a mean of 48.15 (p < 0.0001). This indicated a statistically significant difference between the experimental and conventional exercise groups.
Conclusion. This study concludes that lumbopelvic hip-core stabilisation exercises are more effective than conventional quadriceps strengthening exercises in enhancing VMO activation, improving knee stability, and supporting rehabilitation in individuals with knee osteoarthritis.

Key words
knee osteoarthritis, vastus medialis oblique, lumbopelvic hip-core stabilisation, conventional strengthening, surface EMG

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Effect of Graston technique on hamstring flexibility in knee osteoarthritis patients: A randomized controlled study

Amir Mohamed Saleh, Muhammad Fathi Abdul Galil, Hamada Ahmed Hamada, Ghada Abd-Elmoniem Abdullah

 

Amir Mohamed Saleh, Muhammad Fathi Abdul Galil, Hamada Ahmed Hamada, Ghada Abd-Elmoniem Abdullah – Effect of Graston technique on hamstring flexibility in knee osteoarthritis patients: A randomized controlled study –  Fizjoterapia Polska 2024; 24(5); 38-44

DOI: https://doi.org/10.56984/8ZG020C7YPF

Abstract
Purpose. To investigate the effect of Graston technique on hamstring flexibility in patients with knee osteoarthritis.
Methods. Randomized controlled trial. Overall, 30 patients of both genders with age ranged from 38-50 years with moderate knee osteoarthritis (Kellgren & Lawrence grade 3′ moderate’) were recruited randomly from the outpatient clinic of Kafr El-Sheikh General hospital and the outpatient clinic of Faculty of Physical Therapy in Kafr El-Sheikh University and divided into two equal groups; Group (A) (control group) (15 subjects), received conventional treatment of knee osteoarthritis (in form of stretching exercise for hamstring muscle and strengthening exercise for quadriceps muscle) for 4 weeks, Group (B) (experimental group) (15 subjects), received the same conventional treatment plus Graston technique for 4 weeks. Pre- and post-treatment assessment using active knee extension test (AKET), sit and reach flexibility test (SRFT) and dynamic balance were done for all patients.
Results. The comparison between both groups post-treatment revealed statistically significant improvement in AKET, as well as SRFT and dynamic balance (p < 0.05) in favor of experimental group (B).
Conclusion. Graston technique have a significant effect on improving flexibility of hamstring muscle in patients with knee osteoarthritis.
Keywords
active knee extension test, Graston technique, hamstring flexibility, knee osteoarthritis, sit and reach flexibility test
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Review of systematic reviews on the effects of blood flow restriction training on knee osteoarthritis patients

Ahmed Abdelmoniem Ibrahim, Shammaa Homoud H Alsroor, Mashael Jarallah A Alshammari,Khalid Ayad S Alanazi, Amany Raafat Mohamed, Hisham Mohamed Hussein

Ahmed Abdelmoniem Ibrahim et al. – Review of systematic reviews on the effects of blood flow restriction training on knee osteoarthritis patients –  Fizjoterapia Polska 2024; 24(4); 379-384

DOI: https://doi.org/10.56984/8ZG01A8R3T9

Abstract
Objectives. A review of the systematic reviews designed to assess the overall certainty in the evidence for the effect of blood flow restriction training (BFRT) in patients with knee osteoarthritis (OA).
Methods. A systematic search identified systematic reviews using BFRT in knee osteoarthritis OA. Two authors searched five electronic databases, including Google Scholar, Cochrane Library, PubMed, PEDro, and CINAHL, from October 2010 to October 2023. The quality of included reviews was analyzed by the AMSTAR tool.
Results. Six systematic reviews were eligible, and 33 randomized controlled trials (RCTs) with a total of 1248 participants were included. The quality varied from moderate to high, and results showed minimal enhancement in pain, physical function, and life quality.
Conclusion. The synthesis of the reviews has shown some potential improvement in OA patient outcomes. BFRT can be beneficial in OA rehabilitation, and the findings suggest conducting a higher-quality review to explore the use of BFRT with different loads.
Key words
knee osteoarthritis, training, blood flow restriction, review, AMSTAR
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Gender differences in effects of Graston technique, active release technique, and PNF stretching on hamstring flexibility in knee osteoarthritis

Um Habiba, Aisha Razzaq, Tahir Masood, Suman Sheraz

Um Habiba, Aisha Razzaq, Tahir Masood, Suman Sheraz – Gender differences in effects of Graston technique, active release technique, and PNF stretching on hamstring flexibility in knee osteoarthritis –  Fizjoterapia Polska 2024; 24(4); 202-206

DOI: https://doi.org/10.56984/8ZG01A8Z2Q9

Abstract
Aims. To seek gender differences among the effects of the Graston Technique (GT), Active Release Technique (ART), and Proprioceptive Neuromuscular Facilitation (PNF) stretching on hamstring flexibility, pain, lower extremity function, and physical function in patients with knee osteoarthritis.
Materials and methods. A multicenter, single-blind randomized controlled trial was conducted involving 45 patients – aged above 30 years with knee osteoarthritis – randomly allocated to three equal groups: Group-A (GT), Group-B (ART), and Group C (PNF). Each group received 12 physiotherapy sessions over a four-week intervention period (3 visits per week). Data were collected before and after rehabilitation using the Numeric Pain Rating Scale, Active Knee Extension Test, Lower Extremity Function Scale, and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
Results. A statistically significant interaction between the effects of gender and Active Release Technique on lower extremity function was present (p < 0.001) with males (42.4 ± 2.2) showed more improvement than females (35.6 ± 6.6). On the contrary, females showed more improvement (p < 0.001) than males when Graston Technique and PNF techniques were applied.
Conclusion. There were no significant gender-based differences among GT, ART, and PNF regarding pain, hamstring flexibility and WOMAC score. However, males showed significantly more improvement in lower extremity function than females with ART, and females showed more improvement in lower extremity function as compared to males with GT and PNF.
Keywords
active release technique, graston technique, hamstring flexibility, knee osteoarthritis, proprioceptive neuromuscular facilitation
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Knee stability training exercise versus Biodex balance training on dynamic balance indices in individuals with knee osteoarthritis: A Randomized clinical trial

Yomna F. Ahmed, Marian M. Shafeek, Sarah S. Abdelaziz, Karim Ghuiba, Maha G. Ibrahim


Yomna F. Ahmed, Marian M. Shafeek, Sarah S. Abdelaziz, Karim Ghuiba, Maha G. Ibrahim – Knee stability training exercise versus Biodex balance training on dynamic balance indices in individuals with knee osteoarthritis: A Randomized clinical trial. Fizjoterapia Polska 2023; 23(1); 164-169

DOI: https://doi.org/10.56984/8ZG07B6E6

Abstract
Objective. To compare the impacts of Knee stability training exercise versus Biodex balance training on dynamic balance indices in individuals suffering from knee osteoarthritis. Methods. This randomized, double-blind, pre-post measurement study included forty patients aged 45 to 65 with knee osteoarthritis. They were classified into 2 groups at random: group A (n = 20), which received knee stability training plus strengthening exercise, and group B (n = 20), which received Biodex balance training plus strengthening exercise. The Biodex Balance System and Visual Analog Scale were utilized to quantify dynamic balance indices as well as pain intensity at baseline and four weeks following therapy. Results. Statistically significant differences were reported in the overall stability index (OASI), anterior-posterior stability index (APSI), medial-lateral stability indices (MLSI), and Visual Analogue Scale (VAS) values before and after treatment for group A (p < 0.05) as well as before and after treatment for group B (p < 0.05). Statistically significant differences were reported among the two groups (A & B) regarding the post-treatment values of the OASI, APSI, MLSI, and VAS (p < 0.05). Conclusion. Improvement in all dynamic balance indices and pain was reported after knee stability training exercises and after Biodex balance training, with greater improvement after Biodex balance training.
Keywords
knee osteoarthritis, Biodex Balance System, knee stability training, dynamic balance indices, pain intensity
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