Effect of Weight Bearing Versus Non-Weight Bearing Strengthening Exercises on Dynamic Balance in Knee Osteoarthritis Patients: Randomized Controlled Trial

Abstract

Background: knee osteoarthritis (OA) is one of the most aging problems that causes many problems such as pain, reduced balance, difficulty of walking, up & down stairs and may result in inability to move and dependency. Dynamic balance has been found to be affected in patients with knee OA. Purpose: The aim of this study was to evaluate and compare the effect of weight bearing (WB) and non-weight bearing (NWB) strengthening exercises on dynamic balance, pain and proprioception in knee OA patients. Subjects & Methods:  Sixty patients from both genders, diagnosed with bilateral knee OA mild to moderate (according to Kellgran and Lawrence classification) divided equally into three groups G I (control), G II (WB) and G III (NWB), their mean value of age were 59.7 ± 4.5, 60.6 ± 4 and 60.1 ± 4.9 years respectively and body mass index were 28.8 ± 1, 28.6 ± 0.8and 28.2 ± 1.6 kg/m2 respectively. G I received conventional treatment (TENS and stretching exercises for quadriceps, hamstring and calf muscles), G II received the conventional treatment and WB strengthening exercises while G III received the conventional treatment and NWB strengthening exercises. Interventions were performed for 12 sessions (3 sessions/ week) over a period of four weeks. Outcomes were assessed at the beginning and at the end of the fourth week using biodex balance system for dynamic balance, visual analogue scale (VAS) for pain intensity and bubble inclinometer for joint repositioning error (JRE) for measuring proprioception. Result: G II was improved in all measurements with significant difference between the pre and post measurements of all measured variables, while G II were significant difference of BBS and VAS and G I there was significance difference of VAS only. There were significance differences between G II and G I in VAS, BBS and JRE measurements and between G II and G III in VAS and JRE only with superiority to G II, while there were significance differences between G I and G III in VAS and BBS with superiority to G III. Conclusion:  Both WB and NWB exercises are effective in improving dynamic balance and pain in patients with knee OA. With superiority to WB exercises in improving proprioception.