EFFICACY OF HIP STRENGTHENING ON VARUS THRUST IN KNEE OSTEOARTHRITIS
Background: Varus thrust occurred in patients with knee osteoarthritis (OA); it is associated with degenerative changes in addition to mechanical changes. A debate of literature is present to investigate effective treatment for varus thrust.
Objective: The objective of this study is to investigate the effect of hip strengthening exercises on varus thrust in patients with knee OA.
Methods: Eighty-eight individuals out of ninety three participants were eligible for this study. Participants, age was from 45 to 60 years, body mass index (BMI) was < 30 kg/m², and with medial tibiofemoral OA with 2-3 Kellgren-Lawrence radiographic (KL) grade. The participants were randomly allocated to one of the two groups. The control group [n=44; 22 men, 22 women) received only quadriceps strengthening exercise, and stretching exercise for hamstring and calf muscles; study group [n=44; 22 men, 22 women] received hip abductor, hip extensor, hip external rotator strengthening exercises in addition to the same exercises of control group. Patients in both groups received 12 sessions (3 sessions per week for 4 weeks). The primary outcome was frontal plane projection angle (FPPA) which was measured by digital video camera, and kinovea software used for analysis. Secondary outcomes were muscles strength of hip abductor, hip extensor, hip external rotator and quadriceps measured by handheld dynamometer (HHD).
Results: At the baseline, there was no significant difference between both groups regarding tested variables. After 4 weeks of treatment, both groups had significant improvement in FPPA, hip abductors, hip extensors, hip external rotators and knee extensor strength, compared to pretreatment. However study group had more significant improvement in FPPA, hip abductors, hip extensors, and hip external rotators strength compared to control group, while there was no significant difference in knee extensor strength between both groups.
Conclusions: Hip strengthening exercises can be added to the treatment programm of varus thrust.