Effect of open kinetic chain and closed kinetic chain exercises on Vastus medialis oblique muscle volume and thickness measured with ultrasound in patients with knee osteoarthritis: A single blind, two groups pre test, post-test, experimental design
Background: Knee osteoarthritis (OA) is the common cause for instability of knee associated with impairment or weakness of muscles associated with knee joint. Being a contributor to the extension of lower knee strength and joint range of motion. Weakness of vastus medialis oblique muscle leads to instability and pain in knee OA patients. Purpose: The purpose of the study is to find out the effect of open and closed kinetic chain exercises on vastus medialis oblique muscle volume and thickness measured with ultrasound in patients with knee OA. Methods: Total number of 12 male and female participants between the age group of 45-70 years with knee OA, were selected on the basis of inclusion and exclusion criteria. Then suitable samples were randomly allocated into two groups using Sequentially Numbered Opaque Sealed Envelope. Experimental group and Control group respectively. Diagnostic ultrasound was used to measure the volume and thickness of vastus medialis oblique muscle at baseline and after the two weeks of intervention. Open and close kinetic chain exercises included SLR, full arc extension exercise and dynamic quads, half wall squats, static cycling, step up and step down exercise and placebo exercises for calf and hamstring muscle stretching exercises for 3 weeks, thrice in a week on alternate days. Data Analysis: Data analysis was performed using statistical package for social sciences (SPSS 16 version). data followed normal distribution then parametric tests were used for within as well as for between group analysis. Result: The major findings of the study were that there was statistically significant difference (p value<0.05) for pre and post treatment within group for muscle thickness as well as Quality of life measured with WOMAC in experimental group. Muscle thickness showed statistically non- significant difference in control group, but there was significant difference in QOL( p value <0.05) in control group. Discussion: Vastus medialis oblique (VMO) muscle weakness is commonly associated with Knee OA patients and hampers their activities of daily living. Since there is scantiness of literature about the effect of open and closed kinetic chain exercises on VMO muscle volume and thickness which is being measured with ultrasound. Conclusion: the result of the study has investigated the effect of open and close kinetic chain exercises in improving the VMO muscle volume and thickness in knee osteoarthritis patients.The study concluded that OKC and CKC exercises are beneficial for improving the VMO muscle strength and thickness and also the Quality of life of knee OA patients. Keywords: Knee osteoarthritis (OA), Open kinetic chain (OKC), closed kinetic chain (CKC) exercises, ultrasound, muscle thickness.