Thomas Dias Tina, Eapen Charu, Hegde Atmananda S, Mahale Ajit R, Mane Prajwal Prabhudev, Mehta Saurabh
Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Department of Orthopedics, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
F1000Res. 2025 Jul 21;14:496. doi: 10.12688/f1000research.163321.4. eCollection 2025.
Knee osteoarthritis (KOA) is a prevalent condition. Recent research highlights the role of kinetic chain and core muscle involvement in disease progression, yet evidence for structured core activation protocols such as CARE-KOA© remains limited.This study addresses this gap by evaluating the effectiveness of CARE-KOA©, which specifically targets proximal stability and biomechanical deficits in KOA, aiming to enhance pain, function, and core endurance beyond conventional approaches.
This prospective single-group pre-post study assessed the effect of a Participants underwent a 4-week CARE-KOA© regimen (12 supervised sessions, each including a 10-minute warm-up and core-focused exercises). Pre- and post-intervention assessments included pain (Visual Analog Scale, VAS), patient-reported outcomes (Knee Injury and Osteoarthritis Outcome Score, KOOS), physical function tests (30-second sit-to-stand, 40-meter fast-paced walk, stair climb, timed up-and-go), and knee muscle strength and core endurance. Statistical analysis was performed using non-parametric tests in JAMOVI.
Significant improvements were observed in pain at rest (mean change: 1.13 cm, p = 0.0006, d = 1.07) and during activity (mean change: 2.46 cm, p = 0.000001, d = 1.76), patient-reported outcomes (KOOS Pain: p = 0.00003, d = -0.83; KOOS ADL: p = 0.0000009, d = -1.19), and core endurance (p = 0.027, d = 0.21). Physical function tests also improved (stair climb: p = 0.031, d = 0.34; timed up-and-go: p = 0.006, d = 0.13). Muscle strength gains were significant in flexors of the unaffected knee and extensors of the affected knee (p < 0.05), while other muscle groups showed no significant change.
The CARE-KOA© program led to clinically meaningful improvements in pain, function, and core endurance, highlighting the value of core activation strategies in KOA management. Future research with larger samples and longer follow-up is warranted to confirm these benefits and optimize exercise protocols.
CTRI/2023/07/05480 on 05/07/2024 https://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=69416.70327 L - 158197/2024.
膝关节骨关节炎（KOA）是一种常见病症。近期研究强调了动力链和核心肌肉参与疾病进展的作用，但诸如CARE-KOA©等结构化核心激活方案的证据仍然有限。本研究通过评估CARE-KOA©的有效性来填补这一空白，该方案专门针对KOA中的近端稳定性和生物力学缺陷，旨在比传统方法更有效地缓解疼痛、改善功能和增强核心耐力。
这项前瞻性单组前后对照研究评估了一项干预措施的效果。参与者接受了为期4周的CARE-KOA©方案（12次监督训练，每次包括10分钟热身和以核心为重点的练习）。干预前后的评估包括疼痛（视觉模拟量表，VAS）、患者报告的结果（膝关节损伤和骨关节炎结果评分，KOOS）、身体功能测试（30秒坐立试验、40米快步行走、爬楼梯、定时起立行走测试）以及膝关节肌肉力量和核心耐力。使用JAMOVI中的非参数检验进行统计分析。
静息时疼痛（平均变化：1.13厘米，p = 0.0006，d = 1.07）和活动时疼痛（平均变化：2.46厘米，p = 0.000001，d = 1.76）、患者报告的结果（KOOS疼痛：p = 0.00003，d = -0.83；KOOS日常生活活动：p = 0.0000009，d = -1.19）以及核心耐力（p = 0.027，d = 0.21）均有显著改善。身体功能测试也有所改善（爬楼梯：p = 0.031，d = 0.34；定时起立行走测试：p = 0.006，d = 0.13）。未受影响膝关节的屈肌和受影响膝关节的伸肌力量有显著增加（p < 0.05），而其他肌肉群无显著变化。
CARE-KOA©方案在疼痛、功能和核心耐力方面带来了具有临床意义的改善，突出了核心激活策略在KOA管理中的价值。有必要进行更大样本量和更长随访时间的未来研究，以证实这些益处并优化运动方案。
2024年7月5日在CTRI/2023/07/05480（https://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=69416.70327 L - 158197/2024）注册。
