The Effects of Modified Otago and Neuromuscular Exercise on Falling and Physical Function in Knee Osteoarthritis

Plain-language summary

. This study was carried out to examine the effects on walking, physical function and quality of life. There were 88 individuals in the study and they were divided into three groups as Modified Otago, Neuromuscular and Control groups. Traditional physiotherapy applications (Hotpack + Ultrasound (US) + Transcutaneous Electrical Nerve Stimulation (TENS) were applied to all groups. In addition to these applications, Modified Otago and Neuromuscular exercises were performed 2 days a week in a clinical setting, accompanied by a physiotherapist for 12 weeks. The control group was only followed up. Patients were evaluated for basic parameters before and after treatment: Berg Balance Scale (BBS) and Timed Up Go Test (TUG) for balance and fall risk, International Fall Efficiency Scale (FES-I) for fear of falling, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for symptoms and function, Tampa Kinesiophobia Scale (TKS) for kinesiophobia, 6-minute walk test for functional capacity (6MWT), Nottingham Health Profile (NHP) for quality of life, McGill Short Form (MSF) questionnaire for pain, an android-based smartphone application called "Gait Analyzer" were used for spatio-temporal variables in gait. Joint position sense (JPS) was measured with a goniometer and knee flexion was determined as 30° and 60° target angles. The exercise experiences of the groups who exercised after the treatment were evaluated by asking three questions with answers ranging from 0 to 10. It was observed that modified Otago and Neuromuscular exercises reduced the risk of falling and fear of falling, increased balance, decreased clinical symptoms and pain, increased function and quality of life, provided positive changes in the spatio-temporal parameters of walking and partially improved the sense of joint position compared to the control group (p\<0,05). When the exercise groups were compared, the Modified Otago group had more positive quality of life and pain than the Neuromuscular exercise group (p\<0.05). In addition, individuals in this group evaluated the exercises as less boring and less tiring (p\<0.001). Modified Otago and Neuromuscular exercises can be included in the treatment programs of individuals with geriatric knee osteoarthritis as exercises aimed at reducing possible falls. It was concluded that Modified Otago exercises are superior and therefore more preferable in terms of compliance and satisfaction of individuals.

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