Comparison of closed kinetic chain exercise and open kinetic chain exercise in knee osteoarthritis patients

Objective: Knee osteoarthritis (OA) is an important health problem due to pain, functional disability and reduced quality of life in patients. The purpose of the study is to determine the effects of supervised open and closed kinetic chain exercise training, on pain severity, isokinetic muscle strength, functional level and quality of life in patients with knee OA. Method: Total of 60 patients diagnosed with knee OA (grade I and II) were included in the study. The patients were divided into three groups by simple random sampling method as Group I [Open kinetic chain (OKC)], Group II [Closed kinetic chain (CKC)] and Group III (CG). The mean age of the patients was found to be 53,05±10,88, 54,40±7,92 and 56,10±12,73 years respectively as OKC, CKC and CG respectively. According to groups of patients, the programs consisting of OKC and CKC were applied 3 days a week and 6 weeks under the supervision of a physiotherapist. The next 6 weeks were organized as a home schedule and called up for follow-up and the 3 month program was completed. A standard combined exercise program was composed and presented as a brochure in the control group. All patients were assessed for initial pain severity (VAS), muscle strength, functional status (WOMAC) and quality of life (SF-36). The same assessments were repeated at the sixth week and the third month. Results: Groups were homogeneous in terms of demographic characteristics and assessedvariables at the beginning (p>0.05). Both the OKC and CKC groups showed significant changes in pain severity, increase in isotonic muscle strength, improvement in all subscales of WOMAC score and physical function and pain subscales of SF-36 at 6th week and 12th week assessments (p<0.05 ). The variables of the control group were not significant (p> 0.05). When comparing OKC and CKC groups, assessment results at 6th week and 12th week were similar and the difference was not statistically significant (p> 0.05). Conclusion: Our results have shown that programs of planned and supervised OKC or CKC in treating patients with grade I and grade II knee OA have similar effects in reducing pain severity, increasing isokinetic muscle strength and functioning.