Effectiveness of Modified Agility and Perturbation Training In Patients with Osteoarthritis Knee- A Case Control Study

Introduction Osteoarthritis (OA), also known as degenerative joint disease is the most common form of arthritis and a leading cause of disability worldwide. Osteoarthritis of the knee is one of the five leading cause of physical disability in non-institutionalized elderly men and women. OA knee, along with osteoarthritis of the hip affects the ability to walk and climb stairs more than any other disease. The risk for disability attributable to OA knee is as great as that attributable to cardiovascular disease and greater than that due to any other medical condition in elderly. The incidence of symptomatic knee osteoarthritis is 1% per year, with a radiographic incidence of 2% per year. The rate of radiographic progression has been estimated at about 4% per year.1-4 Knee osteoarthritis contributes significantly to functional limitations and disability in elderly. Physical impairments associated with knee OA include pain, loss of motion, and decreased quadriceps femoris muscle strength. These impairments are believed to contribute to physical disability and the progression of the disease. Quadriceps weakness and arthrogenic quadriceps inhibition can directly influence joint stability, alter the coordination of neuromuscular reflexes, and cause early fatigue in lower limb muscles. Traditional exercise programs for people with OA knee have focused primarily on addressing limitations in lower extremity muscle strength, joint mobility, and aerobic capacity. A recent meta analysis of randomized clinical trials showed that tested interventions aimed at addressing these impairments demonstrated modest improvements in reduction of pain and self-report measures of function.5-18 Patients with OA knee commonly complain of knee instability during activities of daily living. Specifically they report episodes of “slippage" or “giving way" of their knees during activities such as walking, stair climbing or standing from a sitting position. The knee instability appears to be similar to that reported by younger individuals with knee