Compare the Effectiveness of Strengthening and Proprioceptive Exercises Among Knee Osteoarthritis Patients

Abstract

Background: Knee osteoarthritis is a prevalent, disabling condition in older adults, often managed through strengthening exercises. However, proprioceptive deficits remain under-addressed despite their association with pain, instability, and reduced function. Evidence on the added value of proprioceptive training in this context is limited. Objective: To compare the effectiveness of strengthening exercises alone versus combined strengthening and proprioceptive exercises on pain, functional disability, and joint position sense in patients with bilateral knee osteoarthritis. Methods: A randomized controlled trial was conducted at Jinnah Postgraduate Medical Centre, Karachi, enrolling 32 patients with radiologically confirmed bilateral knee osteoarthritis. Participants were randomly assigned to receive either strengthening exercises alone or combined with proprioceptive training, both alongside standard pain relief therapy, for twelve sessions over four weeks. Exclusion criteria included hip OA, recent knee surgery, inflammatory or neurological disorders, and malignancy. Outcomes were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), and Joint Position Sense (JPS) protocol at baseline and after intervention. Data were analyzed using SPSS v20; p-values, effect sizes, and 95% confidence intervals were reported. Ethical approval was obtained in accordance with the Helsinki Declaration. Results: Both groups showed significant improvements in WOMAC and VAS scores (p < 0.001), but the combined group demonstrated greater reductions in functional disability (mean change –46.56 vs. –36.19, p = 0.019) and pain (mean change –5.87 vs. –4.19, p = 0.001). Only the combined group showed a significant improvement in JPS (mean change +7.63, p < 0.001). Conclusion: Integrating proprioceptive exercises with strengthening regimens yields superior outcomes in pain, function, and proprioceptive accuracy in bilateral knee osteoarthritis, supporting a multidimensional approach in rehabilitation.