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. 2025 Oct 29;14(21):7685.
doi: 10.3390/jcm14217685.

Effectiveness of Graded Weight-Bearing Exercises on Pain, Function, Proprioception, and Muscle Strength in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial

Ammar Fadil  1 , Qassim Ibrahim Muaidi  2 , Mohamed Salaheldien Alayat  1 , Moayad S Subahi  1 , Roaa A Sroge  1 , Abdulaziz Awali  1 , Mansour Abdullah Alshehri  1
Affiliations

Effectiveness of Graded Weight-Bearing Exercises on Pain, Function, Proprioception, and Muscle Strength in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial

Ammar Fadil et al. J Clin Med. .

Abstract

Background/Objectives: Knee osteoarthritis (OA) is a prevalent degenerative joint disorder associated with pain, impaired proprioception, and reduced physical function. While closed kinetic chain exercises (CKCEs) are commonly prescribed to enhance joint stability, their weight-bearing nature may exacerbate symptoms. Graded weight-bearing exercises (GWBEs) using anti-gravity treadmill training provide a novel approach to reduce joint loading while maintaining functional mobility. This study aimed to evaluate the effectiveness of GWBEs compared with CKCEs and open kinetic chain exercises (OKCEs) on pain, function, proprioception, and quadricep strength in patients with knee OA. Methods: Forty-five adults aged 40-60 years with radiographically confirmed knee OA were randomized into three groups: (1) GWBE + OKCE, (2) CKCE + OKCE, or (3) OKCE alone. Interventions were conducted three times per week for six-weeks. Outcomes included pain (Visual Analogue Scale), physical function (Western Ontario and McMaster Universities Osteoarthritis Index, 6-Minute Walk Test), proprioception (joint repositioning error at 45°), and quadriceps strength (isokinetic peak torque at 60°, 120°, and 180°/s). Results: All groups demonstrated significant improvements in pain and function (p < 0.05). Proprioception improved in the GWBE + OKCE and CKCE + OKCE groups but not in the OKCE group. No significant changes were observed in quadriceps strength across groups. The GWBE + OKCE group showed significantly greater improvements in pain, function, and proprioception compared to both comparator groups (p < 0.05). Conclusions: GWBE combined with OKCE is more effective than CKCE + OKCE and OKCE alone in improving pain, function, and proprioception in patients with knee OA.

Keywords: closed kinetic chain exercise; knee osteoarthritis; knee pain; physiotherapy; weight-bearing exercise.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Anti-gravity treadmill used in the GWBE + OKCE group.
Figure 2
Figure 2
CONSORT flow diagram of participant recruitment, randomization, allocation, and follow-up.
See this image and copyright information in PMC

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