Related Experiment Video
Updated: Sep 11, 2025

The Lower Body Positive Pressure Treadmill for Knee Osteoarthritis Rehabilitation
Published on: July 22, 2019
Effectiveness Of The Core Activation And Rehabilitation Exercises For Knee Osteoarthritis - Program (CARE -KOA ©)
Dias Tina Thomas1, Charu Eapen1, Atmananda S Hegde2
1Department of Physiotherapy, Kasturba Medical College Mangalore, Manipal Academy of Higher Education, Manipal, India.
Background:
Knee osteoarthritis (KOA) is a prevalent condition. Recent research highlights the role of kinetic chain and core muscle involvement in disease progression, yet evidence for structured core activation protocols such as CARE-KOA© remains limited.This study addresses this gap by evaluating the effectiveness of CARE-KOA©, which specifically targets proximal stability and biomechanical deficits in KOA, aiming to enhance pain, function, and core endurance beyond conventional approaches.
Methods:
This prospective single-group pre-post study assessed the effect of a Participants underwent a 4-week CARE-KOA© regimen (12 supervised sessions, each including a 10-minute warm-up and core-focused exercises). Pre- and post-intervention assessments included pain (Visual Analog Scale, VAS), patient-reported outcomes (Knee Injury and Osteoarthritis Outcome Score, KOOS), physical function tests (30-second sit-to-stand, 40-meter fast-paced walk, stair climb, timed up-and-go), and knee muscle strength and core endurance. Statistical analysis was performed using non-parametric tests in JAMOVI.
Results:
Significant improvements were observed in pain at rest (mean change: 1.13 cm, p = 0.0006, d = 1.07) and during activity (mean change: 2.46 cm, p = 0.000001, d = 1.76), patient-reported outcomes (KOOS Pain: p = 0.00003, d = -0.83; KOOS ADL: p = 0.0000009, d = -1.19), and core endurance (p = 0.027, d = 0.21). Physical function tests also improved (stair climb: p = 0.031, d = 0.34; timed up-and-go: p = 0.006, d = 0.13). Muscle strength gains were significant in flexors of the unaffected knee and extensors of the affected knee (p < 0.05), while other muscle groups showed no significant change.
Conclusion:
The CARE-KOA© program led to clinically meaningful improvements in pain, function, and core endurance, highlighting the value of core activation strategies in KOA management. Future research with larger samples and longer follow-up is warranted to confirm these benefits and optimize exercise protocols.
Study Trial Registration:
CTRI/2023/07/05480 on 05/07/2024 https://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=69416.70327 Copy right registration: L - 158197/2024.
Related Concept Videos
Knee Joint
A total of seven ligaments support the knee joint. The patellar ligament, which is also attached to the quadriceps femoris...
Chest Physiotherapy
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
Exercise and Muscle Performance
Endurance exercises
Endurance exercises involve running, swimming, or cycling, which require repetitive movements with low force output. When a person engages in endurance exercise, a few noticeable changes occur in their skeletal muscles. For instance, the number of capillaries...
Peripheral Artery Disease III: Interprofessional Care

