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Comparison of closed kinetic chain quadriceps and gluteal strength training with open kinetic chain quadriceps and gluteal strength training on pain in runners with patellofemoral knee osteoarthritis: a randomized controlled trial

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INTRODUCTION: Quadriceps and gluteal strength training is considered one of the main treatments for improving symptoms in patients suffering from knee osteoarthritis (KOA). This type of intervention appears to be of interest to runners suffering from this pathology, in view of the benefits of strength training in their discipline, particularly with its emphasis on eccentric work. However, most studies have focused on the effects of open kinetic chain (OKC) strength training on non-athletic subjects and on patients suffering from tibiofemoral KOA (TF KOA). The aim of this study is to compare the effects of two quadriceps and gluteal strength trainings, one in OKC and the other in closed kinetic chain (CKC), on pain, quadriceps and gluteal strength, function and running biomechanics in runners with patellofemoral KOA (PF KOA). METHODS: This study will be a randomized, controlled, multi-centre, single blind (assessors) trial with repeated assessment at baseline, week 12 and week 25. To be included in the study, subjects (males or females) must be aged between 30 and 50, have a running training volume between 50 and 100 kilometres, present a PF KOA of at least grade 2 on the Kellgren-Lawrence scale and already have at least one session of lower-limb strength training per week in the gym. Each subject will be allocated to one of the two study groups and will perform, on their side, CKC or OKC quadriceps and gluteal training for 12 weeks, with 2 sessions per week in addition to their running training. Pain, using the Brief Pain Inventory Short Form (BPISF), will be assessed as a primary outcome. Quadriceps and gluteal strength with the BiodexSystem 4 dynamometer, function with the Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire and running biomechanics with the RunScribe wearable device will be evaluated as secondary outcomes. Statistical analysis will be performed with repeated measures ANOVA and statistical significance at 0.05. DISCUSSION: The expected results are that CKC quadriceps and gluteal strength training will result in greater improvement on pain, quadriceps and gluteal strength, function and running biomechanics compared to OCK quadriceps and gluteal strength training in runners with PF KOA

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