Clinical trials

This randomized controlled trial aims to evaluate the effectiveness of a newly developed Modified Structured Telerehabilitation Intervention Protocol (MSTITP) compared with conventional in-person physical therapy in patients recovering from Total Knee Arthroplasty (TKA). The study also explores whether a hybrid rehabilitation approach may further optimize patient outcomes. A total of eligible participants aged 50-65 years who have undergone primary TKA will be randomly assigned to one of two groups: Group A (Intervention): Telerehabilitation-based structured exercise program (MSTITP) delivered through digital platforms with remote supervision. Group B (Control): Standard conventional face-to-face physiotherapy in a clinical setting. Both groups will receive rehabilitation programs of equal duration focusing on pain management, range of motion (ROM), muscle strengthening, gait training, and functional mobility. The primary objective is to compare the effectiveness of telerehabilitation and conventional therapy in improving pain, ROM, and gait performance. Secondary objectives include evaluation of exercise adherence, kinesiophobia, functional outcomes, quality of life, and patient satisfaction. Additionally, the study will explore whether integrating telerehabilitation with conventional rehabilitation could provide superior outcomes. Outcome assessments will be conducted using validated tools including pain scales (VAS), goniometric ROM measurements, gait analysis, functional performance tests, and standardized questionnaires for quality of life, exercise adherence, and fear of movement. This study addresses the increasing burden of osteoarthritis and the growing number of TKA procedures in Pakistan. Telerehabilitation may offer a cost-effective, accessible, and scalable rehabilitation model that ensures continuity of care and improved access to physiotherapy services, particularly in resource-limited settings. The findings of this trial are expected to provide evidence for developing standardized, technology-assisted rehabilitation protocols to improve post-TKA recovery outcomes and reduce healthcare burden.

The goal of this clinical trial is to learn if knee extensor training with different protocols works to treat LBP in adults.. The main questions it aims to answer are: What are the comparative effects of open and closed kinetic chain knee extensor strengthening exercises versus lumbar stabilization exercises on lumbar curvature, postural control, and disability in individuals with non-specific low back pain? 1.4.2. How does open kinetic chain knee extensor strengthening affect pain, functional capacity, and lumbar spine stability compared to closed kinetic chain exercises in individuals with non-specific low back pain? 1.4.3 What is the effect of open kinetic chain knee extensor strengthening on pain, functional capacity, and lumbar spine stability compared to conventional lumbar muscle exercises in individuals with non-specific low back pain? 1.4.4 What is the effect of closed kinetic chain knee extensor strengthening on pain, functional capacity, and lumbar spine stability compared to conventional lumbar muscle exercises in individuals with non-specific low back pain? 1.4.5 What is the effect of open kinetic chain knee extensor strengthening on pain, functional capacity, and lumbar spine stability in individuals with non-specific low back pain? 1.4.6 What is the effect of close kinetic chain knee extensor strengthening on pain, functional capacity, and lumbar spine stability in individuals with non-specific low back pain? 1.4.7 What is the effect of conventional lumbar extensor strengthening on pain, functional capacity, and lumbar spine stability in individuals with non-specific low back pain Researchers will compare three different exercise protocols to a control group (will not receive exercise) to see if knee extensor training has an effect on problems associated with LBP. Participants will: * Exercise three times per week for 8 weeks * Be assessed before, 4 weeks after, and 8 weeks after intervention

The novelty of thisstudy lies in its comparative assessment of three latest intra-articular injection therapies including steroid injections, dextrose prolotherapy, and PRP, for knee OA associated impairments, with a focus on long-term efficacy and safety profile. While prior studies may have assessed one or two of these treatments individually therefore this protocol is systematically designed.