Exploring the impact of integrated polyvagal exercises and knee reinforcement in females with grade II knee osteoarthritis: a randomized controlled trial

Author: Moattar Raza Rizvi1, Ankita Sharma1, Shahnaz Hasan2, Fuzail Ahmad3, Mohammad Rehan Asad4, Amir Iqbal5, Ahmad H Alghadir6
1 Department of Physiotherapy, School of Allied Health Science, Manav Rachna International Institute of Research and Studies, Faridabad, 121004, India.
2 Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, 11952, Saudi Arabia.
3 Respiratory Care Department, College of Applied Sciences, Almaarefa University, Ad Diriyah, 13713, Saudi Arabia.
4 Department of Basic Sciences, College of Medicine, Majmaah University, Al-Majmaah, 15341, Saudi Arabia.
5 Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia. ajamaluddin@ksu.edu.sa.
6 Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box. 10219, Riyadh, 11433, Saudi Arabia.
Conference/Journal: Sci Rep
Date published: 2023 Nov 3
Other: Volume ID: 13 , Issue ID: 1 , Pages: 18964 , Special Notes: doi: 10.1038/s41598-023-45908-4. , Word Count: 263

This study aimed to compare the effects of knee strengthening exercises to those of polyvagal theory-based exercises combined with knee strengthening exercises on selected outcomes in women with grade II knee osteoarthritis (OA). A randomized controlled trial was conducted, in which 60 female participants diagnosed with grade II knee OA, with a mean age of 57.27 ± 7.81 years and knee pain rated between 4 and 7 on the visual analog scale (VAS), were assigned to either the knee strengthening exercise group (Group 1, n = 30) or the polyvagal theory-based exercise plus knee strengthening exercise group (Group 2, n = 30). Pre- and posttreatment assessment of outcome variables, including WOMAC scores (joint pain, joint stiffness, functional limitations, and the overall index), WHOQOL scores (overall quality of life, general health, physical, psychological, social, and environmental domains), and heart rate variability (HRV, time and frequency domains), were analyzed. Group 2 demonstrated significantly greater reductions in joint pain, stiffness, and functional limitations than Group 1 after the intervention. Group 2 presented with significantly improved WOMAC scores, indicating better overall outcomes. Group 2 showed significant improvements in the psychological and social domains regarding quality of life. There were no significant differences in the physical domain or the environmental domain. Group 2 showed a significant increase in high-frequency power (HF) and a significant decrease in the LF/HF ratio, suggesting improved autonomic regulation. A combination of polyvagal exercise and knee strengthening training resulted in superior outcomes compared to knee strengthening exercises alone in women with grade II knee OA. These findings support the potential effectiveness of incorporating polyvagal exercises as an adjunctive intervention for osteoarthritis management.

PMID: 37923783 PMCID: PMC10624888 DOI: 10.1038/s41598-023-45908-4