Effects of progressive neuromuscular training on pain, function, and balance in patients with knee osteoarthritis: a randomised controlled trial

Background: Sensorimotor dysfunction is one of the factors leading to advancement of knee osteoarthritis (OA). Limited evidence supports the use of neuromuscular training (NMT) incorporating all the elements of sensorimotor function viz. strength, balance, coordination, and proprioception, hence the current study aimed to evaluate the efficacy of NMT integrating all aspects of sensorimotor function on pain, function, and balance in patients with knee OA. Material and methods: This single-blinded RCT recruited 62 subjects (40-65 years) with KL grade II-Ill of knee OA, who were randomly allocated into two groups namely NMT or strengthening group (twice a week for 6 weeks). Outcomes were assessed for pain (NPRS), function (CRD version of WOMAC, PSFS, chair stand test, stair climb test, timed up and go test), and balance (Y-balance) at baseline and at the completion of the intervention. Results: 54 subjects completed the trial. Although both groups had significant improvement NMT was more effective (p value < 0.05) for most clinical outcomes of NPRS, Y-balance, and WOMAC with low-moderate effect size and objective functional tests - chair stand test and timed up and go test. Conclusion: NMT was more effective in improving the clinical outcomes of pain, function (except PSFS), and balance in subjects with KL grade II-Ill knee OA. Knee OA patients may benefit with addition of NMT to their intervention. However, due to limitations of low effect size, the results should be considered with caution.