Key result
Combined polyvagal and knee strengthening exercises significantly improved overall WOMAC scores (Cohen's d 2.46) compared to knee strengthening alone in women with grade II knee osteoarthritis.
Why the study?
The study aimed to compare the effects of knee strengthening exercises alone versus polyvagal theory-based exercises combined with knee strengthening exercises in women with grade II knee osteoarthritis.
Does the addition of polyvagal theory-based exercises to knee strengthening exercises improve pain, functional limitations, quality of life, and autonomic regulation in females with grade II knee osteoarthritis?
RCT (n=60)
None
1:1 allocation ratio using sealed envelopes
No
Does the addition of polyvagal theory-based exercises to knee strengthening exercises improve pain, functional limitations, quality of life, and autonomic regulation in females with grade II knee osteoarthritis?
Standardized Mean Difference: 2.46 (95% CI 1.71–3.19)
Absolute Event Rate: 30.6% vs 43.72%
p-value: p=<0.001
Incorporating polyvagal exercises alongside knee strengthening significantly improves pain, function, quality of life, and autonomic regulation in women with grade II knee osteoarthritis.
May support adjunctive polyvagal exercises for women with grade II knee OA; extends autonomic-targeted rehab but leaves open durability and broader applicability.
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.
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Rizvi et al. (2023) conducted an RCT in Grade II knee osteoarthritis (n=60). Polyvagal theory-based exercises combined with knee strengthening exercises vs. Knee strengthening exercises alone was evaluated on WOMAC index score at 6 weeks (Cohen's d 2.46, 95% CI 1.71-3.19, p=<0.001). Combined polyvagal and knee strengthening exercises significantly improved overall WOMAC scores (Cohen's d 2.46) compared to knee strengthening alone in women with grade II knee osteoarthritis.
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