Comparative effects of calisthenic and neuromuscular training on pain, balance, and functional limitation in patients with knee osteoarthritis: A Randomized Clinical Trial
Background: Knee osteoarthritis is a common and debilitating condition where exercise is a key management strategy. However, the effectiveness of calisthenics and neuromuscular exercises remains unclear. Objective: This study compared the effects of calisthenics and neuromuscular exercises on pain, balance, and functional limitations in patients with knee OA. Methods: This study (RIPHAH/FRAHS/letter-0891) was conducted at Railway General Hospital, Rawalpindi. Forty-two participants with knee osteoarthritis (Kellgren–Lawrence grades II–III) were recruited using convenience sampling and randomly allocated (n=21/group) into calisthenic and neuromuscular training groups. Both groups received supervised 45-minute treatment, 3 times weekly for six weeks. Outcomes were assessed at baseline, 3rd, and 6th week using Numeric Pain Rating Scale (NPRS), Mini-Best Test, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and Short Physical Performance Battery (SPPB). A two-way mixed ANOVA was performed to evaluate group × time interaction effect. When significant interaction effects were observed, one-way ANOVA and repeated-measures ANOVA was used for between and within-group comparisons respectively. Results: The group x time interaction effect was significant, with greater improvement in balance and functional performance for calisthenic group, where Mini-BESTest scores increased from 15.50±1.82 to 25.28±0.82, compared with 15.67±1.37 to 18.56±0.70 in the neuromuscular group (p<0.001; ?²=0.860). WOMAC score decreased from 78.89±7.23 to 46.44±4.06 in calisthenic group, and from 83.17±3.98 to 59.22±4.02 in neuromuscular group (p<0.001; ?²=0.295). Conclusion: This study concluded that both neuromuscular and calisthenic training are effective in reducing pain and improving physical function and balance in patients with KOA but calisthenic group exhibited greater reduction in functional limitation and balance performance. Clinical Trial Number: NCT05173649