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Table 2 Home exercise program protocol

From: Internet-mediated physiotherapy and pain coping skills training for people with persistent knee pain (IMPACT – knee pain): a randomised controlled trial protocol

Maximum of 6 exercises (with progression as appropriate)
  2 knee extensor strengthening exercises
  1 hip abductor strengthening exercise
  1 hamstring strengthening exercise
  1 calf strengthening exercise
  1 other exercise chosen based on assessment findings
1. Quads strengthening (each program must include 2 exercises)
Knee extension Non weight-bearing A. Seated knee extension (with resistance) with 5 second hold Indications: suggested as an initial exercise
Progression: Increase cuff weight or theraband resistance – red through to black
Simplification: eliminate weight or see 1B
Non weight-bearing B. Inner range quads over roll (with resistance) with 5 second hold Indications: Usually only required when any flair ups with seated knee extension (1A)
Progression: Use appropriate level of ankle cuff weight
Simplification: eliminate weight if flare up
Sit-to-stand Weight-bearing C. Sit to stand without using hands Indications: suggested as an initial exercise
Progression: lower chair height, hover above the seat without touching down, more weight on affected leg, slit leg position (affected leg closer to seat)
Simplification: use hands
Steps Weight-bearing D. Step-ups Indications: suitable progression from sit to stand (1C)
Progression: Increase step height, hold extra weight (in hands or backpack)
Simplification: sit to stand (1C)
Weight-bearing E. Forward touchdowns from a step Indications: suitable progression from step-ups (1D)
Progression: Increase step height, hold extra weight (in hands or backpack), don’t touch down
Simplification: step-ups (1D)
Partial squats Weight-bearing F. Partial wall squats Indications: suitable progression from sit to stand (1C)
Progression: Increase to 5 sec hold, more weight on study side)
Simplification: if find flare/problematic step back to sit to stand (1C)
2. Hip abductor strengthening (1 exercise)
Standing hip abduction Non weight-bearing A. Side leg raises in standing Indications: suggested as an initial exercise
Progression: Increase cuff weight or theraband resistance – red through to black
Simplification: eliminate weight
Side stepping Weight-bearing B. Crab walk with resistance band Indications: good progression from standing leg side raises (2A)
Progression: Increase theraband resistance – red through to black
Simplification: side leg raises in standing (2A)
Standing hip abduction Weight bearing C. Wall push standing on study leg Indications: good progression from crab walking (2B) and for variety at final session
Progression: Increase step height. Hold extra weight (in hands or backpack)
Simplification: If unable to tolerate static standing on joint then avoid and use 2B or 2A. Precaution in those with increased varus.
3. Hamstring strengthening (1 exercise)
Standing knee flexion Non weight-bearing Standing over bench knee curls with weight Progression: Increase cuff weight or theraband resistance – red through to black
Simplification: eliminate weight
4. Calf strengthening (1 exercise)
Standing plantar-flexion Weight-bearing Double heel raises Progression: single heel raises, raises from the edge of a step
5. Others (1 exercise if appropriate)
Knee ROM Weight bearing A. Deep squats holding onto a bench/chair Progression: increase squat depth
Hip ROM Weight bearing B. Deep lunges holding onto back of chair/bench Progression: increase lunge depth
Hip extensors Weight-bearing C. Bridging Progression: split leg bridge, single bridge with a hold, bridging one leg