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Table 3 Strengthening exercise protocol, with progressions (where applicable)

From: Technology versus tradition: a non-inferiority trial comparing video to face-to-face consultations with a physiotherapist for people with knee osteoarthritis. Protocol for the PEAK randomised controlled trial

Maximum of 6 exercises at any one time, performed three times/week

2 quadriceps strengthening exercises

1 hip abduction/gluteal strengthening exercise

1 hamstring/gluteal strengthening exercise

1 calf strengthening exercise

1 other exercise as appropriate

1. Quads strengthening

Knee extension

Non weight-bearing

Q1. Seated knee extension

Progression: Increase resistance with elastic band – red through to black

Non weight-bearing

Q2. Inner range quads over roll

 

Sit-to-stand

Weight-bearing

Q3. Sit to stand without using hands

Progression: lower chair height, hover above the seat without touching down, add resistance band around knees and push outwards while performing sit to stand

Weight-bearing

Q4. Asymmetrical chair stands (with more weight on arthritis leg)

 

Steps

Weight-bearing

Q5. Step-ups

Progression: Increase step height

Weight-bearing

Q6. Forward touch-downs from a step

Progression: Increase step height, don’t touch floor

Weight-bearing

Q7. Step-ups with weight

Progression: Increase step height, increase weight

Weight-bearing

Q8. Forward touch-downs with weight

Progression: Increase step height, increase weight

Wall squats

Weight-bearing

Q9. Partial wall squats

Progression: Halfway hold in bent-knee position, increase the amount of body weight taken through the arthritis knee.

Weight-bearing

Q10. Split leg wall squats

 

Controlled squats

Weight-bearing

Q11. Controlled squats (with back of chair support)

 

Controlled knee flexion/extension

Weight-bearing

Q12. Controlled knee flexion/extension with forwards/backwards sliding of opposite leg

 

Weight-bearing

Q13. Controlled knee flexion/extension with forwards/backwards sliding of opposite leg with elastic band

Progression: Increase resistance by changing elastic band colour – red through to black

Weight-bearing

Q16. Controlled knee flexion/extension with sideways sliding of opposite leg

 

Weight-bearing

Q17. Controlled knee flexion/extension with elastic band and sideways sliding of opposite leg

Progression: Increase resistance by changing elastic band colour – red through to black

Step to single leg balance

Weight-bearing

Q14. Step to standing balance on semi-flexed knee

 

Weight-bearing

Q15. Step to standing balance on semi-flexed knee with arm movements

 

2. Hip abductor/gluteal strengthening

Standing hip abduction

Non weight-bearing

HA1. Side leg raises in standing with elastic band.

Progression: Increase resistance by changing elastic band colour – red through to black, add halfway hold

 

Weight- bearing

HA3. Wall push with opposite leg, standing on straight arthritis leg

Progression: Hold weight in hand, increase the hold time

Weight- bearing

HA4. Wall push with opposite leg, standing on arthritis leg with deeper knee bending

 

Side stepping

Weight-bearing

HA2. Crab walking with elastic band

Progression: Increase resistance by changing elastic band colour – red through to black

3. Hamstring/gluteal strengthening

Supine bridging

Weight-bearing

HG1. Bridge with hold

 

Weight-bearing

HG2. Split leg bridge with hold

 

Weight-bearing

HG3. Single-leg bridge with hold

 

Standing knee flexion

Non weight-bearing

HG4. Hamstring curls standing over bench

 

Non weight-bearing

HG5. Hamstring curls standing over bench with elastic band

Progression: Increase resistance by changing elastic band colour – red through to black

Seated knee flexion

Non weight-bearing

HG6. Seated knee flexion with elastic band

Progression: Increase resistance by changing elastic band colour – red through to black

Standing hip extension

Non weight-bearing

HG7. Hip extension with knee bent (90°) standing over a bench

 

Non weight-bearing

HG8. Hip extension with knee straight standing over a bench

 

Non weight-bearing

HG9. Hip extension with knee straight with elastic band standing over a bench

Progression: Increase resistance by changing elastic band colour – red through to black

4. Calf strengthening

Standing plantar-flexion

Weight-bearing

C1. Double leg calf raises

 

Weight-bearing

C2. Single leg calf raises

 

Weight-bearing

C3. Double leg calf raises over edge of step

 

Weight-bearing

C4. Single leg calf raises over edge of step

 

5. Balance (if appropriate)

Tandem stance

Weight- bearing

B1. Maintain balance in tandem stance

Progression: remove hand support (if required), slowly raise arms in the air, eyes closed

Natural stance

Weight- bearing

B2. Maintain balance whilst tapping opposite foot forwards & backwards

 

Single leg stance

Weight- bearing

B3. Maintain balance in single leg stance

Progression: Increase hold time up, slowly raise arms up and down, eyes closed