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Agility and Perturbation Training for a Physically Active Individual With Knee Osteoarthritis

GK Fitzgerald, PT, PhD, OCS, is Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260 (USA) (kfitzger{at}pitt.edu).
JD Childs, PT, MPT, MBA, OCS, CSCS, Capt, US Air Force, is a doctoral student in the Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
TM Ridge, PT, MS, CSCS, is Staff Physical Therapist, Center for Sports Medicine, University of Pittsburgh Medical Center, and Adjunct Instructor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh
JR Irrgang, PT, PhD, ATC, is Assistant Professor, Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh

Address all correspondence to Dr Fitzgerald

Background and Purpose. People with knee osteoarthritis (OA) sometimes report episodes of knee instability that limit their activities of daily living. The episodes of instability are similar to those reported by people with knee ligament injuries. The authors believe that modifications of interventions that are used to promote knee stability in individuals with knee ligament injuries can be used to enhance knee stability and function in people with knee OA. The purpose of this case report is to describe the development and implementation of an agility and perturbation training program that was used in conjunction with traditional rehabilitation activities for a patient with knee OA. Case Description. The patient was a 73-year-old woman with a diagnosis of bilateral knee OA. Her chief complaints were knee pain and episodes of partial"giving way" at the knee during walking, stair climbing, and participation in tennis and golf. The patient participated in 12 treatment sessions at a frequency of 2 visits per week. The rehabilitation program consisted of lower-extremity stretching, strengthening and endurance exercises that were supplemented with a variety of walking-based agility training techniques, and perturbation training techniques. Outcome. At the completion of rehabilitation, the patient was able to walk on level surfaces and stairs and return to playing golf and tennis without episodes of instability and with reduced pain. Discussion. Supplementing rehabilitation programs for people with knee OA with a modified agility and perturbation training program may assist them in returning to higher levels of physical activity with less pain and instability following rehabilitation. Further research is needed to determine the role of agility and perturbation training in people with knee OA.

Key Words: Agility • Exercise • Knee • Osteoarthritis • Perturbation

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