Initiating Rehabilitation with Open versus Closed Kinetic Chain Exercises in Patients with Degenerative Meniscal Tears: A Randomized Controlled Trial.

Abstract

To compare the effects of initiating rehabilitation program with open kinetic chain (OKC) versus closed kinetic chain (CKC) exercises on clinical outcomes in degenerative meniscal tears (DMT). Fifty-six patients with DMT were randomized to an 8-week one-on-one synchronous telerehabilitation program. For the first two weeks, rehabilitation was initiated with either OKC or CKC exercises. From weeks 3 to 8, both groups performed strengthening exercises targeting their assigned kinetic chain alongside identical functional exercises. The primary outcome was the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes included Visual Analogue Scale, active range of motion, isometric muscle strength, Lysholm Knee Scoring Scale, and Short Form-12 (SF-12). Both groups showed significant improvements in KOOS subscales after 8 weeks (P<0.05). However, the OKC group demonstrated greater improvements in KOOS Pain and Knee-related Quality of Life subscales, with mean differences of 12.01 (95% CI: 0.71-18.71) and 17.60 (95% CI: 4.84-30.36), respectively. Additionally, the OKC group showed superior results in pain intensity, isometric knee extensor strength, and the SF-12 Physical Component Score (P<0.05). Initiating rehabilitation with OKC exercises for the first two weeks might offer therapeutic advantages by enhancing early symptom management and quality of life in DMT.