title: Agility and perturbation training for a physically active individual with knee osteoarthritis.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physical Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, 6035 Forbes Tower, Pittsburgh, PA 15260, USA. kfitzger@pitt.edu
authors.forename: G Kelley
authors.initials: GK
authors.lastname: Fitzgerald
authors.forename: John D
authors.initials: JD
authors.lastname: Childs
authors.forename: Tara M
authors.initials: TM
authors.lastname: Ridge
authors.forename: James J
authors.initials: JJ
authors.lastname: Irrgang
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology / Q000534:rehabilitation*; D007719:Knee Joint / Q000503:physiopathology*; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation*; D016730:Program Development