Implementation, preliminary efficacy, and outcomes of TUCK exercise program in individuals with Knee Osteoarthritis: a feasibility pilot study

BACKGROUND: Core strengthening exercises are recommended for the management of knee osteoarthritis (KOA). However, individualized, self-adjustable exercise programs may maximize benefits, improve adherence, and reduce risk. This pilot trial aimed to assess the feasibility of the TUCK core strengthening exercise programs and its preliminary clinical effectiveness on core strength, functional mobility, gait parameters, pain and function in adults with KOA. METHODS: In a preliminary randomized feasibility trial, 60 adults with unilateral or bilateral KOA were recruited from multiple centers and randomized into the TUCK exercise group or a standard physiotherapy group. Both interventions were delivered over 12 weeks, with assessments at baseline, week 6, and week 12. Feasibility was evaluated via recruitment, adherence and retention. Clinical effectiveness was assessed for core strength (ADIM and KLAT), functional mobility (TUG and 4-Meter Walk Test), gait parameters (stride length, double support time), pain (NPRS), and physical function (KOOS-PS), Statistical analysis included paired and independent-t-test for continuous variables, chi-square tests for categorical variables, and effect sizes (Cohen’s d). Significance was set at P < 0.05, with 95% confidence intervals reported for between-group differences. RESULT: The TUCK was feasible, with more than 80% participants satisfaction and high adherence. The experimental group showed significant improvements in dynamic core strength (KLAT) compared with control: mean difference = 3.7mmHg, 95% CI [2.5, 5.2], P<0.001, Cohen’s d=0.74. Both groups demonstrated significant within-group improvements in TUG, 4MWT, stride length, NPRS, and KOOS-PS (P< 0.05). Between-group differences in functional mobility and gait were generally small to moderate, reflecting baseline variability. CONCLUSION: The TUCK exercise program is feasible, safe and demonstrates potential for effectiveness in improving core strength, functional mobility, gait, pain and physical function among adults with KOA. These findings support the rationale for a larger definitive randomized trial.