{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:07:59Z","timestamp":1772168879433,"version":"3.50.1"},"update-to":[{"DOI":"10.12688\/f1000research.140342.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000}},{"DOI":"10.12688\/f1000research.140342.2","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000}},{"DOI":"10.12688\/f1000research.140342.3","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000}}],"reference-count":54,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T00:00:00Z","timestamp":1726444800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"<ns3:p>Background Knee osteoarthritis affects the performance of daily activities, independence, and quality of life. The etiopathogenesis of this condition considers the mechanisms of activation of metalloproteinase and reactive oxygen species production pathways. Metalloproteinases-3 (MMP-3) and Glutathione Peroxidase (GPx) may be responsible for cartilage destruction. Aquatic physiotherapy promotes a positive impact on the clinical picture of osteoarthritis, and this study presents an intervention protocol that aims to evaluate the effects of a single session of different aquatic physiotherapy modalities on the biochemical and functional behavior of patients with knee osteoarthritis. Methods This will be a crossover randomized controlled trial in which 15 individuals will be submitted to three aquatic physiotherapy modalities with a minimum 15-day wash-out period in patients over 50 years old and diagnosed with OA in at least one knee, presence of pain and at least one functional dysfunction for at least 6 months, absence of physical limitation that prevents the exercise protocol from being performed, Kellgren and Lawrence ranking between I and IV, walk independently and without auxiliary device. Variations in the concentrations of MMP-3 and GPx in peripheral blood, pain, edema, and flexibility resulting from the three aquatic physiotherapeutic interventions will be evaluated both pre- and immediate post-intervention. The reference group will be submitted to the same aquatic physiotherapy protocols, however, only the biochemical parameters and the self-perception questionnaires will be evaluated. Registration ClinicalTrials.gov (NCT05610696, 18\/01\/2023).<\/ns3:p>","DOI":"10.12688\/f1000research.140342.4","type":"journal-article","created":{"date-parts":[[2024,9,16]],"date-time":"2024-09-16T11:25:09Z","timestamp":1726485909000},"page":"1605","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of a low, medium, and high-intensity aquatic physiotherapy protocol on functional and biochemical parameters in individuals with knee osteoarthritis: protocol for a crossover randomized controlled trial"],"prefix":"10.12688","volume":"12","author":[{"given":"Cesar","family":"Augusto Teixeira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisete","family":"Haas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruna","family":"Frata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andressa","family":"Fiori Bortoli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Scalco Acco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1090-2828","authenticated-orcid":false,"given":"Gustavo","family":"de Castro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda","family":"Cechetti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2560","published-online":{"date-parts":[[2024,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"91","DOI":"10.3390\/sports11040091","article-title":"High-Intensity Training for Knee Osteoarthritis: A Narrative Review.","volume":"11","author":"D Tarantino","year":"2023","journal-title":"Sports."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"193-202","DOI":"10.1590\/S0103-51502013000100022","article-title":"Exerc\u00edcios f\u00edsicos e osteoartrose: uma revis\u00e3o sistem\u00e1tica.","volume":"26","author":"V Duarte","year":"2013 Mar","journal-title":"Fisioterapia em Movimento."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"33-40","DOI":"10.1177\/0269215518792041","article-title":"The efficacy of a muscle exercise program to improve functional performance of the knee in patients with osteoarthritis.","volume":"85","author":"V Kuptniratsaikul","year":"2002 Jan","journal-title":"J. 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Given the high global prevalence of this pathology, we understand the significance of this study. Similarly, we uphold our intervention strategy within a safe physiotherapeutic approach represented by Aquatic Physiotherapy. Therefore, we aim to investigate the relationship between the behavior of two biochemical variables involved in the pathogenesis of knee osteoarthritis in Aquatic Physiotherapy programs of varying intensities. We hope our findings may eventually contribute to an exercise prescription with reduced production of biochemical agents responsible for collagen degradation. We acknowledge this as a significant challenge for physiotherapists dedicated to knee osteoarthritis treatment using Aquatic Physiotherapy. Based on your contributions, we have sought to reinforce this issue in the Introduction and discussion sections. Regarding the sample size, we relied on two previous studies that analyzed the biochemical variables under study. These studies were conducted on individuals with knee osteoarthritis undergoing exercise. This consideration is stated in the article's Methods section. To minimize any potential doubts, we clarify the essence of the previous studies in the text, specifically concerning the profile of the subjects investigated. Finally, as per your suggestion, we propose a new layout for Figure 1.","URL":"https:\/\/f1000research.com\/articles\/12-1605\/v4#referee-comment-11287","order":1,"name":"referee-comment-11287","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.163915.r265791, Onu Ilie, Department of Biomedical Sciences, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, Iasi, 04 Jun 2024, version 2, 2 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/12-1605\/v2#referee-response-265791","order":2,"name":"referee-response-265791","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"<b>Gustavo de Castro<\/b>; \n<i>Posted: 17 Jun 2024<\/i>; Dear Reviewer,  We appreciate the feedback and would like to address our considerations based on the reviewed items as follows:  \n<b>15 patients are too few to validate a study:<\/b> To investigate the necessary number of participants and estimate the immediate effects of exercise in different Aquatic Physiotherapy programs on the concentration levels of the joint biomarkers MMP-3 and oxidative stress, we performed a sample size calculation using GPower software, version 3.1.9.7. The input parameters included a one-tailed test, an estimated effect size of 1.0, a significance level of 0.05, and a statistical power of 0.95. This calculation assumed a normal distribution, aiming to detect differences between groups and repeated measures (within-subject effect). Previous studies, such as those by Germanou (2013) and Nascimento (2016), were used to estimate the parameters. Germanou demonstrated variation in oxidative stress, and Nascimento observed significant variation in MMP-2 and MMP-9. The GPower results were as follows: the non-centrality parameter (\u03b4) was 3.8, indicating a moderate effect on biomarker variations, the critical t-value was 2.10, the degrees of freedom (df) were 16.143, resulting in a total sample size of 15 participants and an actual power of 0.95. These results demonstrate that the effects of the markers used in the referenced articles show a moderate response to exercise, with sufficient homogeneity for a sample size of 15 individuals. We have included this information in the third paragraph of the Trial Design section. \n<b>GIFs in tables cannot be viewed:<\/b> The figures in all tables are static and, according to our access, are available on the website where the article is published (https:\/\/f1000research.com\/articles\/12-1605\/v2#referee-response-265791). They are also visible in the PDF version. We will report your observation to the publisher, who should find a solution to make them viewable directly on the website. This adjustment depends on the publisher and not the authors. \n<b>The study does not include limitations:<\/b> We appreciate the suggestion, and the limitations have been included in the text. \n<b>To be replicated, the study should have patients who fall into one KL classification (e.g., KL3 or KL4):<\/b> We have addressed this suggestion, and the change has been included in the new version of the article. \n<b>A control group should be included in the study:<\/b> We confirm that we have a control group. The last sentence of the Eligibility Criteria section states: &quot;For control purposes, a reference group will be constituted with age matching and exclusion criteria identical to the experimental group.&quot;  Sincerely,  Cesar Augusto Teixeira","URL":"https:\/\/f1000research.com\/articles\/12-1605\/v4#referee-comment-11800","order":3,"name":"referee-comment-11800","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.171009.r324080, Domiziano Tarantino, University of Naples Federico II, Naples, 17 Sep 2024, version 4, indexed","URL":"https:\/\/f1000research.com\/articles\/12-1605\/v4#referee-response-324080","order":4,"name":"referee-response-324080","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":5,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}