Journal of Ecophysiology and Occupational Health · Mar 3, 2026
Effectiveness of Mcgill’s Big Three Exercises on Knee Osteoarthritis: A Randomized Controlled Trial
By Ganesan S, Sultana H
Background: Osteoarthritis (OA) is a degenerative joint condition causing pain, stiffness, and reduced mobility, significantly affecting quality of life. Knee OA is associated with gait and balance impairments, increasing fall risk in elderly individuals. Core stability exercises play a vital role in enhancing functional movement and reducing knee joint burden, yet evidence on their effectiveness in knee OA is limited. Aim: To determine the effectiveness of McGill’s Big Three exercises in patients with knee OA. Materials and Methods: A pretest-posttest randomized controlled trial was conducted on 36 subjects meeting the inclusion criteria, randomly assigned into two groups (n = 18 each). Group A received McGill’s Big Three exercises along with conventional management, while Group B received conventional management alone. Interventions were administered atleast 3 sessions/week, 25-30 minutes per session, for 6 weeks. Outcome measures included WOMAC, Timed Up and Go (TUG) test and Step test. Results: Group A demonstrated statistically significant improvements across all WOMAC domains, including pain (mean difference: 3.22, p = 0.001), stiffness (mean difference: 1.39, p = 0.039), physical function (mean difference: 10.56, p < 0.001), and total WOMAC score (mean difference: 15.39, p < 0.001). Functional performance also improved markedly in Group A, shown by a 3.32-second reduction in TUG time (p < 0.001) and an increase of 3 repetitions in the Step Test (p < 0.001). In contrast, Group B showed no significant change in any WOMAC domain (p > 0.05), with minimal improvements observed in TUG (0.88 seconds, p = 0.008) and the Step Test (0.39 repetitions, p = 0.004). Between-group analyses confirmed that Group A achieved significantly greater improvements across all outcome measures (p < 0.001). Conclusion: Incorporating McGill’s Big Three exercises into conventional physiotherapy significantly improves pain, reduces stiffness, and enhances physical function, mobility, and dynamic balance in individuals with knee osteoarthritis, demonstrating their effectiveness as an adjunct intervention. Major Findings: McGill’s Big Three exercises led to significant improvements in WOMAC pain (3.22, p = 0.001), stiffness (1.39, p = 0.039), physical function (10.56, p < 0.001), and total score (15.39, p < 0.001). Functional outcomes improved substantially, with TUG improving by 3.32 seconds (p < 0.001) and Step Test performance increasing by 3 repetitions (p < 0.001). Between-group comparisons confirmed the superior effectiveness of McGill’s Big Three, with all key outcomes favouring Group A (p < 0.05).