Ergon Technique Versus PNF Stretching on Hamstring Flexibility in Knee Osteoarthritis

NCT ID: NCT05110326

Last Updated: 2023-03-17

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 57 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2022-01-10
• Study Completion Date: 2022-06-25

Brief Summary

The study will be a randomized control trial and will be conducted in Pakistan Railway Hospital Rawalpindi. A sample of 60 participants will be taken. Patients will be divided into two groups (A&B) of 30 participants in each group by sealed envelope method. Hot pack will be applied to both groups for 15 minutes at the start of intervention. ERGON Technique(IASTM) will be applied to group A along with strengthening exercise. Proprioceptive Neuromuscular Facilitation (PNF) stretching will be given to group B along with strengthening exercise. A 35 minute session will be given to the patients and 3 sessions will be given once a week. Intervention will be given for 6 weeks. The outcome measure will be Visual analog Scale (VAS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Active Knee Extension Test (AKE) will be measured at baseline and at the end of 6th week. Data will be analyzed by SPSS 22.

Conditions

Knee Osteoarthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

ERGON Technique Group

Patients in this group will receive ERGON Technique along with conventional therapy

Group Type: EXPERIMENTAL

ERGON Technique

Intervention Type: OTHER

• Hot pack for 15 minutes.
• Patient position: Prone with knee flexion approximately 45◦.
• Position of therapist: Standing at the affected side of patient.
• Technique:Massage cream will be applied on the hamstring and overactive or short muscle fibres that are restricted.The instrument will be applied parallel to the muscle fibers, both in a distal to proximal and them proximal to distal direction as needed.Then gentle massage stroking from the origin to the insertion will be performed using the instrument. Instrument Assisted Soft Tissue Mobilization(IASTM) will be applied for 5 minutes.
• Strengthening exercises for quadriceps and hamstring will then be performed.
• Isometrics exercises of Quadriceps: By placing a towel roll below the knee and press and hold for 20 seconds, 5 sets.
• Isometrics exercises Hamstrings: By placing a towel roll below the knee and press and hold for 20 seconds, 5 sets.
• Wall sits: For 10 seconds, 5 sets.

Proprioceptive Neuromuscular Facilitation(PNF) stretching Group

Patients in this group will receive Proprioceptive Neuromuscular Facilitation (PNF) stretching along with conventional therapy

Group Type: EXPERIMENTAL

Proprioceptive Neuromuscular Facilitation (PNF) stretching

Intervention Type: OTHER

• The patient will be laid down prone and moist heat will be given for 15 minutes prior to stretching the hamstrings.
• Then patient will be lying supine with hip in 90⁰ of flexion. Patient's knee will be extended until a very mild stretching sensation is felt in hamstring muscles.
• Then patient will be asked to flex the knee against the resistance applied by hand of therapist.
• The patient will be asked to use a force of around 50% of maximal strength and an isometric form of contraction will be gained in the hamstring muscles. The patient will hold the contraction for 8 seconds and then the therapist command to relax the hamstring muscle.
• Immediately after the muscle relaxation the therapist further stretches the hamstring muscles up to a point where the subject reported a mild to moderate stretching sensation without any pain and will be held for 30 seconds.
• The procedure will be repeated 3 times in every session.

Strengthening Exercises:

• Same as ERGON Group

Interventions

ERGON Technique

• Hot pack for 15 minutes.
• Patient position: Prone with knee flexion approximately 45◦.
• Position of therapist: Standing at the affected side of patient.
• Technique:Massage cream will be applied on the hamstring and overactive or short muscle fibres that are restricted.The instrument will be applied parallel to the muscle fibers, both in a distal to proximal and them proximal to distal direction as needed.Then gentle massage stroking from the origin to the insertion will be performed using the instrument. Instrument Assisted Soft Tissue Mobilization(IASTM) will be applied for 5 minutes.
• Strengthening exercises for quadriceps and hamstring will then be performed.
• Isometrics exercises of Quadriceps: By placing a towel roll below the knee and press and hold for 20 seconds, 5 sets.
• Isometrics exercises Hamstrings: By placing a towel roll below the knee and press and hold for 20 seconds, 5 sets.
• Wall sits: For 10 seconds, 5 sets.

Intervention Type: OTHER

Proprioceptive Neuromuscular Facilitation (PNF) stretching

• The patient will be laid down prone and moist heat will be given for 15 minutes prior to stretching the hamstrings.
• Then patient will be lying supine with hip in 90⁰ of flexion. Patient's knee will be extended until a very mild stretching sensation is felt in hamstring muscles.
• Then patient will be asked to flex the knee against the resistance applied by hand of therapist.
• The patient will be asked to use a force of around 50% of maximal strength and an isometric form of contraction will be gained in the hamstring muscles. The patient will hold the contraction for 8 seconds and then the therapist command to relax the hamstring muscle.
• Immediately after the muscle relaxation the therapist further stretches the hamstring muscles up to a point where the subject reported a mild to moderate stretching sensation without any pain and will be held for 30 seconds.
• The procedure will be repeated 3 times in every session.

Strengthening Exercises:

• Same as ERGON Group

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Unilateral/bilateral osteoarthritis
• Participants with unilateral/bilateral hamstring tightness
• 200 from Active Knee Extension test
• Grade 1 and 2 in Kellgren and Lawrence criteria for knee osteoarthritis

Exclusion Criteria

• Participant failing to fall in the category below will be excluded from the study:
• Any lower extremity injury in past 3 months
• Any fracture or surgery done for pelvis, hip or knee.
• Any neurological symptoms.
• Any recent knee reconstructive surgery
• Burns of lower extremities
• Other musculoskeletal disorders associated with knee joint, Iliotibial band, adductor muscle and Sartorius muscle tightness

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 50 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Waqar Ahmed Awan, PhD

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

RHS Rehabilitation Centre

Islamabad, , Pakistan

Countries

Pakistan

Other Identifiers

Narmeen Anjum

Identifier Type: -

Identifier Source: org_study_id