Effect of Tissue Flossing, AIS, PNF on Hamstring Among Knee OA Patients
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      Tissue flossing has been known to produce results such as pain relief and improved range of
      motion, this technique might yield positive results in knee OA patients as well. These
      effects can further be compared with existing treatment method for treatment of hamstring
      such as Active isolated stretch and Proprioceptive Neuromuscular facilitation. This study
      will be among the first to carry out the technique of flossing in knee OA patients.
    

Detailed description: 
      Arthritis is a broad term that encompasses a large number of diseases that affects one or
      more joints of the body. Amongst all other forms, Osteoarthritis (OA) is the most prevalent.
      Osteoarthritis is widespread throughout the world. It is one of the top leading causes of
      disability on a global scale. Previously this disease was thought to simply be due to
      biomechanical disturbances causing 'wear and tear' thus giving the characteristic feature of
      articular destruction leading to stiffness, inflammation and loss of mobility of joints over
      a long period of time. Due to recent advances in this area of study, evidence has revealed
      that OA has a collection of a much more complex multifactorial process composed of
      inflammatory and metabolic factors.

      Typical clinical symptoms found in patients with Osteoarthritis include severe joint pain,
      stiffness, and significantly reduced mobility, which leads to decreased productivity and
      quality of life among the patients . Osteoarthritis can develop in any joint of the human
      body but the most frequently affected are the knees, hips, hands, facet joints and feet. This
      disease not only has an impact on the patient but in addition it also gives rise to an
      increased socioeconomic burden on the society. In 2005, it was estimated that over 26 million
      people in the USA had some form of OA. An estimated 30.8 million adults in the United States
      and 300 million individuals worldwide are living with OA. The severity of the Osteoarthritis
      can be categorized according Kellgren-Lawrence Grading System for Osteoarthritis.

      Osteoarthritis frequently affects the weight bearing joints of the body. Knee OA has a high
      prevalence and is a disabling joint disease. The OA of the knee joint almost accounts for
      more than 80% of the disease's total burden and it affects no less than 19% of American
      adults aged 45 years and older. The knee joint Osteoarthritis is not only more important for
      its high prevalence rate in comparison to other types of OA but also for its presentation at
      earlier age groups. The incidence of knee OA increases by age and further increases with
      longer lifetime. The prevalence is found to be higher in females as compared to males.
      Participation in sports, injury to the joint, high BMI, and genetic susceptibility are also
      some factors that predispose individuals to the development of Knee osteoarthritis. Previous
      knee trauma increases the risk of knee OA 3.86 times. Overall an estimate of 80% of patients
      with knee OA suffer from some form of movement restriction, while 20% are unable to perform
      basic daily activities; indeed, 11% of sufferers require personal care. Amongst the cardinal
      symptoms of OA, pain is the biggest concern, and motor disability and impaired proprioception
      are important secondary factors.

      Proprioceptive neuromuscular facilitation (PNF) technique has already been found to have
      beneficial effects in improving hamstring flexibility and reducing pain in the knee joint of
      knee OA patients. Active isolated stretch is also found to be effective to increase
      flexibility and improve ROM.

      Tissue flossing is a relatively new technique to be introduced in the world of research.
      Tissue flossing is a new method that aims to improve range of motion (ROM), reduce pain,
      prevent injury, or enhance recovery. Since its arrival the technique has been researched upon
      mainly on the athletic population. Tissue flossing is a technique that requires wrapping of a
      thick rubber band around a joint or muscle concomitantly performing ROM tasks for 1-3
      minutes. The results include increase in range of motion and a decrease in pain of the
      effected muscles. The phenomenon behind getting results through this technique is
      hypothesized to be blood reperfusion to an occluded area via tissue flossing augments
      exercise performance mechanisms such as growth hormone, catecholamine responses, muscle force
      contractility and the efficiency of excitation-contraction coupling in the muscles. In
      addition, tissue flossing may influence fascia tightness via the fascial mechanoreceptors,
      therefore reducing muscle activity, resulting in a greater ROM. Nevertheless, the underlying
      mechanism for tissue flossing, these mechanisms remain speculative.
    

Intervention name(s): Tissue Flossing; Active Isolated Stretch; Proprioceptive Neuromuscular Facilitation
Intervention type(s): Other; Other; Other
Intervention description(s): Tissue flossing is a technique that requires wrapping of a thick rubber band around a joint or muscle concomitantly performing ROM tasks for 1-3 minutes. The results include increase in range of motion and a decrease in pain of the effected muscles. The phenomenon behind getting results through this technique is hypothesized to be blood reperfusion to an occluded area via tissue flossing augments exercise performance mechanisms such as growth hormone, catecholamine responses, muscle force contractility and the efficiency of excitation-contraction coupling in the muscles. In addition, tissue flossing may influence fascia tightness via the fascial mechanoreceptors, therefore reducing muscle activity, resulting in a greater ROM. Nevertheless, the underlying mechanism for tissue flossing, these mechanisms remain speculative.; AIS is a specific stretching program developed by Aaron Mattes. This technique is based on these four basic principles:
Isolate the muscle to be stretched. Repeat the stretch eight to 10 times. Hold each stretch for no more than two seconds. Exhale on the stretch; inhale on the release.; Proprioceptive neuromuscular facilitation (PNF) technique has already been found to have beneficial effects in improving hamstring flexibility and reducing pain in the knee joint of knee OA patients
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Tissue Flossing; Active Isolated Stretch; Proprioceptive Neuromuscular Facilitation; Knee Osteoarthritis; Pain; Range of motion