Adding Deep Front Line Myofascial Release to Selected Exercises in Patients With Knee Osteoarthritis

Study Overview
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Brief Summary
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the aim of the study is to investigate the effect of deep front line myofascial release to selected exercises in patients with knee osteoarthritis

Detailed Description
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: Knee osteoarthritis (KOA) also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. The myofascial meridian is a new approach to the facial restriction .the knee capsules, the adductor muscles and the tipialis posterior are part of the deep front line which is a line of the myofascial meridian. Exercise is the highest evidence in the treatment of knee osteoarthritis. The myofascial release is effective in the treatment of knee osteoarthritis so the study will investigate the effect of adding deep front line myofascial release to selected exercises in patients with knee osteoarthritis.

Official Title
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Effects of Adding Deep Front Line Myofascial Release to Selected Exercises in Patients With Knee Osteoarthritis

Conditions
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Knee Osteoarthritis

Intervention / Treatment
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* Other: exercises
* Other: myofascial release


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Mild to moderate unilateral or bilateral medial tibiofemoral OA grade II-III (K/L). The age of the participants will range from 45 to 60 years old . BMI ranged from 20-30 kg/m2 Exclusion Criteria: Severe knee OA (grade IV according to K/L classification). Congenital or acquired inflammatory, rheumatic or neurological (systemic or local) diseases involving the knee. Patients receiving oral or injected corticosteroids for the last 3 months . History of knee surgery/fracture. Patients with ACL and meniscus injury

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: exercise plus myofascial release of the adductor and tipialis posterior muscles.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Sham Comparator: control group<br>it will receive selective exercises therapy in the form of strengthening and stretching exercises for selective muscles | Other: exercises<br>* strengthening of the gluteus maximus and medius, calf muscles stretching for calf and hamstring muscles<br>|
| Experimental: study group<br>it will receive selective exercises therapy in the form of strengthening and stretching exercises for selective muscles plus myofascial release technique of the deep front line | Other: exercises<br>* strengthening of the gluteus maximus and medius, calf muscles stretching for calf and hamstring muscles<br>Other: myofascial release<br>* myofascial release using instrument assisted soft tissue mobilization<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| pain intensity | The scale that will be used the visual analogue scale;each subject will instructed to record pain intensity on line of 100mm. Starting from no pain on the leftto the most sever pain imaginable on the right Patient will choose the point which describe his pain.the more the score toward the end the more severe pain | up to four weeks | 
| function | The Arabic version of reduced Western Ontario and McMasters University Osteoarthritis Index (ArWOMAC) index will be used to measure functional disability.is a self-administered questionnaire consisting of 24 items divided into 3 subscales: Pain (5 items): During walking, using stairs, in bed, sitting or lying, and standing upright Stiffness (2 items): After first waking and later in the day Physical Function (17 items).The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function.Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations | up to four weeks | 
| rang of motion | using digital inclinometer | up to four weeks | 
| joint position sense | using digital inclinometer for target angle 30 degree knee flexion | up to four weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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myofascial release, Knee osteoarthritis, Deep front line