Stretching Techniques of Knee Muscles and Their Effect on Joint Range, Suppleness and Muscle Activity in Elderly

Study Overview
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Brief Summary
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The goal of this clinical trial was to compare the effect of two different types of stretching techniques in elderly population. The main questions it aims to answer are: What is the immediate effect (after a single intervention) of these stretching techniques on muscle flexibility, amount of knee joint motion and muscle activity? What is the effect of a four week intervention program of these stretching techniques on muscle flexibility, amount of knee joint motion and muscle activity? There were three groups with ten randomly allocated participants in each group. Intervention group I was given a stretching technique called contract-relax technique and the Intervention group II was given static stretching. The third group was not given any treatment and was taken as a control. The main aim was to find out that whether the two techniques are effective or not and which one of the two is better than the other in terms of improvement in the above mentioned parameters.

Detailed Description
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The objective of the study was to compare the effects of Proprioceptive Neuromuscular Facilitation - Contract Relax (PNF- CR) and static stretch techniques immediately and post four weeks of intervention on knee range of motion, flexibility and electromyographic activity of knee muscles among older adults. This is an outcome assessor-blinded pre-test post-test randomized controlled trial with two experimental groups (PNF-CR and Static Stretching) and a control group. 30 males aged 55-75 years were randomly assigned into PNF group (n=10), Static Stretch group (n=10) and Control group (n=10). Knee range of motion, electromyographic activity of hamstrings and sit and reach test, were taken for the dominant side thrice: pre-intervention, immediately after stretching and after the training period. Active knee range of motion (ROM) was assessed using a universal goniometer. Surface Electromyography (EMG) was used to record Maximal voluntary isometric contraction (MVIC) of biceps femoris and the Chair Sit-and-Reach Test (CART) was used to assess the hamstring muscle's length flexibility.

Official Title
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Effects of Proprioceptive Neuromuscular Facilitation on Joint Range of Motion, Flexibility and Electromyographic Activity of Knee Muscles in Older Adults

Conditions
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Muscle Tightness, Muscle Weakness

Intervention / Treatment
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* Other: Proprioceptive Neuromuscular Stretching - Contract Relax stretching (PNF-CR)
* Other: Static Stretching (SS)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male adults aged between 55 and 75 years Able to do activities of daily living (ADL) without assistance Able to comprehend and follow instructions Exclusion Criteria: Grade III or IV osteoarthritis or any other musculoskeletal condition affecting the muscle length. History of any surgery to hip, knee, low back or ankle History of any medication (anti-inflammatory, for pain relief, or anti-arthritic) in previous six months History of life-threatening disease (neurological disease, cardiovascular disease, severe hypertension) Passive full knee extension (popliteal angle 180 degrees)

Ages Eligible for Study
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Minimum Age: 55 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 30 males aged 55-75 years were randomly assigned into 3 arms - PNF group (n=10), Static Stretch group (n=10) and Control group (n=10)
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PNF- CR Group<br>The participants in the group were given PNF contract- relax stretching using the standard protocol. One trial had two isometric contractions each followed by five seconds muscle stretch and there was a total of four trials. Total of 12 sessions in 4 weeks (3sessions/week). | Other: Proprioceptive Neuromuscular Stretching - Contract Relax stretching (PNF-CR)<br>* PNF-CR utilized the concept of autogenic inhibition of the muscle for improving the flexibility of the muscle. It includes stretching a muscle after a brief period of activation.<br>|
| Experimental: Static Stretching Group<br>The participants in the group were given sustained stretching for a period of 80s at a stretch. Total of 12 sessions in 4 weeks (3sessions/week). | Other: Static Stretching (SS)<br>* The SS technique utilized the concept of creep for improving the hamstring flexibility. The stretch was maintained for a prolonged period passively by the therapist.<br>|
| No Intervention: Control Group<br>No intervention was given in this group | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Active Knee Range of Motion | The active extension knee range of motion was measured using a universal goniometer. | Baseline, After 1st intervention (immediate), 4 weeks after intervention | 
| Change in Maximum Voluntary Isometric Contraction (MVIC) | The Electromyographic activity of the biceps femoris muscle was evaluated using the surface electrodes during the maximal isometric contraction. | Baseline, After 1st intervention (immediate), 4 weeks after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Hamstring flexibility | The hamstring flexibility was measured using the Chair Sit and Reach Test (CART) | Baseline, After 1st intervention (immediate), 4 weeks after intervention | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Contract Relax, Proprioceptive Neuromuscular Facilitation, Electromyography, Elderly, Flexibility, Range of Motion