Clinical trial NCT06855303: Muscle Energy Technique and Muscle Flexibility
Official title: Comparison Between the Effects of Two Different Muscle Energy Techniques on Hamstring Flexibility in Patients with Hamstring Tightness Secondary to Knee Osteoarthritis: Randomized Controlled Trial
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Hamstring Shortness
Lead sponsor: University of Hail
Sponsor class: OTHER
First posted: 2025-03-03
Enrollment: 60
Sex: ALL
Minimum age (years): 40
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: The study model will include 2 parallel groups of equal number. Each group will receive a different variation of muscle energy technique (MET)
Primary purpose: TREATMENT

Brief summary: The current study will compare the effect of using the muscle energy technique in 2 different methods on the hamstring muscle flexibility

Detailed description: Osteoarthritis (OA) is a painful musculoskeletal disease that primarily affects the knee, resulting in the gradual degeneration of articular cartilage. Knee OA commonly affects the elderly population and may cause impairment throughout the world. About 4% of the world's population suffers from osteoarthritis, especially in those who are 50 years of age or older.

Age, trauma, congenital and acquired deformity, metabolic conditions, obesity, muscle weakness or imbalance, an occupation that requires prolonged sitting and knee bending, and female gender are all risk factors linked to the development of Knee OA.

Knee pain, morning stiffness, knee locking, or giving way, crepitus, and functional impairments are the common clinical symptoms of Knee OA.

Initial treatment always begins with conservative modalities and progresses to surgical treatment when conservative treatment fails. There is a variety of conservative techniques available for the treatment of knee OA.

The two main muscles that move the knee joint are the quadriceps and hamstrings, which help the knee joint's ambulatory growth factors move smoothly and precisely.

The hamstring muscles are noted for their tendency to shorten, and knee OA has been linked to decreased hamstring flexibility that can put more strain on the knee joint, reduce range of motion, and walking abnormalities. Furthermore, reduced flexibility can result in patellofemoral syndrome, which can cause pain and restrictions in physical functioning and increase the compressive load on the patellofemoral joint. Patellofemoral syndrome frequently contributes to osteoarthritis.

In general, when muscle is flexible, the body may avoid unnecessary energy expenditure and improve movement accuracy, strength, and coordination to ensure that muscles and joints can move freely. Therefore, increasing hamstring flexibility can aid in relieving symptoms and reducing knee joint pressure in patients with knee OA.

The first-line treatment for all symptomatic knee OA patients includes education and physiotherapy. Among the physiotherapy techniques, muscle energy techniques (MET) like post-isometric relaxation (PIR) and reciprocal inhibition (RI) have become popular due to their efficacy in relaxing and lengthening muscles, reducing pain, and improving overall function in patients with knee OA. Furthermore, MET helps the body drain blood and bodily fluids through the lymphatic or venous pumps, strengthen muscles, and increase the range of motion in joints with limited range of motion.

Numerous studies have demonstrated the benefits of MET in improving function, flexibility, and pain in knee OA patients. For example, MET may be more beneficial than conventional treatments in enhancing knee OA patients' flexibility and functional outcomes, whether used with or without other techniques.

However, few studies have compared the relative effectiveness of various MET approaches in treating knee OA patients' flexibility, pain, and joint mobility problems.

Finally, the majority of research regarding the impact of the MET on hamstring flexibility has brief observation periods involving small samples and low quality, primarily focusing on healthy individuals under the age of 45. Consequently, additional high-quality research should evaluate the efficacy of MET on hamstring flexibility required with larger sample sizes that include older age groups.

Therefore, more research is required to evaluate the impact of different MET on hamstring flexibility in knee OA patients.

Eligibility criteria: Inclusion Criteria:

* Radiologically and clinically diagnosed cases of Osteoarthritis knee by a certified Orthopaedic surgeon or Physiotherapist. Patients with Grade 2 or 3. Osteoarthritis knee according to Kellgren - Lawrence classification,
* Between the age group of 40-60 years, including both men and women.
* Hamstring tightness of more than 20 from the active knee extension test (AKET)

Exclusion Criteria:

* Other knee joint pathologies such as Chondromalacia patella, plica syndrome,
* Neurological disorders.
* Patients having lower extremity injury/surgeries in the past 6 months,
* Hip or knee fractures or deformity,

Primary outcomes:
measure: The Numeric Pain Rating
timeFrame: From baseline to the end of the treatment at 6 weeks
measure: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
timeFrame: From baseline to the end of the treatment at 6 months
measure: Sit and reach test
timeFrame: From baseline to the end of the treatment at 6 weeks
Secondary outcomes:
Other outcomes:
Locations:
city: Hail
country: Saudi Arabia
facility: University of Hail
Study officials:
affiliation: University of Hail
name: Hisham M Hussein, PhD
role: PRINCIPAL_INVESTIGATOR
References: