Clinical trial NCT04645238: Comparison of the Effects of Static and PNF Hamstring Stretching Exercises in Patients With Knee Osteoarthritis
Official title: Comparison of the Effects of Static and PNF Hamstring Stretching Exercises in Patients With Knee Osteoarthritis
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Knee Osteoarthritis
Keywords: Knee Osteoarthritis
Hamstring
Stretching
Lead sponsor: Dokuz Eylul University
Sponsor class: OTHER
First posted: 2020-11-27
Enrollment: 36
Sex: ALL
Minimum age (years): 40
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The aim of this study is to determine and compare the effects of static and PNF hamstring stretching exercises on joint pain, hamstring flexibility and functional status in patients with knee osteoarthritis.

Detailed description: A total of 36 patients between the ages of 40 and 75 who were diagnosed with Kellgren-Lawrence Stage II and III knee OA by the physician were included in the study. Participants were divided into two groups as static stretching group or PNF stretching group. Patients' demographic and clinical information was recorded. Pain intensity was evaluated with visual pain scale, hamstring flexibility with Active Knee Extension Test, functional status with Western Ontario and McMasters University Osteoarthritis Index and Timed Get Up and Go Test. In addition to the standard physiotherapy program, the subjects practiced stretching exercises according to the groups that they've been separated. Evaluations were repeated in the end of the treatment and in the follow-up.

Eligibility criteria: Inclusion Criteria:

* Individuals with knee osteoarthritis severity II, III, or IV according to the Kellgren-Lawrence Classification,
* Individuals with positive active knee extension test,
* Individuals with a body mass index of 30 or less,
* Individuals with a pain severity of at least 3/10 according to the visual pain scale.

Exclusion Criteria:

* Individuals with health problems that prevent them from doing the evaluations and exercises to be used in the study,
* Individuals who exercise regularly for the last six months,
* Individuals with a diagnosis of neurological disease affecting the lower extremity.

Primary outcomes:
measure: Active Knee Extension Test for Hamstring Flexibility
timeFrame: Baseline and post-intervention
measure: Active Knee Extension Test for Hamstring Flexibility
timeFrame: Post-intervention and follow-up
Secondary outcomes:
measure: Visual Analogue Scale for Pain
timeFrame: Baseline and post-intervention
measure: Visual Analogue Scale for Pain
timeFrame: Post-intervention and follow-up
measure: Western Ontario and McMaster Universities Osteoarthritis Index
timeFrame: Baseline and post-intervention
measure: Western Ontario and McMaster Universities Osteoarthritis Index
timeFrame: Post-intervention and follow-up
measure: The Timed Up & Go Test
timeFrame: Baseline and post-intervention
measure: The Timed Up & Go Test
timeFrame: Post-intervention and follow-up
Other outcomes:
Locations:
city: Trabzon
country: Turkey
facility: Fizyotem Medical Center
Study officials:
affiliation: Dokuz Eylul University
name: Nihal Gelecek, Professor
role: STUDY_DIRECTOR
References:
citation: Reid DA, McNair PJ. Effects of an acute hamstring stretch in people with and without osteoarthritis of the knee. Physiotherapy. 2010 Mar;96(1):14-21. doi: 10.1016/j.physio.2009.06.010. Epub 2009 Sep 4.
citation: Hortobagyi T, Westerkamp L, Beam S, Moody J, Garry J, Holbert D, DeVita P. Altered hamstring-quadriceps muscle balance in patients with knee osteoarthritis. Clin Biomech (Bristol). 2005 Jan;20(1):97-104. doi: 10.1016/j.clinbiomech.2004.08.004.
citation: Krishnasamy P, Hall M, Robbins SR. The role of skeletal muscle in the pathophysiology and management of knee osteoarthritis. Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv22-iv33. doi: 10.1093/rheumatology/kex515.
citation: Rutherford DJ, Hubley-Kozey CL, Stanish WD. Changes in knee joint muscle activation patterns during walking associated with increased structural severity in knee osteoarthritis. J Electromyogr Kinesiol. 2013 Jun;23(3):704-11. doi: 10.1016/j.jelekin.2013.01.003. Epub 2013 Jan 26.
citation: Lempke L, Wilkinson R, Murray C, Stanek J. The Effectiveness of PNF Versus Static Stretching on Increasing Hip-Flexion Range of Motion. J Sport Rehabil. 2018 May 1;27(3):289-294. doi: 10.1123/jsr.2016-0098. Epub 2018 May 22.
citation: Lim KI, Nam HC, Jung KS. Effects on hamstring muscle extensibility, muscle activity, and balance of different stretching techniques. J Phys Ther Sci. 2014 Feb;26(2):209-13. doi: 10.1589/jpts.26.209. Epub 2014 Feb 28.
citation: Hill KJ, Robinson KP, Cuchna JW, Hoch MC. Immediate Effects of Proprioceptive Neuromuscular Facilitation Stretching Programs Compared With Passive Stretching Programs for Hamstring Flexibility: A Critically Appraised Topic. J Sport Rehabil. 2017 Nov;26(6):567-572. doi: 10.1123/jsr.2016-0003. Epub 2016 Aug 24.
citation: Maddigan ME, Peach AA, Behm DG. A comparison of assisted and unassisted proprioceptive neuromuscular facilitation techniques and static stretching. J Strength Cond Res. 2012 May;26(5):1238-44. doi: 10.1519/JSC.0b013e3182510611.
citation: Fasen JM, O'Connor AM, Schwartz SL, Watson JO, Plastaras CT, Garvan CW, Bulcao C, Johnson SC, Akuthota V. A randomized controlled trial of hamstring stretching: comparison of four techniques. J Strength Cond Res. 2009 Mar;23(2):660-7. doi: 10.1519/JSC.0b013e318198fbd1.
citation: Yildirim MS, Ozyurek S, Tosun O, Uzer S, Gelecek N. Comparison of effects of static, proprioceptive neuromuscular facilitation and Mulligan stretching on hip flexion range of motion: a randomized controlled trial. Biol Sport. 2016 Mar;33(1):89-94. doi: 10.5604/20831862.1194126. Epub 2016 Feb 8.
citation: Alghadir AH, Anwer S, Iqbal A, Iqbal ZA. Test-retest reliability, validity, and minimum detectable change of visual analog, numerical rating, and verbal rating scales for measurement of osteoarthritic knee pain. J Pain Res. 2018 Apr 26;11:851-856. doi: 10.2147/JPR.S158847. eCollection 2018.
citation: Song Q, Shen P, Mao M, Sun W, Zhang C, Li L. Proprioceptive neuromuscular facilitation improves pain and descending mechanics among elderly with knee osteoarthritis. Scand J Med Sci Sports. 2020 Sep;30(9):1655-1663. doi: 10.1111/sms.13709. Epub 2020 Jun 1.