Comparison of the Effects of Static and PNF Hamstring Stretching Exercises in Patients With Knee Osteoarthritis

Knee Osteoarthritis Clinical Trial

Official title:

Comparison of the Effects of Static and PNF Hamstring Stretching Exercises in Patients With Knee Osteoarthritis

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04645238
• Other study ID #: DEU-FTR-IK-01
• Status: Completed
• Phase: N/A
• Start date: September 1, 2019
• Est. completion date: September 30, 2020

Study information

• Verified date: February 2021
• Source: Dokuz Eylul University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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 (n = 18) or PNF stretching group (n = 18). 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 praticed stretching exercises for 15 sessions according to the groups that they've been separated. Evaluations were repeated in the end of the treatment (4th week) and in the 3rd month after the treatment.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 36
• Est. completion date: September 30, 2020
• Est. primary completion date: September 30, 2020
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years to 75 Years

Eligibility

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.

Related Conditions & MeSH terms

• Knee Osteoarthritis
• Osteoarthritis
• Osteoarthritis, Knee

Intervention

Other:
• Static Stretching
Static hamstring stretching exercise lasting 30 seconds and 10 repetitions under the supervision of the physiotherapist
• PNF Stretching
PNF hold-relax stretching technique that consists of 10 seconds isometric contraction, 30 seconds hamstring stretching and 10 repetitions under the supervision of the physiotherapist

Locations

Country	Name	City	State
Turkey	Fizyotem Medical Center	Trabzon

Sponsors (1)

Lead Sponsor	Collaborator
Dokuz Eylul University

Country where clinical trial is conducted

Turkey, 

References & Publications (12)

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 — View 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.0b0 — View 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. — View Citation

Hortobágyi 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, Avon). 2005 Jan;20(1):97-104. — View 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. Review. Erratum in: Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv124. — View 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. Review. — View 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. — View 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. — View 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. — View 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. — View 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 — View 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 — View Citation

* Note: There are 12 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Active Knee Extension Test for Hamstring Flexibility	Higher values represent better outcomes.	Baseline and post-intervention, up to 4 weeks
Primary	Active Knee Extension Test for Hamstring Flexibility	Higher values represent better outcomes.	Post-intervention and follow-up, up to 3 months
Secondary	Visual Analogue Scale for Pain	The scale varies from 0 to 10. Higher values represent worse outcomes.	Baseline and post-intervention, up to 4 weeks
Secondary	Visual Analogue Scale for Pain	The scale varies from 0 to 10. Higher values represent worse outcomes.	Post-intervention and follow-up, up to 3 months
Secondary	Western Ontario and McMaster Universities Osteoarthritis Index	The scale varies from 0 to 96. Higher values represent worse outcomes.	Baseline and post-intervention, up to 4 weeks
Secondary	Western Ontario and McMaster Universities Osteoarthritis Index	The scale varies from 0 to 96. Higher values represent worse outcomes.	Post-intervention and follow-up, up to 3 months
Secondary	The Timed Up & Go Test	Higher values represent worse outcomes.	Baseline and post-intervention, up to 4 weeks
Secondary	The Timed Up & Go Test	Higher values represent worse outcomes.	Post-intervention and follow-up, up to 3 months