Back to resultsBowen Technique and Post Isometric Relaxation in Knee Osteoarthritis Patients
Primary Purpose
Knee Osteoarthritis
Status
Completed
Phase
Not Applicable
Locations
Pakistan
Study Type
Interventional
Intervention
Bowen Technique
Post Isometric Relaxation
Sponsored by
About this trial
This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Post Isometric Relaxation, Bowen Technique, Hamstring muscle flexibility, Knee Osteoarthritis
Eligibility Criteria
Inclusion Criteria: Symptomatic subjects with hamstring tightness Both male and female Age between 45 to 65 O degree to 20-degree active knee extension loss Subject with inter-articular knee joint pathology Diagnosed osteoarthritis patients Grade 1 to 4 Osteoarthritis Exclusion Criteria: Subject history of lower extremity injury Any Neurological symptoms or radiating pain Any lower limb deformity Any fracture or Surgery is done for knee
Sites / Locations
- Al-Mustafa Medical and Physiotherapy Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Group A: Bowen Technique
Group B: Post Isometric Relaxation Technique
Arm Description
The subjects will receive Bowen Technique. The treatment session will be 3 times per week for 4 weeks for 20 minutes. The Bowen technique is a subtle and precise mobilization called Bowen moves. The mobilization is applied by using the fingers and thumbs over muscles, tendon, nerves and fascia. Only gentle non-invasive pressure is applied. A Bowen moves challenges the muscles for several seconds by the application of a gentle lateral pressure applied by the therapist thumb, against its medial edge. The muscle fibres and its fascia are disturbed from their neutral position and they are slightly stretched. The therapist apply gentle pressure towards the muscles using the skin slack available, and then rolls the thumb across the muscles and gently compressing it, the muscle will bounce back to its original position. The therapist has a sense of tissue tension, and this enables his/her to feel where stress has built up in the tissue.
The subjects will receive Post Isometric Relaxation Technique. Treatment session includes 3 times per week for 4 weeks for 20 minutes. Evaluation will be done before and after the treatment at the end of the 4th week. The outcome will be measured by the Active Knee Extension test, Numeric pain Rating Scale, and Goniometer. Post Isometric Relaxation is performed in supine position on treatment table. The therapist passively flexed the hip and knee at the 90 degrees and then passively extends the knee until the point of tissue resistance. Patient placed their leg on therapist shoulder and contracts his hamstring muscles by pushing down on the therapist shoulder for 10 seconds. After the contraction, patient is asked to relax, then therapist passively stretch to gain new range of muscles. The intervention is performed three times in a single session with 30 seconds rest intervals.
Outcomes
Primary Outcome Measures
Change in Active knee extension test
In this test, the subject is on the left-side lying on the examination table for bony landmark identification. The lateral femoral condyle, head of a fibula, and lateral malleolus of the right leg are marked to ensure that the same reference point is used for repeated measurement. When the landmarks are identified, the subject is instructed to lie in the supine position. The subject flexes the right hip at 90 degrees and grasps behind the right knee to stabilize the hip at 90 degrees. A goniometer is used to position the right knee at 90 degrees. A stationary arm long lateral femur and movable arm aligned with lateral fibula keeping lateral femoral condyle as an axis. The Patient actively extends the right knee as much as possible without moving the thigh from a vertical position. The active Range of motion of the knee is measured by a goniometer. (7) The active knee extension test have excellent intra-rater reliability(r = .7).
Change in Numeric pain rating scale
The Numeric pain rating scale is a self-reported measurement tool consisting of a numerical point scale. The scale is set up on a horizontal or vertical line, which ranges most commonly from 0 to 10, where 0 is no pain and 10 is the worst pain. The patient is asked to rate his or her pain intensity. There are three categories of pain least pain, average pain and, worst pain. The test-retest reliability for the Numeric pain rating scale varies from 0.67 to 0.96.
Change in Goniometer test
In this test, each subject is in the supine position, while a small pillow is placed beneath his head and neck. Then the legs and thighs of the other lower extremity are fixed to the bed with a strap. The knee flexion axis is being marked by a pen and from this point; a line is being drawn to the greater trochanter of the femur and one other line to the external malleolus of the ankle. These lines are used to measure the knee joint angles. The goniometer axis is placed on the knee axis and its arm is the place along with the line drawn on the thigh and the other arm is placed along with the line drawn on the leg. The Hip joint is 90 degrees and the vertical position of the thigh is being maintained. The subject is asked to do the active Knee extension slowly while the ankle is in the neutral position.
Secondary Outcome Measures
Full Information
NCT ID
NCT05723029
First Posted
January 24, 2023
Last Updated
April 18, 2023
Sponsor
Riphah International University
1. Study Identification
Unique Protocol Identification Number
NCT05723029
Brief Title
Bowen Technique and Post Isometric Relaxation in Knee Osteoarthritis Patients
Official Title
Comparative Effects of Bowen Technique and Post Isometric Relaxation on Pain, Range of Motion and Hamstring Flexibility in Knee Osteoarthritis Patients
Study Type
Interventional
2. Study Status
Record Verification Date
April 2023
Overall Recruitment Status
Completed
Study Start Date
January 18, 2023 (Actual)
Primary Completion Date
March 31, 2023 (Actual)
Study Completion Date
March 31, 2023 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Riphah International University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The Hamstring muscles are present at the posterior surface of the thigh. The muscles start in the gluteal region and run back of the thigh and insert into the popliteal fossa. The function of hamstring muscles flexes the knee and extension of the thigh. In degenerative joint disease, muscles tightness of the lower extremity leads to a decrease in joint flexibility. In knee joint osteoarthritis, hamstring muscles are more prone to tightness. The objective of this study is to compare the effects of the Bowen technique and Post Isometric Relaxation on pain, range of motion, and hamstring flexibility in knee osteoarthritis patients.
Detailed Description
This study will be a randomized clinical trial and will be conducted at Al- Mustafa Medical and Physiotherapy Center. The study will be completed within the time duration of six months. For data collection, a convenient sampling technique will be used. The Population will be diagnosed with osteoarthritis patients. A sample size of total 24 patients will be taken in this study. The measurement tool will be Active knee extension test, Goniometer and Numeric pain rating scale. The pre-test and post-test outcome measurement will be taken. Patients will be divided into two groups. Group A will receive the Bowen technique intervention and Group B will receive the Post Isometric Relaxation technique. The interventions groups will receive three sessions per week for 4 weeks.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Post Isometric Relaxation, Bowen Technique, Hamstring muscle flexibility, Knee Osteoarthritis
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Group A: Bowen Technique
Arm Type
Experimental
Arm Description
The subjects will receive Bowen Technique. The treatment session will be 3 times per week for 4 weeks for 20 minutes. The Bowen technique is a subtle and precise mobilization called Bowen moves. The mobilization is applied by using the fingers and thumbs over muscles, tendon, nerves and fascia. Only gentle non-invasive pressure is applied. A Bowen moves challenges the muscles for several seconds by the application of a gentle lateral pressure applied by the therapist thumb, against its medial edge. The muscle fibres and its fascia are disturbed from their neutral position and they are slightly stretched. The therapist apply gentle pressure towards the muscles using the skin slack available, and then rolls the thumb across the muscles and gently compressing it, the muscle will bounce back to its original position. The therapist has a sense of tissue tension, and this enables his/her to feel where stress has built up in the tissue.
Arm Title
Group B: Post Isometric Relaxation Technique
Arm Type
Experimental
Arm Description
The subjects will receive Post Isometric Relaxation Technique. Treatment session includes 3 times per week for 4 weeks for 20 minutes. Evaluation will be done before and after the treatment at the end of the 4th week. The outcome will be measured by the Active Knee Extension test, Numeric pain Rating Scale, and Goniometer. Post Isometric Relaxation is performed in supine position on treatment table. The therapist passively flexed the hip and knee at the 90 degrees and then passively extends the knee until the point of tissue resistance. Patient placed their leg on therapist shoulder and contracts his hamstring muscles by pushing down on the therapist shoulder for 10 seconds. After the contraction, patient is asked to relax, then therapist passively stretch to gain new range of muscles. The intervention is performed three times in a single session with 30 seconds rest intervals.
Intervention Type
Other
Intervention Name(s)
Bowen Technique
Intervention Description
A Bowen moves challenges the muscles for several seconds by the application of a gentle lateral pressure applied by the therapist thumb, against its medial edge. The muscle fibres and its fascia are disturbed from their neutral position and they are slightly stretched. The therapist apply gentle pressure towards the muscles using the skin slack available, and then rolls the thumb across the muscles and gently compressing it, the muscle will bounce back to its original position.
Intervention Type
Other
Intervention Name(s)
Post Isometric Relaxation
Intervention Description
Post Isometric Relaxation is performed in supine position on treatment table. The therapist passively flexed the hip and knee at the 90 degrees and then passively extends the knee until the point of tissue resistance. Patient placed their leg on therapist shoulder and contracts his hamstring muscles by pushing down on the therapist shoulder for 10 seconds. After the contraction, patient is asked to relax, then therapist passively stretch to gain new range of muscles.
Primary Outcome Measure Information:
Title
Change in Active knee extension test
Description
In this test, the subject is on the left-side lying on the examination table for bony landmark identification. The lateral femoral condyle, head of a fibula, and lateral malleolus of the right leg are marked to ensure that the same reference point is used for repeated measurement. When the landmarks are identified, the subject is instructed to lie in the supine position. The subject flexes the right hip at 90 degrees and grasps behind the right knee to stabilize the hip at 90 degrees. A goniometer is used to position the right knee at 90 degrees. A stationary arm long lateral femur and movable arm aligned with lateral fibula keeping lateral femoral condyle as an axis. The Patient actively extends the right knee as much as possible without moving the thigh from a vertical position. The active Range of motion of the knee is measured by a goniometer. (7) The active knee extension test have excellent intra-rater reliability(r = .7).
Time Frame
Baseline measurement (Pre-Treatment) in start on 1st day and post treatment follow-up for change will be taken on 4th week
Title
Change in Numeric pain rating scale
Description
The Numeric pain rating scale is a self-reported measurement tool consisting of a numerical point scale. The scale is set up on a horizontal or vertical line, which ranges most commonly from 0 to 10, where 0 is no pain and 10 is the worst pain. The patient is asked to rate his or her pain intensity. There are three categories of pain least pain, average pain and, worst pain. The test-retest reliability for the Numeric pain rating scale varies from 0.67 to 0.96.
Time Frame
Baseline measurement (Pre-Treatment) in start at at 1st week and post treatment follow-up for change will be taken on4th week
Title
Change in Goniometer test
Description
In this test, each subject is in the supine position, while a small pillow is placed beneath his head and neck. Then the legs and thighs of the other lower extremity are fixed to the bed with a strap. The knee flexion axis is being marked by a pen and from this point; a line is being drawn to the greater trochanter of the femur and one other line to the external malleolus of the ankle. These lines are used to measure the knee joint angles. The goniometer axis is placed on the knee axis and its arm is the place along with the line drawn on the thigh and the other arm is placed along with the line drawn on the leg. The Hip joint is 90 degrees and the vertical position of the thigh is being maintained. The subject is asked to do the active Knee extension slowly while the ankle is in the neutral position.
Time Frame
Baseline measurement (Pre-Treatment) in start on 1st day and post treatment follow-up for change will be taken on 4th week
10. Eligibility
Sex
All
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Symptomatic subjects with hamstring tightness
Both male and female
Age between 45 to 65
O degree to 20-degree active knee extension loss
Subject with inter-articular knee joint pathology
Diagnosed osteoarthritis patients
Grade 1 to 4 Osteoarthritis
Exclusion Criteria:
Subject history of lower extremity injury
Any Neurological symptoms or radiating pain
Any lower limb deformity
Any fracture or Surgery is done for knee
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Samrood Akram, Mphil
Organizational Affiliation
Riphah International University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Al-Mustafa Medical and Physiotherapy Center
City
Lahore
State/Province
Punjab
ZIP/Postal Code
54000
Country
Pakistan
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
Citation
Kahl C, Cleland JA. Visual analogue scale, numeric pain rating scale and the McGill Pain Questionnaire: an overview of psychometric properties. Physical therapy reviews. 2005;10(2):123-8.
Results Reference
background
PubMed Identifier
30949343
Citation
Shamsi M, Mirzaei M, Khabiri SS. Universal goniometer and electro-goniometer intra-examiner reliability in measuring the knee range of motion during active knee extension test in patients with chronic low back pain with short hamstring muscle. BMC Sports Sci Med Rehabil. 2019 Mar 22;11:4. doi: 10.1186/s13102-019-0116-x. eCollection 2019.
Results Reference
background
PubMed Identifier
25364856
Citation
Neto T, Jacobsohn L, Carita AI, Oliveira R. Reliability of the Active-Knee-Extension and Straight-Leg-Raise Tests in Subjects With Flexibility Deficits. J Sport Rehabil. 2015 Dec 3;24(4):2014-0220. doi: 10.1123/jsr.2014-0220. Print 2015 Nov 1.
Results Reference
background
Citation
Khuman PR, Surbala L, Patel P, Chavda D. Immediate effects of single session post isometric relaxation muscle energy technique versus mulligan's bent leg raise technique on pain and hamstring flexibility in knee osteoarthritis participants: A randomised controlled study. Physiotherapy. 2014;3(9):324-35.
Results Reference
background
Citation
Masekar MB, Rayjade DA, Yadav DT, Chotai DK. Effectiveness of Muscle Energy Technique and Proprioceptive Neuromuscular Facilitation in Knee Osteoarthritis.(2021). Int J Life SciPharmaRes.11(1):L16- 22.
Results Reference
background
PubMed Identifier
21665103
Citation
Marr M, Baker J, Lambon N, Perry J. The effects of the Bowen technique on hamstring flexibility over time: a randomised controlled trial. J Bodyw Mov Ther. 2011 Jul;15(3):281-90. doi: 10.1016/j.jbmt.2010.07.008. Epub 2010 Sep 15.
Results Reference
background
Learn more about this trial
Bowen Technique and Post Isometric Relaxation in Knee Osteoarthritis Patients
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