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

Primary Purpose

Knee Osteoarthritis

Status
Completed
Phase
Not Applicable
Locations
Turkey
Study Type
Interventional
Intervention
Static Stretching
PNF Stretching
Sponsored by
Dokuz Eylul University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Knee Osteoarthritis focused on measuring Knee Osteoarthritis, Hamstring, Stretching

Eligibility Criteria

40 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

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.

Sites / Locations

  • Fizyotem Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Static Hamstring Stretching

PNF Stretching

Arm Description

Static Hamstring Stretching

PNF Hamstring Stretching (Hold-Relax)

Outcomes

Primary Outcome Measures

Active Knee Extension Test for Hamstring Flexibility
Higher values represent better outcomes.
Active Knee Extension Test for Hamstring Flexibility
Higher values represent better outcomes.

Secondary Outcome Measures

Visual Analogue Scale for Pain
The scale varies from 0 to 10. Higher values represent worse outcomes.
Visual Analogue Scale for Pain
The scale varies from 0 to 10. Higher values represent worse outcomes.
Western Ontario and McMaster Universities Osteoarthritis Index
The scale varies from 0 to 96. Higher values represent worse outcomes.
Western Ontario and McMaster Universities Osteoarthritis Index
The scale varies from 0 to 96. Higher values represent worse outcomes.
The Timed Up & Go Test
Higher values represent worse outcomes.
The Timed Up & Go Test
Higher values represent worse outcomes.

Full Information

First Posted
November 20, 2020
Last Updated
February 2, 2021
Sponsor
Dokuz Eylul University
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1. Study Identification

Unique Protocol Identification Number
NCT04645238
Brief Title
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

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
September 1, 2019 (Actual)
Primary Completion Date
September 30, 2020 (Actual)
Study Completion Date
September 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Dokuz Eylul University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

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 (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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Knee Osteoarthritis
Keywords
Knee Osteoarthritis, Hamstring, Stretching

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Static Hamstring Stretching
Arm Type
Active Comparator
Arm Description
Static Hamstring Stretching
Arm Title
PNF Stretching
Arm Type
Active Comparator
Arm Description
PNF Hamstring Stretching (Hold-Relax)
Intervention Type
Other
Intervention Name(s)
Static Stretching
Intervention Description
Static hamstring stretching exercise lasting 30 seconds and 10 repetitions under the supervision of the physiotherapist
Intervention Type
Other
Intervention Name(s)
PNF Stretching
Intervention Description
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
Primary Outcome Measure Information:
Title
Active Knee Extension Test for Hamstring Flexibility
Description
Higher values represent better outcomes.
Time Frame
Baseline and post-intervention, up to 4 weeks
Title
Active Knee Extension Test for Hamstring Flexibility
Description
Higher values represent better outcomes.
Time Frame
Post-intervention and follow-up, up to 3 months
Secondary Outcome Measure Information:
Title
Visual Analogue Scale for Pain
Description
The scale varies from 0 to 10. Higher values represent worse outcomes.
Time Frame
Baseline and post-intervention, up to 4 weeks
Title
Visual Analogue Scale for Pain
Description
The scale varies from 0 to 10. Higher values represent worse outcomes.
Time Frame
Post-intervention and follow-up, up to 3 months
Title
Western Ontario and McMaster Universities Osteoarthritis Index
Description
The scale varies from 0 to 96. Higher values represent worse outcomes.
Time Frame
Baseline and post-intervention, up to 4 weeks
Title
Western Ontario and McMaster Universities Osteoarthritis Index
Description
The scale varies from 0 to 96. Higher values represent worse outcomes.
Time Frame
Post-intervention and follow-up, up to 3 months
Title
The Timed Up & Go Test
Description
Higher values represent worse outcomes.
Time Frame
Baseline and post-intervention, up to 4 weeks
Title
The Timed Up & Go Test
Description
Higher values represent worse outcomes.
Time Frame
Post-intervention and follow-up, up to 3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
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.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nihal Gelecek, Professor
Organizational Affiliation
Dokuz Eylul University
Official's Role
Study Director
Facility Information:
Facility Name
Fizyotem Medical Center
City
Trabzon
Country
Turkey

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
15567543
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, Avon). 2005 Jan;20(1):97-104. doi: 10.1016/j.clinbiomech.2004.08.004.
Results Reference
background
PubMed Identifier
29351644
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. Erratum In: Rheumatology (Oxford). 2018 May 1;57(suppl_4):iv124.
Results Reference
background
PubMed Identifier
23357547
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.
Results Reference
background
PubMed Identifier
28182516
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.
Results Reference
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PubMed Identifier
27632820
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.
Results Reference
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PubMed Identifier
22395273
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.
Results Reference
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PubMed Identifier
20113758
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.
Results Reference
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PubMed Identifier
24648633
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.
Results Reference
result
PubMed Identifier
19204565
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.
Results Reference
result
PubMed Identifier
26929476
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.
Results Reference
result
PubMed Identifier
29731662
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.
Results Reference
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PubMed Identifier
32407583
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.
Results Reference
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Comparison of the Effects of Static and PNF Hamstring Stretching Exercises in Patients With Knee Osteoarthritis

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