Effects of Diagonal Proprioceptive Neuromuscular Facilitation Patterns on Pain and Functional Outcomes in Patients With Knee Osteoarthritis

University of Karachi150 enrolled

Overview

A randomized controlled trial will be conducted at the Department of Physiotherapy, Dr. Ziauddin Hospital and Al-Rayaz Hospital, Karachi, Pakistan. A total of 150 patients diagnosed with knee osteoarthritis, aged between 40-60 years, will be recruited through a non-probability purposive sampling technique. Written informed consent will be obtained from all eligible participants prior to enrollment. The participants will be randomly allocated by the help of computer generated randomization sheet, into two groups i.e. experimental and the control group, with 75 participants in each group. Group A (experimental group) will receive diagonal proprioceptive neuromuscular facilitation (PNF) pattern exercises, while Group B (control group) will receive conventional strength training exercises. Heat therapy will be administered to both groups. All participants will be assessed using a standardized assessment form. Outcome measures will include pain intensity, knee range of motion, functional disability, hamstring flexibility, dynamic balance, and fatigue level. A single blinded assessor will assess all participants at baseline and at post intervention. Treatment sessions will be given thrice a week on alternate days for 6 weeks.

The Statistical Package for the Social Sciences (SPSS) version 23 will be used for data analysis. Mean and standard deviation will be calculated for quantitative variables such as age. Qualitative variables will be presented as frequencies and percentages. Outcome measures (decrease pain intensity, improve functional disability, increase knee range of motion, improve hamstring flexibility, dynamic balance, and fatigue level) recorded at baseline and after 18th session of intervention will be compared and analyzed. Repeated measures ANOVA will be applied for statistical analysis. A p-value of less than 0.05 will be considered as the level of statistical significance.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Interventions

Diagonal Proprioceptive Neuromuscular Facilitation (PNF) Pattern ExercisesOTHER

Diagonal PNF pattern exercises include Diagonal 1 and Diagonal 2 lower limb pattern movements performed against resistance to improve strength, flexibility, and functional performance.

Conventional Strength Training ExercisesOTHER

The conventional strength training exercises include quadriceps and hip abductor strengthening performed using resisted active movements to improve muscle strength and functional ability.

Heat TherapyOTHER

Heat therapy will be given for 10 minutes by the help of electric heating pad.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Both male and females with an age range between 40-60 years. * Patients diagnosed with unilateral or bilateral Knee OA. * Grade-II or grade-III on kellgren and Lawrence classification. * Patients having pain intensity more than 3.4 cm on VAS as minimum cut off value. * Duration of knee OA more than 3 months (chronic). Exclusion Criteria: * Patients with any neurological disorder. * History of lower limb arthroplasty or any other knee surgery. * Septic knee arthritis. * Inflammatory rheumatic disease such as rheumatoid arthritis and gout. * Cancer or any other malignancy such as bone tumor. * Knee deformities such as contracture, genu valgum and genu varum. * History of ligamentous injury and meniscal tear.

Outcomes

Primary Outcomes

Change in pain intensity will be assessed with Visual Analogue Scale

The Visual Analogue Scale is a unidimensional measure of pain intensity, used to record patients' pain progression, or assess pain severity in different conditions. It is 0 to 10 cm scale. Patients rate their pain on the scale. Higher the score in centimeter, severe will be the pain experienced.

Time frame: Baseline and after 6 weeks of intervention

Change in range of motion will be assessed with Universal Goniometer

The universal goniometer is an instrument for the precise measurement of range of movement angles in degree, especially one used to measure the angles before and after range of motion. Increase in the degree of angle suggests increase in range of movement.