Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. The objective of the study will be to compare the effects of Sahrmann's approach versus conventional treatment on pain, valgus angle and functional disability in patients with knee osteoarthritis.
This randomized controlled trial will be conducted at Sehat Medical Complex, Hanjarwal and Sir Ganga Ram Hospital, Lahore. Sample size of the study will be 40. We will include the patients of age between 40-60 years, with diagnosis of knee osteoarthritis of grade 2, their pain intensity should be 3 points on NPRS and with gradual onset of pain from past 3 months, with valgus angle of knee \> 10° and a positive HKA angle \> 1° of valgus knee OA on radiographs. All the participants will be randomly divided into two groups. GROUP A which will be EXPERIMENTAL GROUP, will receive Sahrmann's approach protocol and GROUP B which will be CONTROL GROUP, will receive conventional treatment. Both groups will receive baseline treatment including hot pack/cold pack, TENS and basic exercises. The study will be comparing the effects of both treatments after 4 weeks, with 3 sessions per week on alternate days. Patients will be assessed by Numeric pain rating scale (NPRS) for pain, by Universal Goniometer (UG) for the assessment of valgus angle and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functioning of knee. Statistical Analysis will be done by statistical package for social sciences SPSS version 26.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
* with and without resistance band-SLR * with and without resistance band-Hip extension * with and without resistance band-clamshells * IT Band stretch * Squatting in front of mirror * with resistance band-lateral walk * Hip lateral rotation
Comparator group patients will receive, Conventional treatment exercises. • ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching
University of Lahore Teaching Hospital, Lahore HOD Physio Department
Lahore, Punjab Province, Pakistan
Numeric Pain Rating Scale (NPRS) - Pain Assessment
The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain." The NPRS is widely used in musculoskeletal and orthopedic conditions due to its simplicity, high responsiveness, and strong psychometric properties. It demonstrates excellent reliability (test-retest reliability ICC \> 0.80) and good construct validity in chronic pain populations including knee osteoarthritis.
Time frame: upto 4 weeks
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - Functional Outcome (Knee OA)
The WOMAC Osteoarthritis Index is a disease-specific, self-administered questionnaire designed to evaluate symptoms and functional status in patients with hip and knee osteoarthritis. It consists of 24 items divided into three subscales: Pain (5 items) Stiffness (2 items) Physical Function (17 items) Each item is typically scored using a 5-point Likert scale (0 = none to 4 = extreme), or alternatively via a visual analog format depending on study design. Total scores are summed, with higher scores indicating greater pain, stiffness, and functional disability.
Time frame: upto 4 weeks
Universal Goniometer (UG) - Valgus Angle Measurement
The Universal Goniometer (UG) is a standard clinical instrument used to measure joint angles and assess alignment. In this study, it will be used to measure the knee valgus angle, which reflects medial-lateral alignment of the lower limb in the frontal plane. The participant is typically assessed in a standing anatomical position, with landmarks aligned at: Anterior superior iliac spine (ASIS) Center of patella Ankle/midline of tibia or second toe alignment (depending on protocol standardization) The stationary arm of the goniometer is aligned with the femur, while the movable arm follows the tibial shaft. The angle between these segments represents the dynamic or static valgus alignment, depending on whether assessment is static posture or functional task-based measurement. Changes in valgus angle will be used to assess biomechanical alignment improvements following the intervention.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: upto 4 weeks