Stroke
Conditions
Keywords
Knee Osteoarthritis, Strain Counterstrain, Muscle Energy Technique, Pain Management, Functional Disability
Brief summary
This study aimed to evaluate the comparative effects of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) on pain, range of motion (ROM), and functional disability in patients with knee osteoarthritis (KOA). Conducted as a single-blinded randomized control trial at the University of Lahore Teaching Hospital, 76 participants were divided into two groups, receiving either SCS or MET alongside routine physical therapy. Outcome measures included pain intensity, ROM, and functional disability via KOOS.
Detailed description
This randomized controlled trial investigated the comparative efficacy of Strain Counterstrain (SCS) and Muscle Energy Technique (MET) in managing knee osteoarthritis (KOA) symptoms. A total of 76 patients meeting inclusion criteria were randomly assigned into two equal groups. Group A received SCS along with routine physical therapy, and Group B received MET with the same physiotherapy protocol. The interventions were carried out five days a week for eight weeks, and outcomes were measured at baseline, four weeks, and eight weeks. Pain was assessed using the Numeric Rating Scale (NRS), range of motion (ROM) via goniometry, and functional disability using the KOOS index.
Interventions
BEHAVIORALStrain Counterstrain with Routine Physical Therapy
This intervention involves applying the Strain Counterstrain (SCS) technique in combination with standard physical therapy. SCS targets tender points through passive positioning to reduce muscle tension and pain. The patient is positioned in a position of comfort for 90 seconds while monitoring the tender point. This is followed by gradual return to neutral. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), strengthening (short arc quads, terminal knee extension), and stretching exercises. The therapy is administered 5 days per week over 8 weeks.
BEHAVIORALMuscle Energy Technique with Routine Physical Therapy
This intervention combines Muscle Energy Technique (MET) with routine physical therapy. MET involves voluntary muscle contractions against resistance, followed by stretching to restore range of motion and relieve pain. Techniques include post-isometric relaxation and slow eccentric isotonic stretching, particularly targeting hamstring and quadriceps tightness. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), as well as structured strengthening and stretching exercises. The intervention was delivered 5 days a week for 8 weeks.
Sponsors
University of Lahore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Only the outcomes assessor was blinded to the participants' group assignments to ensure objective measurement of pain, ROM, and functional disability scores.
Intervention model description
Two-arm parallel design where each group receives a distinct manual therapy intervention (SCS or MET) along with standardized physiotherapy. The study tracks changes in pain, ROM, and disability over 8 weeks.
Eligibility
Sex/Gender
ALL
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age between 45 to 65 years (Pandiselvi, 2019). * Patients who were willing and able to comply with the study protocol and follow-up procedures (Arslan et al., 2022). * Patients having Grade 2 knee OA Kellgren and Lawrence system. In this system, grade 2 signifies minimal severity of OA (Ratzlaff et al., 2018).
Exclusion criteria
* Congenital deformities (Deng et al., 2021). * Having any tumor or related pathology such as cancer (Arslan et al., 2022). * Patients having any previous knee surgery (Khan et al., 2023). * Patients with isolated/predominantly patellofemoral symptomatic osteoarthritis, inflammatory diseases, joint effusion, or excessive knee deformity (Deng et al., 2021).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Pain intensity reduction measured by Numeric Pain Rating Scale (NPRS) | Baseline, Week 4, and Week 8 | Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 indicates no pain and 10 indicates worst possible pain. Assessments were conducted at baseline, 4 weeks, and 8 weeks. A lower score represents improvement. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Improvement in range of motion (ROM) measured using goniometry | Baseline, Week 4, and Week 8 | Range of motion (ROM) of the affected knee was measured using a standard universal goniometer. The focus was on knee flexion and extension. Measurements were taken at baseline, 4 weeks, and 8 weeks to evaluate changes over time. |
| Change in functional disability measured by KOOS questionnaire | Baseline, Week 4, and Week 8 | Functional disability was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). It includes five subscales (pain, symptoms, ADL, sport/recreation, QOL). Higher scores indicate better function. Assessed at baseline, 4 weeks, and 8 weeks. |
Countries
Pakistan
Outcome results
None listed