Effects of Myofascial Release and Neuromuscular Training for Pes Anserine Syndrome Associated With Knee Osteoarthritis

Effects of Myofascial Release and Neuromuscular Training for Pes Anserine Syndrome Associated With Knee Osteoarthritis: A Randomized Control Trial

A randomized control trial will be conducted at the outpatient department of Dow Institute of Physical Medicine and Rehabilitation. A sample size of 80 is calculated using PASS version 11 software. The subjects will be first screened and those who fulfill the inclusion criteria, will be asked to fill the consent form. After selection, the participants will be randomly allocated by the help of computer generated randomization sheet, into two groups i.e. experimental and the control group. The group A will be provided with the myofascial release along with the neuromuscular training whereas the group B will only receive the neuromuscular training. Cold pack will be applied to both the groups. The neuromuscular training consists of warm-up phase, lunges, sideways exercises, wall squats, weight transfer exercises, step up and down and the cool down phase. Total 12 sessions of 35 minutes each will be given to all the participants for about 4 weeks on alternate days. Outcome measures will be analyzed by visual analogue scale (VAS) for pain assessment, goniometry for range of motion and the Knee injury and Osteoarthritis Outcome Score (KOOS) to evaluate the functional assessment of the patients at the baseline and the post intervention.

Study Overview

• Status: Completed
• Conditions: Knee Osteoarthritis; Pes Anserine Bursitis
• Intervention / Treatment: Other: Myofascial release; Other: Neuromuscular exercises; Other: Cold pack

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rabia Hassan, DPT; Phone Number: 03345448859; Email: rabiahassan096@gmail.com

Study Locations

• Pakistan
  • Sindh
    • Karachi, Sindh, Pakistan, 74200
      • Dow Institute of Physical Medicine and Rehabilitation
    • Karachi, Sindh, Pakistan, 74200
      • Sindh Institute of Physical Medicine and Rehabilitation

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 60 years (Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male and Females both with the age between 40-60 years.
• Patients with unilateral or bilateral knee osteoarthritis with pes anserine syndrome.
• Patients with knee pain more than 3.4 cm on visual analogue scale as minimum cut of value.
• Kellgren and Lawrence grade II and III on radiological findings.
• Duration of knee osteoarthritis more than 3 months (chronic).

Exclusion Criteria:

• Patients with any neurological disorder.
• Knee deformities such as contractures, genu valgum and genu varum.
• Septic knee arthritis.
• History of ligamentous injury or meniscal tear.
• Cancer or any other malignancy or bone tumor.
• Any history of previous lower limb arthroplasty or other knee surgery.
• Comorbid like diabetes mellitus.
• Inflammatory rheumatic disease (R.A).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Myofascial release + Neuromuscular exercises + Cold pack	Other: Myofascial release; It is a type of physical therapy often used to treat myofascial pain syndrome with pressure.; Other: Neuromuscular exercises; Exercises commonly utilized in neuromuscular training programs to improve strength, balance , speed and agility. It will comprised of Warm-up, Lunges, Sideways exercises, Wall squats, Weight transfer exercise, Step up & down, Cool-down; Other: Cold pack; Application of cold pack around the patient's body, and covered with dry towel; Other Names: Cold pack therapy
Active Comparator: Neuromuscular exercises + Cold pack	Other: Neuromuscular exercises; Exercises commonly utilized in neuromuscular training programs to improve strength, balance , speed and agility. It will comprised of Warm-up, Lunges, Sideways exercises, Wall squats, Weight transfer exercise, Step up & down, Cool-down; Other: Cold pack; Application of cold pack around the patient's body, and covered with dry towel; Other Names: Cold pack therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in pain intensity on visual analogue scale after four weeks	The Visual Analogue Scale is a unidimensional measure of pain intensity, used to record patients' pain progression, or compare pain severity between pains with similar conditions.. It is 0 to 10 cm scale. Patients rate their pain on that scale. Higher the score in centimeter, severe will be the pain experienced.	Baseline and 4 weeks
Change in range of motion assessed with universal goniometer after four weeks	The 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.	Baseline and 4 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in functional disability assessed with Knee injury and osteoarthritis outcome score after four weeks.	The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a knee-specific instrument, developed to assess the patients' opinion about their knee and associated problems regarding functional disability. In consists of total 100 scores. Increase in scores suggests decreased functional disability and decrease in scores suggests increased functional disability.	Baseline and 4 weeks

Collaborators and Investigators

• Sponsor: Dow University of Health Sciences
• Investigators: Study Director: Farhan I Khan, PhD, Dow University of Health Sciences

Study record dates

Study Major Dates

• Study Start (Actual): September 27, 2022
• Primary Completion (Actual): March 30, 2023
• Study Completion (Actual): April 30, 2023

Study Registration Dates

• First Submitted: September 3, 2022
• First Submitted That Met QC Criteria: September 3, 2022
• First Posted (Actual): September 7, 2022

Study Record Updates

• Last Update Posted (Actual): January 9, 2024
• Last Update Submitted That Met QC Criteria: January 7, 2024
• Last Verified: January 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Osteoarthritis; Osteoarthritis, Knee; Bursitis
• Other Study ID Numbers: RHassan

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No