Stretching Techniques of Knee Muscles and Their Effect on Joint Range, Suppleness and Muscle Activity in Elderly

Effects of Proprioceptive Neuromuscular Facilitation on Joint Range of Motion, Flexibility and Electromyographic Activity of Knee Muscles in Older Adults

The goal of this clinical trial was to compare the effect of two different types of stretching techniques in elderly population. The main questions it aims to answer are:

1. What is the immediate effect (after a single intervention) of these stretching techniques on muscle flexibility, amount of knee joint motion and muscle activity?
2. What is the effect of a four week intervention program of these stretching techniques on muscle flexibility, amount of knee joint motion and muscle activity? There were three groups with ten randomly allocated participants in each group. Intervention group I was given a stretching technique called contract-relax technique and the Intervention group II was given static stretching. The third group was not given any treatment and was taken as a control. The main aim was to find out that whether the two techniques are effective or not and which one of the two is better than the other in terms of improvement in the above mentioned parameters.

Study Overview

• Status: Completed
• Conditions: Muscle Weakness; Muscle Tightness
• Intervention / Treatment: Other: Proprioceptive Neuromuscular Stretching - Contract Relax stretching (PNF-CR); Other: Static Stretching (SS)

Detailed Description

The objective of the study was to compare the effects of Proprioceptive Neuromuscular Facilitation - Contract Relax (PNF- CR) and static stretch techniques immediately and post four weeks of intervention on knee range of motion, flexibility and electromyographic activity of knee muscles among older adults. This is an outcome assessor-blinded pre-test post-test randomized controlled trial with two experimental groups (PNF-CR and Static Stretching) and a control group. 30 males aged 55-75 years were randomly assigned into PNF group (n=10), Static Stretch group (n=10) and Control group (n=10). Knee range of motion, electromyographic activity of hamstrings and sit and reach test, were taken for the dominant side thrice: pre-intervention, immediately after stretching and after the training period. Active knee range of motion (ROM) was assessed using a universal goniometer. Surface Electromyography (EMG) was used to record Maximal voluntary isometric contraction (MVIC) of biceps femoris and the Chair Sit-and-Reach Test (CART) was used to assess the hamstring muscle's length flexibility.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• India
  • Delhi
    • New Delhi, Delhi, India, 110025
      • Out Patient Department, Centre for Physiotherapy & Rehabilitation Sciences, Jamia Millia Islamia

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 55 years to 75 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Male adults aged between 55 and 75 years
• Able to do activities of daily living (ADL) without assistance
• Able to comprehend and follow instructions

Exclusion Criteria:

• Grade III or IV osteoarthritis or any other musculoskeletal condition affecting the muscle length.
• History of any surgery to hip, knee, low back or ankle
• History of any medication (anti-inflammatory, for pain relief, or anti-arthritic) in previous six months
• History of life-threatening disease (neurological disease, cardiovascular disease, severe hypertension)
• Passive full knee extension (popliteal angle 180 degrees)

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: PNF- CR Group; The participants in the group were given PNF contract- relax stretching using the standard protocol. One trial had two isometric contractions each followed by five seconds muscle stretch and there was a total of four trials. Total of 12 sessions in 4 weeks (3sessions/week).	Other: Proprioceptive Neuromuscular Stretching - Contract Relax stretching (PNF-CR); PNF-CR utilized the concept of autogenic inhibition of the muscle for improving the flexibility of the muscle. It includes stretching a muscle after a brief period of activation.
Experimental: Static Stretching Group; The participants in the group were given sustained stretching for a period of 80s at a stretch. Total of 12 sessions in 4 weeks (3sessions/week).	Other: Static Stretching (SS); The SS technique utilized the concept of creep for improving the hamstring flexibility. The stretch was maintained for a prolonged period passively by the therapist.
No Intervention: Control Group; No intervention was given in this group

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Active Knee Range of Motion	The active extension knee range of motion was measured using a universal goniometer.	Baseline, After 1st intervention (immediate), 4 weeks after intervention
Change in Maximum Voluntary Isometric Contraction (MVIC)	The Electromyographic activity of the biceps femoris muscle was evaluated using the surface electrodes during the maximal isometric contraction.	Baseline, After 1st intervention (immediate), 4 weeks after intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Hamstring flexibility	The hamstring flexibility was measured using the Chair Sit and Reach Test (CART)	Baseline, After 1st intervention (immediate), 4 weeks after intervention

Collaborators and Investigators

• Sponsor: Deepak Malhotra
• Collaborators: Jamia Millia Islamia
• Investigators: Principal Investigator: Sahar Zaidi, MPT, Jamia Millia Islamia

Study record dates

Study Major Dates

• Study Start (Actual): March 1, 2018
• Primary Completion (Actual): November 28, 2018
• Study Completion (Actual): January 24, 2019

Study Registration Dates

• First Submitted: March 13, 2023
• First Submitted That Met QC Criteria: March 24, 2023
• First Posted (Actual): March 27, 2023

Study Record Updates

• Last Update Posted (Actual): March 27, 2023
• Last Update Submitted That Met QC Criteria: March 24, 2023
• Last Verified: March 1, 2023

More Information

Terms related to this study

• Keywords: Elderly; Electromyography; Range of Motion; Proprioceptive Neuromuscular Facilitation; Flexibility; Contract Relax
• Additional Relevant MeSH Terms: Pathologic Processes; Nervous System Diseases; Neurologic Manifestations; Musculoskeletal Diseases; Muscular Diseases; Neuromuscular Manifestations; Muscle Weakness
• Other Study ID Numbers: 16/9/121/JMI/IEC/2017

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