Effects of Sahrmann's Approach Versus Conventional Treatment Oin Patients With Knee Osteoarthritis

June 8, 2026 updated by: Riphah International University

Effects of Sahrmann's Approach Versus Conventional Treatment on Pain, Valgus Angle and Functional Disability in Patients With Knee Osteoarthritis

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.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

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

Enrollment (Estimated)

40

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54000
        • University of Lahore Teaching Hospital, Lahore HOD Physio Department

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Males and females between 40 to 60 years of age.
  • Diagnosed patients of knee Osteoarthritis with grade 2.
  • Valgus angle of knee > 10°.

Exclusion Criteria:

  • Any other inflammatory conditions.
  • Rheumatoid arthritis, ankylosing spondylitis or any other auto immune disorder

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Sahrmann's exercises
Dr. Shirley Sahrmann's Movement System Impairment (MSI) approach for knee osteoarthritis operates on the kinesiopathologic model: it asserts that repetitive faulty movement patterns and sustained improper alignments-not just age or wear-are primary drivers of joint stress and cartilage breakdown
Other: Sahrmann's exercises
  • 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
Active Comparator: Standard Physical therapy

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
Other: standard physical therapy treatment

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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale (NPRS) - Pain Assessment
Time Frame: upto 4 weeks

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.
upto 4 weeks
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - Functional Outcome (Knee OA)
Time Frame: upto 4 weeks

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.
upto 4 weeks
Universal Goniometer (UG) - Valgus Angle Measurement
Time Frame: upto 4 weeks

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.
upto 4 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Arooj Sohail, MSPT*, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

July 1, 2026

Primary Completion (Estimated)

September 1, 2026

Study Completion (Estimated)

October 1, 2026

Study Registration Dates

First Submitted

June 8, 2026

First Submitted That Met QC Criteria

June 8, 2026

First Posted (Actual)

June 11, 2026

Study Record Updates

Last Update Posted (Actual)

June 11, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0112 Arooj

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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