Muscle Energy Technique and Muscle Flexibility

Not Applicable

Not yet recruiting

• Conditions: Hamstring Shortness

• Registration Number: NCT06855303
• Lead Sponsor: University of Hail

Brief Summary

The current study will compare the effect of using the muscle energy technique in 2 different methods on the hamstring muscle flexibility

Detailed Description

Osteoarthritis (OA) is a painful musculoskeletal disease that primarily affects the knee, resulting in the gradual degeneration of articular cartilage. Knee OA commonly affects the elderly population and may cause impairment throughout the world. About 4% of the world's population suffers from osteoarthritis, especially in those who are 50 years of age or older.

Age, trauma, congenital and acquired deformity, metabolic conditions, obesity, muscle weakness or imbalance, an occupation that requires prolonged sitting and knee bending, and female gender are all risk factors linked to the development of Knee OA.

Knee pain, morning stiffness, knee locking, or giving way, crepitus, and functional impairments are the common clinical symptoms of Knee OA.

Initial treatment always begins with conservative modalities and progresses to surgical treatment when conservative treatment fails. There is a variety of conservative techniques available for the treatment of knee OA.

The two main muscles that move the knee joint are the quadriceps and hamstrings, which help the knee joint's ambulatory growth factors move smoothly and precisely.

The hamstring muscles are noted for their tendency to shorten, and knee OA has been linked to decreased hamstring flexibility that can put more strain on the knee joint, reduce range of motion, and walking abnormalities. Furthermore, reduced flexibility can result in patellofemoral syndrome, which can cause pain and restrictions in physical functioning and increase the compressive load on the patellofemoral joint. Patellofemoral syndrome frequently contributes to osteoarthritis.

In general, when muscle is flexible, the body may avoid unnecessary energy expenditure and improve movement accuracy, strength, and coordination to ensure that muscles and joints can move freely. Therefore, increasing hamstring flexibility can aid in relieving symptoms and reducing knee joint pressure in patients with knee OA.

The first-line treatment for all symptomatic knee OA patients includes education and physiotherapy. Among the physiotherapy techniques, muscle energy techniques (MET) like post-isometric relaxation (PIR) and reciprocal inhibition (RI) have become popular due to their efficacy in relaxing and lengthening muscles, reducing pain, and improving overall function in patients with knee OA. Furthermore, MET helps the body drain blood and bodily fluids through the lymphatic or venous pumps, strengthen muscles, and increase the range of motion in joints with limited range of motion.

Numerous studies have demonstrated the benefits of MET in improving function, flexibility, and pain in knee OA patients. For example, MET may be more beneficial than conventional treatments in enhancing knee OA patients' flexibility and functional outcomes, whether used with or without other techniques.

However, few studies have compared the relative effectiveness of various MET approaches in treating knee OA patients' flexibility, pain, and joint mobility problems.

Finally, the majority of research regarding the impact of the MET on hamstring flexibility has brief observation periods involving small samples and low quality, primarily focusing on healthy individuals under the age of 45. Consequently, additional high-quality research should evaluate the efficacy of MET on hamstring flexibility required with larger sample sizes that include older age groups.

Therefore, more research is required to evaluate the impact of different MET on hamstring flexibility in knee OA patients.

Study Timeline

• Study First Submitted: 2025-02-25
• Study First Submitted QC: 2025-02-25
• Status Verified: 2025-03
• Study First Posted: 2025-03-03
• Last Update Submitted: 2025-03-07
• Last Update Posted: 2025-03-12
• Study Start: 2025-04-30
• Primary Completion: 2025-10-30
• Study Completion: 2025-10-30

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 60

Inclusion Criteria

• Radiologically and clinically diagnosed cases of Osteoarthritis knee by a certified Orthopaedic surgeon or Physiotherapist. Patients with Grade 2 or 3. Osteoarthritis knee according to Kellgren - Lawrence classification,
• Between the age group of 40-60 years, including both men and women.
• Hamstring tightness of more than 20 from the active knee extension test (AKET)

Exclusion Criteria

• Other knee joint pathologies such as Chondromalacia patella, plica syndrome,
• Neurological disorders.
• Patients having lower extremity injury/surgeries in the past 6 months,
• Hip or knee fractures or deformity,

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
The Numeric Pain Rating	From baseline to the end of the treatment at 6 weeks	The numeric pain rating Scale (NPRS) is the simplest and most commonly used numeric scale to rate the pain from 0 (no pain) to 10 (worst pain). The NPRS will be used for subjective pain measurement that has good test-retest reliability.
The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)	From baseline to the end of the treatment at 6 months	The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) will be used to measure symptoms and physical disability, originally developed for people with OA of the hip or knee. It evaluates three dimensions: pain, stiffness, and physical function
Sit and reach test	From baseline to the end of the treatment at 6 weeks	The Sit and reach test is one of the linear flexibility tests that helps to measure flexibility of the lower back and hamstring muscles.; equipment required: sit and reach box (or alternatively a ruler can be used, and a step or box).; procedure: This test involves sitting on the floor with legs stretched out straight ahead. Shoes should be removed. The soles of the feet are placed flat against the box. Both knees should be locked and pressed flat to the floor - the tester may assist by holding them down. With the palms facing downwards, and the hands on top of each other or side by side, the subject reaches forward along the measuring line as far as possible. After some practice reaches, the subject reaches out and holds that position for at least one to two seconds while the distance is recorded.; Ayala et al. showed acceptable reproducibility measures for the sit and reach test with 8.74% coefficient of variation (CV) and 0.92 intraclass correlation coe

Trial Locations

Locations (1)

University of Hail; 🇸🇦 Hail, Saudi Arabia