Strain Counterstrain and Muscle Energy Technique in Patients of Knee Osteoarthritis

University of Lahore

Status: Completed

Conditions: Stroke

Treatments: Behavioral: Muscle Energy Technique with Routine Physical Therapy; Behavioral: Strain Counterstrain with Routine Physical Therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT07066670

Rec-UOL-/204/08/24

Details and patient eligibility

About

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.

Full 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.

Enrollment: 76 patients

Sex: All

Ages: 45 to 65 years old

Volunteers: No Healthy Volunteers

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).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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76 participants in 2 patient groups

Strain Counterstrain with Routine Physical Therapy

Experimental group

Description:

Participants in this arm received Strain Counterstrain (SCS) along with routine physical therapy. SCS involved identifying and holding tender points in positions of comfort for 90 seconds to relieve pain and improve range of motion. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was delivered 5 days a week for 8 weeks. Education on weight management and joint protection strategies was also provided.

Treatment:

Behavioral: Strain Counterstrain with Routine Physical Therapy

Muscle Energy Technique with Routine Physical Therapy

Experimental group

Description:

Participants in this arm received Muscle Energy Technique (MET) along with routine physical therapy. MET involved post-isometric relaxation and slow eccentric isotonic stretching techniques targeting hamstrings and quadriceps, helping to restore joint mobility and muscle flexibility. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was administered 5 days per week over 8 weeks, along with patient education on lifestyle and joint care.

Treatment:

Behavioral: Muscle Energy Technique with Routine Physical Therapy