Tag: Knee osteoarthritis

Effectiveness of adding neuromuscular taping to ultrasound therapy and exercise therapy in increasing physical activity in older adults with knee osteoarthritis

Siti Muawanah, Azliyana Azizan, Zarina Zahari, Susi Endrini, Nova Relida Samosir, Suci Wahyu Ismiyasa, Rezky Guna Putra

Siti Muawanah, Azliyana Azizan, Zarina Zahari, Susi Endrini, Nova Relida Samosir, Suci Wahyu Ismiyasa et al. – Effectiveness of adding neuromuscular taping to ultrasound therapy and exercise therapy in increasing physical activity in older adults with knee osteoarthritis –  Fizjoterapia Polska 2025; 25(3); 392-402

DOI: https://doi.org/10.56984/8ZG7D19623K

Abstract
Introduction. Knee osteoarthritis (KOA) is a common degenerative condition that causes pain, swelling, limited range of motion, reduced leg muscle strength, restricted walking and stair climbing ability, and decreased quality of life.
Aim. This study aimed to evaluate the effectiveness of ultrasound therapy, exercise therapy, and neuromuscular taping (NMT) on pain, balance, and physical activity in older adults with knee osteoarthritis.
Materials and methods. An experimental design was used to compare two groups: a control group of KOA patients receiving ultrasound therapy and exercise, and an intervention group receiving a combination of neuromuscular taping, ultrasound therapy, and exercise. The effectiveness was assessed using core outcome measures: the visual analogue scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), range of motion (ROM), and the timed up and go (TUG) test, measured before and after a 4-week intervention (3 sessions per week) in a sample of 20 participants. Data were analyzed using parametric tests (independent samples t-test) as normality was confirmed (p > 0.05).
Results. Both groups showed a significant reduction in pain and improvements in balance and daily function, with superior outcomes in the intervention group (NMT + ultrasound + exercise). In the intervention group, VAS decreased by 2.60 (p < 0.000), WOMAC by 18.00 (p < 0.004), and TUG time by 10.86 seconds (p < 0.004). In the control group, VAS decreased by 3.20 (p < 0.000), WOMAC by 23.40 (p < 0.000), and TUG time by 14.40 seconds (p < 0.001).
Conclusions. The combination of ultrasound therapy, exercise, and neuromuscular taping is an effective therapeutic approach for improving pain, balance, and physical activity in older adults with knee osteoarthritis.
Key words
ultrasound therapy, exercise, neuromuscular taping, knee osteoarthritis, physical activity
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Effect of plyometric training in unilateral knee osteoarthritis

Prasanna Kumar R, Kotteeswaran K, Kamalakannan M, Hariharan J, Supriya P, Priyanga Seemathan, Dinesh S

 

Prasanna Kumar R et al.– Effect of plyometric training in unilateral knee osteoarthritis –  Fizjoterapia Polska 2025; 25(3); 100-103

DOI: https://doi.org/10.56984/8ZG7D19PD06

Abstract
Background. Osteoarthritis is a degenerative condition that begins with the onset of pain and gradually leads to decreased functional movement and activities. It is a complex, progressive disorder resulting in loss of articular cartilage, reduction of joint space, pain, loss of function, and physical incapacity, which together deteriorate quality of life. Plyometrics can be effective in improving joint awareness, balance, and neuromuscular properties, helping to enhance proprioception, kinaesthesia, and muscle performance.
Materials and methods. One hundred and four subjects with unilateral knee osteoarthritis were included in the study. Subjects with rheumatoid arthritis, polyarthritis, other joint complaints, systemic inflammatory arthropathies, previous knee replacement surgery, or intra-articular corticosteroid injections in either knee in the past 12 weeks were excluded. Participants were divided into two groups of 52 each: a control group (conventional exercises) and an experimental group (plyometric training along with conventional exercises) for 4 weeks. Pre- and post-tests were conducted using the knee injury and osteoarthritis outcome score (KOOS), which assesses pain, daily activities, and quality of life.
Results. The post-test values of both groups were compared to determine the difference in improvement due to the interventions. Based on all the data, the results show that the experimental group demonstrated greater improvement in KOOS components compared to the control group that received only conventional treatment.
Conclusion. It is concluded that plyometric training is an effective intervention for improving pain and functional outcomes among individuals with unilateral knee osteoarthritis.
Key words
conventional exercises, knee injury and osteoarthritis outcome score (KOOS), knee osteoarthritis, plyometric exercises
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Assessing the relationship between vitamin D, magnesium, and functional outcomes in knee osteoarthritis

Aisyah, Yose Waluyo, Nuralam Sam, Andi Alfian Zainuddin, Rumaisah Hasan, Anshory Sahlan

 

Aisyah, Yose Waluyo, Nuralam Sam, Andi Alfian Zainuddin, Rumaisah Hasan, Anshory Sahlan – Assessing the relationship between vitamin D, magnesium, and functional outcomes in knee osteoarthritis –  Fizjoterapia Polska 2025; 25(2); 86-91

DOI: https://doi.org/10.56984/8ZG7D19FZ3A

Abstract
Introduction. Knee osteoarthritis (KOA) is the most common degenerative joint disease and a major contributor to disability, highlighting the need to assess functional status alongside clinical findings. Despite the growing incidence of KOA, no simple therapy has significantly improved its functional impairments. Identifying modifiable risk factors, such as micronutrient levels, is necessary. While current research explores the relationship between vitamin D and magnesium with KOA severity, their association with specific functional status remains unclear. This study investigates the relationship between serum vitamin D and magnesium levels with functional status in KOA patients, using total and subscale Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.
Methods. Data from clinical assessments and laboratory tests were analyzed against total WOMAC scores using Fisher’s exact test, independent t-test, and Mann-Whitney test. Subscale correlations were evaluated with Pearson and Spearman tests.
Results. The mean vitamin D level was 20.59 ± 5.43 ng/ml, while the median magnesium level was 1.90 mmol/L. Vitamin D showed a significant negative correlation with total WOMAC scores (p < 0.05), whereas magnesium did not. Vitamin D was significantly negatively correlated with the pain and function subscales (p < 0.01), and magnesium was negatively correlated with the stiffness subscale (p < 0.05). Cut-off points for differentiating mild-moderate and severe WOMAC scores were 18.42 ng/ml for vitamin D (AUC 0.833, sensitivity 88.9%, specificity 69.2%) and 1.945 mmol/L for magnesium (AUC 0.634, sensitivity 88.9%, specificity 40.4%).
Conclusion. Compared to magnesium, vitamin D showed a significant negative correlation with total WOMAC scores, as well as the pain and function subscales, indicating a stronger association with functional outcomes in KOA. Its identified cut-off point effectively differentiates mild-moderate from severe WOMAC classifications. However, magnesium had a correlation with the stiffness subscale, a relationship not observed with vitamin D.

Keywords
vitamin D, magnesium, functional outcomes, knee osteoarthritis, WOMAC score

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Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha

 

Nevatha S, Kotteeswaran K, Kamalakannan M, Priyadarshini Babu Rajendra Prasad, Hariharan J, Josyula Snigdha – Effectiveness of lumbopelvic hip-core stabilisation exercises versus conventional strengthening exercises on electromyographic analysis of vastus medialis oblique activation in knee osteoarthritis –  Fizjoterapia Polska 2025; 25(2); 23-27

DOI: https://doi.org/10.56984/8ZG7D19CE52

Abstract
Introduction. Knee osteoarthritis (OA) is a common and debilitating condition, particularly affecting the medial compartment of the tibiofemoral joint, leading to pain, stiffness, and functional limitations. Exercise therapy, including muscle strengthening, is a primary conservative treatment for managing OA symptoms. The vastus medialis oblique (VMO) plays a crucial role in patellar stability, and its dysfunction is frequently associated with knee OA, contributing to altered joint mechanics and increased pain. Lumbopelvic hip-core exercises focus on improving control of trunk and pelvic movements, which may influence lower limb alignment and reduce knee joint load. Conventional quadriceps strengthening exercises primarily target the knee extensors, with an emphasis on enhancing VMO function.
Aim. The aim of the study was to determine which exercise approach is more effective in enhancing VMO activation, improving knee stability, and optimizing rehabilitation outcomes.
Materials and methods. Based on inclusion and exclusion criteria, 104 individuals diagnosed with knee osteoarthritis were recruited from Saveetha Hospital. Each group completed five exercise sessions per week over a four-week period. Electromyographic (EMG) analysis was used to assess muscle activation patterns and determine which intervention more effectively enhanced VMO activation.
Results. The post-test mean value for the experimental group was 60.29, while the control group had a mean of 48.15 (p < 0.0001). This indicated a statistically significant difference between the experimental and conventional exercise groups.
Conclusion. This study concludes that lumbopelvic hip-core stabilisation exercises are more effective than conventional quadriceps strengthening exercises in enhancing VMO activation, improving knee stability, and supporting rehabilitation in individuals with knee osteoarthritis.

Key words
knee osteoarthritis, vastus medialis oblique, lumbopelvic hip-core stabilisation, conventional strengthening, surface EMG

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Capsular stretching as physiotherapy technique for Sudanese patients with knee osteoarthritis in Al-Neelain University Physiotherapy Outpatient Clinic

Heba Alkazaleh, Yosra Adam, Hassan Abdelnour, Nermeen Bleedy

Heba Alkazaleh, Yosra Adam, Hassan Abdelnour, Nermeen Bleedy – Capsular stretching as physiotherapy technique for Sudanese patients with knee osteoarthritis in Al-Neelain University Physiotherapy Outpatient Clinic –  Fizjoterapia Polska 2024; 24(5); 195-200

DOI: https://doi.org/10.56984/8ZG020CXF6T

Abstract Background. Osteoarthritis (OA) is a chronic articular disorder of multifactorial etiology. Its pathogenesis contributes to the degradation of articular cartilage, periarticular bone remodeling, and capsular fibrosis. It is conventionally treated by a combination of pharmacologic and non-pharmacologic modalities and surgical interventions. Physiotherapy is considered a first- and second-line treatment. Recent developments in manual therapy have shown very promising improvements in pain and physical function. Purpose of the study. To explore the prevalence of knee osteoarthritis patients in Al-Neelain University Faculty of Physiotherapy Outpatient Clinic. Materials and methods. It’s a single-blinded randomized controlled trial conducted in the outpatient clinic of the Faculty of Physiotherapy at Al-Neelain University. Thirty patients were recruited for the study and divided randomly into two groups; 15 (experimental), known as group A, received capsular stretching technique & 15 (control), known as group B, received no treatment. Both groups were assessed at the baseline and after two weeks for ROM by electro-goniometer, and functional performance by WOMAC scale. Data was analyzed by Statistical Package for the Social Sciences (SPSS). Results. The group A that received capsular stretching showed statistically significant improvement in knee ROM (both flexion & extension; active & passive) compared with no treatment. Regarding functional performance; WOMAC scores showed a highly statistically significant difference between comparative groups with P value = 0.00003 in Group A and = 0.28 in Group B. Conclusion. The study concluded that the capsular stretching technique is effective in treating & improving patients with knee OA in pain, ROM, and functional performance.
Key words knee osteoarthritis, manual therapy, capsular stretching
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Effect of Graston technique on hamstring flexibility in knee osteoarthritis patients: A randomized controlled study

Amir Mohamed Saleh, Muhammad Fathi Abdul Galil, Hamada Ahmed Hamada, Ghada Abd-Elmoniem Abdullah

 

Amir Mohamed Saleh, Muhammad Fathi Abdul Galil, Hamada Ahmed Hamada, Ghada Abd-Elmoniem Abdullah – Effect of Graston technique on hamstring flexibility in knee osteoarthritis patients: A randomized controlled study –  Fizjoterapia Polska 2024; 24(5); 38-44

DOI: https://doi.org/10.56984/8ZG020C7YPF

Abstract
Purpose. To investigate the effect of Graston technique on hamstring flexibility in patients with knee osteoarthritis.
Methods. Randomized controlled trial. Overall, 30 patients of both genders with age ranged from 38-50 years with moderate knee osteoarthritis (Kellgren & Lawrence grade 3′ moderate’) were recruited randomly from the outpatient clinic of Kafr El-Sheikh General hospital and the outpatient clinic of Faculty of Physical Therapy in Kafr El-Sheikh University and divided into two equal groups; Group (A) (control group) (15 subjects), received conventional treatment of knee osteoarthritis (in form of stretching exercise for hamstring muscle and strengthening exercise for quadriceps muscle) for 4 weeks, Group (B) (experimental group) (15 subjects), received the same conventional treatment plus Graston technique for 4 weeks. Pre- and post-treatment assessment using active knee extension test (AKET), sit and reach flexibility test (SRFT) and dynamic balance were done for all patients.
Results. The comparison between both groups post-treatment revealed statistically significant improvement in AKET, as well as SRFT and dynamic balance (p < 0.05) in favor of experimental group (B).
Conclusion. Graston technique have a significant effect on improving flexibility of hamstring muscle in patients with knee osteoarthritis.
Keywords
active knee extension test, Graston technique, hamstring flexibility, knee osteoarthritis, sit and reach flexibility test
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Review of systematic reviews on the effects of blood flow restriction training on knee osteoarthritis patients

Ahmed Abdelmoniem Ibrahim, Shammaa Homoud H Alsroor, Mashael Jarallah A Alshammari,Khalid Ayad S Alanazi, Amany Raafat Mohamed, Hisham Mohamed Hussein

Ahmed Abdelmoniem Ibrahim et al. – Review of systematic reviews on the effects of blood flow restriction training on knee osteoarthritis patients –  Fizjoterapia Polska 2024; 24(4); 379-384

DOI: https://doi.org/10.56984/8ZG01A8R3T9

Abstract
Objectives. A review of the systematic reviews designed to assess the overall certainty in the evidence for the effect of blood flow restriction training (BFRT) in patients with knee osteoarthritis (OA).
Methods. A systematic search identified systematic reviews using BFRT in knee osteoarthritis OA. Two authors searched five electronic databases, including Google Scholar, Cochrane Library, PubMed, PEDro, and CINAHL, from October 2010 to October 2023. The quality of included reviews was analyzed by the AMSTAR tool.
Results. Six systematic reviews were eligible, and 33 randomized controlled trials (RCTs) with a total of 1248 participants were included. The quality varied from moderate to high, and results showed minimal enhancement in pain, physical function, and life quality.
Conclusion. The synthesis of the reviews has shown some potential improvement in OA patient outcomes. BFRT can be beneficial in OA rehabilitation, and the findings suggest conducting a higher-quality review to explore the use of BFRT with different loads.
Key words
knee osteoarthritis, training, blood flow restriction, review, AMSTAR
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Gender differences in effects of Graston technique, active release technique, and PNF stretching on hamstring flexibility in knee osteoarthritis

Um Habiba, Aisha Razzaq, Tahir Masood, Suman Sheraz

Um Habiba, Aisha Razzaq, Tahir Masood, Suman Sheraz – Gender differences in effects of Graston technique, active release technique, and PNF stretching on hamstring flexibility in knee osteoarthritis –  Fizjoterapia Polska 2024; 24(4); 202-206

DOI: https://doi.org/10.56984/8ZG01A8Z2Q9

Abstract
Aims. To seek gender differences among the effects of the Graston Technique (GT), Active Release Technique (ART), and Proprioceptive Neuromuscular Facilitation (PNF) stretching on hamstring flexibility, pain, lower extremity function, and physical function in patients with knee osteoarthritis.
Materials and methods. A multicenter, single-blind randomized controlled trial was conducted involving 45 patients – aged above 30 years with knee osteoarthritis – randomly allocated to three equal groups: Group-A (GT), Group-B (ART), and Group C (PNF). Each group received 12 physiotherapy sessions over a four-week intervention period (3 visits per week). Data were collected before and after rehabilitation using the Numeric Pain Rating Scale, Active Knee Extension Test, Lower Extremity Function Scale, and Western Ontario and McMaster Universities Arthritis Index (WOMAC).
Results. A statistically significant interaction between the effects of gender and Active Release Technique on lower extremity function was present (p < 0.001) with males (42.4 ± 2.2) showed more improvement than females (35.6 ± 6.6). On the contrary, females showed more improvement (p < 0.001) than males when Graston Technique and PNF techniques were applied.
Conclusion. There were no significant gender-based differences among GT, ART, and PNF regarding pain, hamstring flexibility and WOMAC score. However, males showed significantly more improvement in lower extremity function than females with ART, and females showed more improvement in lower extremity function as compared to males with GT and PNF.
Keywords
active release technique, graston technique, hamstring flexibility, knee osteoarthritis, proprioceptive neuromuscular facilitation
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Impact of high-power laser therapy on bilateral knee osteoarthritis: A randomized trial

Mohamed I. Roheym, Mona E. Morsy, Mahmoud Saber, Alaa A. Balbaa, Samya Mohamed Hegazy

Mohamed I. Roheym, Mona E. Morsy, Mahmoud Saber, Alaa A. Balbaa, Samya Mohamed Hegazy – Impact of high-power laser therapy on bilateral knee osteoarthritis: A randomized trial. Fizjoterapia Polska 2023; 23(5); 162-168

DOI: https://doi.org/10.56984/8ZG20AA3C

Abstract
Background. Osteoarthritis is the most common type of arthritis. It is the main cause of chronic musculoskeletal pain and disability, it decreases the flexibility of the joint, and causes pain, joint effusion and loss of function among the elderly population.
Objective. To examine how HILL therapy (High intensity laser therapy NDYAG 1064 nm) affects knee osteoarthritis. Design. A prospective randomized controlled trial. Setting. Outpatient Swiss physical therapy center.
Methods. Thirty patients of both gender having bilateral knees osteoarthritis were recruited and randomized into two equal groups: the control group received a program of selected quadriceps muscle sets exercise and hamstring, calf muscles stretching for 4 weeks, and the study group received the same control group interventions in addition to HILL application. Ultrasonography degree was the primary outcome, While Western Ontario and McMaster universities (WOMAC) osteoarthritis index measures were the secondary outcomes. All variables were measured at the baseline and after 4 weeks of the intervention.
Results. Statistical analysis was done by using paired’ test which showed significant improvement in both groups. Therefore, there was a significant difference between Group(A) and Group(B), showing that HILL group(A) is more effective than group(B) on pain, Stiffness, Function and ultrasonographic findings (p < 0.05).
Conclusion. Using HILT with a standard program of quadriceps muscle strengthen exercise sets and hamstring, calf muscles stretching has more beneficial effects on bilateral knee osteoarthritis than practicing the exercise program alone.

Keywords
knee osteoarthritis, high power laser, physical exercise, ultrasonography

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Comparative study of the effectiveness of high-power laser and ketoprofen phonophoresis in chronic knees osteoarthritis

Mohamed I. Roheym, Mona E. Morsy, Mahmoud Saber, Alaa A. Balbaa, Abdullah M, Al-Shenqiti

 

Mohamed I. Roheym, Mona E. Morsy, Mahmoud Saber, Alaa A. Balbaa, Abdullah M, Al-Shenqiti – Comparative study of the effectiveness of high-power laser and ketoprofen phonophoresis in chronic knees osteoarthritis. Fizjoterapia Polska 2023; 23(4); 196-201

DOI: https://doi.org/10.56984/8ZG20A657

Abstract
Background. Osteoarthritis is one of the major causes of disability and reduced quality of life. characterized by progressive joint degeneration. It decreases the flexibility of the joint, and causes pain, joint effusion, deformities and loss of function.
Objective. To investigate the effectiveness of phonophoresis and high-power laser therapy on bilateral knees osteoarthritis.
Design. A prospective randomized double-blind trial.
Setting. Outpatient Swiss physical therapy center.
Methods. Thirty patients from both genders, with their age ranging from 50-65 years that had diagnosed bilateral knees osteoarthritis selected randomized assigned into two equal groups. Group (A) received single application of high-power laser NDYAG 1064nm.Group (B) received single application of phonophoresis. Pain, Difficulty and joint effusion were measured by Ultrasonographic findings and western Ontario and McMaster universities (WOMAC) osteoarthritis index before and after 10 sessions treatment.
Results. Statistical analysis was done by using paired’ test which showed significant improvement in both groups. Therefore, there was a significant difference between Group(A) and Group(B), showing that HILL group(A) is more effective than group(B) on pain, Stiffness, Function and ultrasonographic findings (p < 0.05).
Conclusion. High power laser therapy has shown significant results in the reduction of pain, stiffness, improving function and effusion in subjects with bilateral knees osteoarthritis.
Keywords
knee osteoarthritis, high power laser, phonophoresis, ultrasonography
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