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Different Proprioceptive Neuromuscular Facilitation (PNF) Technique in Patients With Knee Osteoarthritis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03615521
Recruitment Status : Recruiting
First Posted : August 6, 2018
Last Update Posted : February 11, 2020
Information provided by (Responsible Party):
Ayşenur Karaman, Hacettepe University

Brief Summary:
The aim of this study is to investigate the effects of 6-week physiotherapy and rehabilitation programs involving different 'Proprioceptive Neuromuscular Facilitation' (PNF) techniques in patients with knee osteoarthritis on pain, proprioception, postural control, muscle strength, range of motion and knee functions

Condition or disease Intervention/treatment Phase
Muscle Weakness Balance Disorders Knee Pain Knee Osteoarthritis Other: Hotpack Other: Ultrasound Other: Combine Exercise Other: Repeated Contraction Exercise Other: Standart Exercise Therapy Not Applicable

Detailed Description:

The results obtained from this study will contribute to the selection of PNF technique which is most suitable for physiotherapies working on knee osteoarthritis in clinics as well as demonstrating the efficacy of PNF which has been studied in the literature very few times.

As a result of this study, the evidence value of the PNF technique will be determined in the physiotherapy and rehabilitation program of patients with knee osteoarthritis, and the efficacy of this technique, which is theoretically adopted, will be demonstrated scientifically. It will also determine the most ideal of the two PNF techniques to be applied in patients with knee osteoarthritis

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 35 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: Diz Osteoartritinde Farklı Proprioseptif Nöromüsküler Fasilitasyon Tekniklerinin, Ağrı, Propriosepsiyon, Postural Kontrol, Kas Kuvveti, Eklem Hareket Açıklığı ve Diz Fonksiyonları Üzerine Olan Etkileri
Actual Study Start Date : January 20, 2018
Estimated Primary Completion Date : May 20, 2020
Estimated Study Completion Date : October 10, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: Repeated Contraction Exercise Group
Repeated Contractions Exercise Group, Hotpack apply for knee 20 minute, Ultrasound is a termal ajan which use for 10 minute and Repeated Stretch (Repeated Contractions) exercise. Repeated Contractions exercise is type of Proprioceptive Neuromusculer Facilititation Exercise. 3 session for 6 weeks.
Other: Hotpack
Hotpack applied 20 minutes for knee 3 session for 6 weeks

Other: Ultrasound
Ultrasound applied 10 minutes for knee 3 session for 6 weeks

Other: Repeated Contraction Exercise
Proprioceptive Neuromusculer Facilitation Technique include concentric contractions 3 session for 6 week

Experimental: Combine Exercise Group

Combination of Isotonics Exercise Group, Hotpack apply for knee 20 minute, Ultrasound is a termal ajan which use for 10 minute Combination of Isotonics Exercise. Combination of Isotonics Exercise is type of PNF. Combined concentric, eccentric, and stabilizing contractions of one group of muscles (agonists) without relaxation.

3 Session for 6 weeks.

Other: Hotpack
Hotpack applied 20 minutes for knee 3 session for 6 weeks

Other: Ultrasound
Ultrasound applied 10 minutes for knee 3 session for 6 weeks

Other: Combine Exercise
Proprioceptive Neuromusculer Facilitation Technique İnclude eccentric and concentric contractions 3 session for 6 week

Experimental: Standart Exercise Therapy

Classic Physiotherapy: Hotpack, Ultrasound, Standart exercise program to improve Quadriceps, Hamstring and hip muscle strength.

3 session for 6 weeks.

Other: Hotpack
Hotpack applied 20 minutes for knee 3 session for 6 weeks

Other: Ultrasound
Ultrasound applied 10 minutes for knee 3 session for 6 weeks

Other: Standart Exercise Therapy

Quadriceps, hamstring and hip muscle strength exercise. Hamstring stretch exercise.

3 session for 6 week

Primary Outcome Measures :
  1. Quadriceps Femoris Muscle Strength [ Time Frame: 6 week ]

    Quadriceps Femoris muscle strength is evaluated Biodex System. Patients performs knee extension strongly and system analyzed. System gives us Peak Torque which indicates the muscle's maximum strength capability.

    1 repetition maximum (RM) isotonic strength test.

Secondary Outcome Measures :
  1. Knee Proprioception (30-45 and 60 degree) [ Time Frame: 6 week ]
    Proprioception is evaluated with Biodex System (30-45 and 60 degree)

  2. KOOS score [ Time Frame: 6 week ]
    KOOS consists of 5 subscales; Pain, other Symptoms, Function in daily living (ADL), Function in sport and recreation (Sport/Rec) and knee related Quality of life (QOL). The previous week is the time period considered when answering the questions. Standardized answer options are given (5 Likert boxes) and each question is assigned a score from 0 to 4. A normalized score (100 indicating no symptoms and 0 indicating extreme symptoms) is calculated for each subscale (scoring instructions are available in a separate document: KOOS Scoring). A total score has not been validated and is not recommended.

  3. Step test [ Time Frame: 6 week ]
    Climb and step in 10 steps. Brief time is better.

  4. Womac Score [ Time Frame: 6 week ]

    It is a self-administered questionnaire consisting of 24 items divided into 3 subscales Pain (5 items): during walking, using stairs, in bed, sitting or lying, and standing upright Stiffness (2 items): after first waking and later in the day Physical Function (17 items): using stairs, rising from sitting, standing, bending, walking, getting in / out of a car, shopping, putting on / taking off socks, rising from bed, lying in bed, getting in / out of bath, sitting, getting on / off toilet, heavy domestic duties, light domestic duties scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. Usually a sum of the scores for all three subscales gives a total WOMAC score, however there are other methods that have been used to combine scores.

    Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

  5. 6 Minute walking test [ Time Frame: 6 week ]
    The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity. "The object of this test is to walk as far as possible for 6 minutes. More walk in a short time is better performance.

  6. Balance [ Time Frame: 6 week ]
    Balance is evaluated Biodex Balance System (BBS). This device, clinicians can assess neuromuscular control by quantifying the ability to maintain dynamic bilateral and unilateral postural stability on a static or unstable surface. In the measurement with the BBS, the personal values of the patient are determined and compared to reference values. Balance deficits are determined on this basis. BBS permits three measurements to be obtained including overall stability index (OSI), anterior-posterior stability index (APSI) and medial-lateral stability index (MLSI). Balance and risk of fall were assessed using two trials over a period of 30 seconds with 10 seconds rest in between. If total score close zero, accepted better.

  7. Knee Pain Severity [ Time Frame: 6 week ]
    Pain is evaluated with visual analog scale. The pain VAS is self‐completed by the respondent. The respondent is asked to place a line perpendicular to the VAS line at the point that represents their pain intensity. ''0'' means no pain, ''10'' means much pain, ''5'' means moderate pain.

  8. Algometer [ Time Frame: 6 week ]
    Algometers are devices that can be used to identify the pressure and/or force eliciting a pressure-pain threshold.The handheld algometer had a 1-cm2 round rubber application surface.The investigator placed the digital pressure algometer on a site to be inspected and pressed against the tester in a vertical direction while increasing the force at a constant rate of 1 kg/cm2. The investigator instructed the subjects to express pain either by saying "ouch" or raising their hands when only slight pain was felt.

Other Outcome Measures:
  1. Time up and go test [ Time Frame: 6 week ]

    Patient stand up, walk to the line on the floor and turn around and walk back to the chair and sit down. Start timing on the word "GO" and stop timing when the subject is seated again correctly in the chair with their back resting on the back of the chair.

    Normal healthy elderly usually complete the task in ten seconds or less. Very frail or weak elderly with poor mobility may take 2 minutes or more.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   45 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Between the ages of 45-65
  • The diagnosis of stage 1-2 osteoarthritis by the orthopedist
  • Volunteerig for research
  • No hearing, vision and speech impediment

Exclusion Criteria:

  • Patients with intra-articular contracture,
  • No Meniscus and no ligament problems
  • Presence of any neurological or cardiopulmonary disease that may affect the results of the study

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03615521

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Contact: Ayşenur Karaman, PT 03123051576

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Hacettepe Recruiting
Ankara, Turkey
Contact: AYŞENUR KARAMAN, Pt    05536431292   
Sponsors and Collaborators
Hacettepe University
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Study Director: Filiz Can, Prof. Hacettepe University

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Responsible Party: Ayşenur Karaman, Research Assistant, Hacettepe University Identifier: NCT03615521    
Other Study ID Numbers: 2017/09-36 (KA-17112)
First Posted: August 6, 2018    Key Record Dates
Last Update Posted: February 11, 2020
Last Verified: February 2020

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Osteoarthritis, Knee
Muscle Weakness
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases
Muscular Diseases
Neuromuscular Manifestations
Neurologic Manifestations
Nervous System Diseases
Pathologic Processes
Signs and Symptoms