Impact of Tissue Flossing and Therapeutic Exercises in Patient With Knee Osteoarthritis

Summary

Knee osteoarthritis (OA) is a common degenerative joint disease that primarily affects individuals aged 40 years and older, and results in painful symptoms along with limited range of motion (ROM) and muscle weakness(1). Therapeutic exercise covers a range of targeted physical activities that directly aim to improve muscle strength, neuromotor control, joint range of motion and aerobic fitness. One of the main aims of exercise is to improve muscle strength, given that weakness is common in knee OA. Exercise, especially isometric ROM exercises and step-ups as therapeutic exercise, are very important in OA patients, because they not only maintain the activity of the joint but also treat the pain and strengthen the joint (2).Use of tissue flossing, in which an elastic band is wrapped around muscles and joints to enhance blood flow and reduce pain(3).It has been on the rise as an adjunct to rehabilitation, but its efficacy when combined with therapeutic exercise is not well-known. The objective of this non-blinded randomized controlled trial is to compare the effects of tissue flossing combined with therapeutic exercises versus therapeutic exercises alone on pain, ROM, and muscle strength in patients with knee OA. The study will be conducted over a period of 4 weeks, with two sessions per week at Sheikh Khalifa Bin Zayed Hospital, Quetta. Initially, participants aged 40-70 years with diagnosed Grade 1,2and 3 knee OA will be screened for eligibility based on inclusion and exclusion criteria. Eligible participants will be informed about the study objectives and procedures, and written informed consent will be obtained. Participants will then be randomly allocated into two groups using the envelope method for group randomization. Baseline assessment will include knee ROM measurement, muscle strength assessment using Manual Muscle Testing (MMT), pain evaluation using the Numeric Pain Rating Scale (NPRS), Group A will receive tissue flossing in addition to therapeutic exercises, while Group B will receive only therapeutic exercises. All outcome measures will be reassessed after 4 weeks of intervention to evaluate the effects of the intervention. Data will be entered and analyzed using SPSS v.22.

Conditions

• Knee Osteoarthristis

Interventions

PROCEDURE

Tissue flossing with Therapeutic exercises

Isometric Knee Extension - Standing Hamstring Curl - Wall Squats - Leg Press Against Wall. The Red TheraBand from Thera Tool (2m \* 5cm \* 1.3mm) will be used. The band will be wrapped starting from the tibial tuberosity and extending to 5 cm above the femoral epicondyle. Care will be taken to ensure that the patella remains uncovered. * The band will be wrapped with 50% tension and 50% overlap. * Flossing Duration: The floss band will be kept on for 2 minutes, and during this time, the patient will perform the exercises mentioned above. The number of repetitions for each exercise will depend on the patient's tolerance level, with a reference of 10 repetitions per exercise (based on similar tissue flossing protocols, though adapted for knee OA patients).

PROCEDURE

Therapeutic Exercises

Isometric Knee Extension - Standing Hamstring Curl - Wall Squats - Leg Press Against Wall.

Sponsors & Collaborators

• Foundation University Islamabad

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

40 Years

Max Age

70 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-09-30

Primary Completion

2026-08-01

Completion

2026-08-01

Countries

• Pakistan

Study Locations