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NCT Number: NCT07066670

Strain Counterstrain and Muscle Energy Technique in Patients of Knee Osteoarthritis

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.

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Key information

Conditions

Stroke Agnosia Arthritis Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Joint Diseases Musculoskeletal Diseases Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Osteoarthritis Osteoarthritis, Knee Pathological Conditions, Signs and Symptoms Perceptual Disorders Rheumatic Diseases Signs and Symptoms Vascular Diseases

Age range

45 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The University of Lahore Teaching Hospital

Lahore, 54590, Pakistan

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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).

Treatment and study plan

Strain Counterstrain with Routine Physical Therapy

Behavioral

This intervention involves applying the Strain Counterstrain (SCS) technique in combination with standard physical therapy. SCS targets tender points through passive positioning to reduce muscle tension and pain. The patient is positioned in a position of comfort for 90 seconds while monitoring the tender point. This is followed by gradual return to neutral. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), strengthening (short arc quads, terminal knee extension), and stretching exercises. The therapy is administered 5 days per week over 8 weeks.

Muscle Energy Technique with Routine Physical Therapy

Behavioral

This intervention combines Muscle Energy Technique (MET) with routine physical therapy. MET involves voluntary muscle contractions against resistance, followed by stretching to restore range of motion and relieve pain. Techniques include post-isometric relaxation and slow eccentric isotonic stretching, particularly targeting hamstring and quadriceps tightness. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), as well as structured strengthening and stretching exercises. The intervention was delivered 5 days a week for 8 weeks.

Primary outcomes

  1. Pain intensity reduction measured by Numeric Pain Rating Scale (NPRS)

    Time frame: Baseline, Week 4, and Week 8

    Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 indicates "no pain" and 10 indicates "worst possible pain." Assessments were conducted at baseline, 4 weeks, and 8 weeks. A lower score represents improvement.

Secondary outcomes

  1. Improvement in range of motion (ROM) measured using goniometry

    Time frame: Baseline, Week 4, and Week 8

    Range of motion (ROM) of the affected knee was measured using a standard universal goniometer. The focus was on knee flexion and extension. Measurements were taken at baseline, 4 weeks, and 8 weeks to evaluate changes over time.

  2. Change in functional disability measured by KOOS questionnaire

    Time frame: Baseline, Week 4, and Week 8

    Functional disability was assessed using the Knee Injury and Osteoarthritis Outcome Score (KOOS). It includes five subscales (pain, symptoms, ADL, sport/recreation, QOL). Higher scores indicate better function. Assessed at baseline, 4 weeks, and 8 weeks.

Sponsors and collaborators

Lead sponsor

University of Lahore

Other

Registry information

Official study title

Comparative Effects of Strain Counterstrain and Muscle Energy Technique on Pain, Range of Motion, and Functional Disability in Patients of Knee Osteoarthritis

Important dates

Study start
2024
Primary completion
2024
Study completion
2025
First posted
Jul 15, 2025
Registry last updated
Jul 15, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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