Effects of Voodoo Flossing Technique in Knee Osteoarthritis Patients

NCT06986694 | Recruiting

• 1 other identifier: REC/RCR&AHS/24/0153
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by pain, stiffness, and reduced physical function, significantly impacting quality of life especially in elderly population. This study aims to evaluating the effectiveness of an emerging technique, known as 'Voodoo Flossing' on pain, range of motion and physical function in KOA to provide evidence-based insight of voodoo flossing as a potential therapeutic adjunct in KOA management. This randomized controlled trial will be conducted at Riphah Rehabilitation Clinic, Lahore and Horizon Hospital Lahore in a time span of 8 months. A sample size of 42 subjects selected through non-probability convenient sampling with age group between 45 to 65 having present complain confirmed through Kellgren-Lawrence (KL) scale of grade-II will be divided into two groups, will undergo aerobic exercises, strengthening exercises and conventional physiotherapy protocol either with or without Voodoo Flossing technique.

Conditions

Knee Osteoarthritis; Pain; Range of Motion; Physiotherapy

Keywords

Knee Osteoarthritis; Pain; Physical Function; Physiotherapy; Range of Motion; Voodoo Flossing

Outcome Measures

Primary Outcomes (2)

• Numeric Pain Rating Scale

  Patient level of pain will be assessed using this scale. This scale ranges from 0 to 10. 0 indicates "no pain" and 10 indicates "worst pain". In this study, participants rating ≥2 and ≤9 on NPRS will be taken.

  4th week

• The Western Ontario and McMaster Universities Osteoarthritis Index

  WOMAC index is a widely used questionnaire designed to assess the three dimensions of pain, stiffness, and physical function in individuals with OA of the hip or knee. It is a 24-item questionnaire divided into three sub-categories: Pain (5 items), Stiffness (2 items), Physical Function (17 items). Participants having poor scoring on WOMAC scale for pain, stiffness and physical activities will be considered for this study.

  4th week

Secondary Outcomes (2)

• Time Up & Go Test

  4th week

• Universal Goniometer

  4th week

Study Arms (2)

Voodoo Flossing technique along with aerobic & strengthening exercises and conventional protocol.

EXPERIMENTAL

Patient will sit or lie down comfortably with affected knee exposed and in extension. Start by wrapping voodoo floss band at the shin bone just below the knee joint with 50% tension in the band and 50% overlapping on each wrap by working your way up towards the thigh. Keep the flossing band on for at least 1-2 minutes and perform gentle knee movements to promote mobility. * Knee flexion and extension in full range of motion in standing position 20-30 sec. * Knee squats with/without support 20-30 sec. * Abduction and Adduction 20-30 sec. Perform each exercise with 10-15 seconds of rest between each set. After completing ROM exercises, allow the knee to rest in comfortable position and then carefully unwrap the voodoo band from the knee joint. Also monitor the knee for any changes.

Other: Group A will receive Voodoo Flossing Technique along with aerobic and strengthening exercises & conventional physiotherapy protocol for Knee OA.

Aerobic and strength training and conventional physiotherapy protocol for knee OA.

ACTIVE COMPARATOR

Aerobic Exercises: Walking or Stationary Cycling 2 times a week for 4 weeks. Walking: On flat surface or Treadmill 10 minutes warm-up, 30 minutes brisk walking, 5 minutes cool down. Cycling: Ergometer cycling * 10 minutes warm-up, 30 minutes on moderate loading (75% of max. heart rate), 5 minutes cool down. Strengthening Exercises Conventional Exercise Program: 2 times per week for 4 weeks Heat Therapy Ultrasound Therapy * Static Quadriceps activation 10\*2 RM * SLR 10\*2 RM * VMO activation 10\*2 RM * Knee to Chest 5\*2 RM * Quads, Hams \& Calf stretches

Other: Group B will receive aerobic and strength training and conventional physiotherapy protocol for knee OA only.

Interventions

Group A will receive Voodoo Flossing Technique along with aerobic and strengthening exercises & conventional physiotherapy protocol for Knee OA. OTHER

Patient will sit or lie down comfortably with affected knee exposed and in extension. Start by wrapping voodoo floss band at the shin bone just below the knee joint with 50% tension in the band and 50% overlapping on each wrap by working your way up towards the thigh. Keep the flossing band on for at least 1-2 minutes and perform gentle knee movements to promote mobility. * Knee flexion and extension in full range of motion in standing position 20-30 sec. * Knee squats with/without support 20-30 sec. * Abduction and Adduction 20-30 sec. Perform each exercise with 10-15 seconds of rest between each set. After completing ROM exercises, allow the knee to rest in comfortable position and then carefully unwrap the voodoo band from the knee joint. Also monitor the knee for any changes.

Voodoo Flossing technique along with aerobic & strengthening exercises and conventional protocol.

Group B will receive aerobic and strength training and conventional physiotherapy protocol for knee OA only. OTHER

Aerobic Exercises: Walking or Stationary Cycling 2 times a week for 4 weeks Walking: On flat surface/Treadmill * 10 minutes warm-up, 30 minutes brisk walking, 5 minutes cool down. Cycling: Ergometer cycling * 10 minutes warm-up, 30 minutes on moderate loading (75% of max. heart rate), 5 minutes cool down. Strengthening Exercises: Quadriceps, Hamstrings, Hip Abductors, Adductors and Calf Muscles Strengthening and Balance Training 2 times a week for 4 weeks. * Hip Abduction in standing 8-10\*2 RM * Hip Adduction in standing 8-10\*2 RM * Knee Flexion and Extension in standing 10\*2 RM * Knee Squats 8-10\*2 RM * Sit/stand from chair 10\*2 RM * Step up and down 10\*2 RM * Heel raises 10\*2 RM * Hip Bridges 10\*2 RM Conventional Exercise Program: 2 times per week for 4 weeks Heat Therapy Ultrasound Therapy * Static Quads activation 10\*2 RM * SLR 10\*2 RM * VMO activation 10\*2 RM * Knee to Chest 5\*2 RM * Quadriceps, Hamstrings and Calf stretches 5\*2 RM

Aerobic and strength training and conventional physiotherapy protocol for knee OA.

Eligibility Criteria

• Age: 45 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥ 45 and ≤ 65
• Both Male and Female
• Knee Pain persisting for at-least 3 months
• Pain severity during walking ≥ 2/10 on a Numeric Pain Rating Scale
• Walking and Balance (Mobility) problems according to Time Up \& Go (TUG) test
• Poor scoring on WOMAC scale for pain, stiffness and physical activities
• Knee OA Grade II (according to Kellgren-Lawrence method)
• Participants must provide informed consent for participation in RCT

You may not qualify if:

• Age \< 45 and \> 65
• Severe Knee pain during Walking ≥ 9/10 on a Numeric Pain Rating Scale
• Knee OA Grade I, III \& IV (according to Kellgren-Lawrence method)
• Physical or Mental co-morbidity severely affecting daily life of patient
• Any Contraindication to provide Exercise Therapy
• Suspicion of chronic widespread pain (i.e., pain present for at least 3 months in at least three joints including left and right side of the body, above and below the waist, and the axial skeleton)
• Participant undergone total knee arthroplasty or on waiting list for total knee arthroplasty in any knee
• Any other reasons for knee pain than knee OA (e.g., rheumatoid arthritis and gout)
• Received intraarticular injections in past 6 months because of knee pain (Hyaluronic Gel or steroid)

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Horizon Hospital

Lahore, Punjab Province, 54782, Pakistan

RECRUITING

Related Publications (5)

• Acar S, Aljumaa H, Sevik K, Karatosun V, Unver B. The Intrarater and Interrater Reliability and Validity of Universal Goniometer, Digital Inclinometer, and Smartphone Application Measuring Range of Motion in Patients with Total Knee Arthroplasty. Indian J Orthop. 2024 Apr 19;58(6):732-739. doi: 10.1007/s43465-024-01129-z. eCollection 2024 Jun.

  PMID: 38812867 BACKGROUND

• Oiestad BE, Aroen A, Rotterud JH, Osteras N, Jarstad E, Grotle M, Risberg MA. The efficacy of strength or aerobic exercise on quality of life and knee function in patients with knee osteoarthritis. A multi-arm randomized controlled trial with 1-year follow-up. BMC Musculoskelet Disord. 2023 Sep 8;24(1):714. doi: 10.1186/s12891-023-06831-x.

  PMID: 37684597 BACKGROUND

• Kelly CF, Oliveri Z, Saladino J, Senatore J, Kamat A, Zarour J, Douris PC. The Acute Effect of Tissue Flossing on Pain, Function, and Perception of Movement: A Pilot Study. Int J Exerc Sci. 2023 Jul 1;16(3):855-865. doi: 10.70252/OKAO5505. eCollection 2023.

  PMID: 37637031 BACKGROUND

• Tore NG, Oskay D, Haznedaroglu S. The quality of physiotherapy and rehabilitation program and the effect of telerehabilitation on patients with knee osteoarthritis. Clin Rheumatol. 2023 Mar;42(3):903-915. doi: 10.1007/s10067-022-06417-3. Epub 2022 Oct 24.

  PMID: 36279075 BACKGROUND

• Geng R, Li J, Yu C, Zhang C, Chen F, Chen J, Ni H, Wang J, Kang K, Wei Z, Xu Y, Jin T. Knee osteoarthritis: Current status and research progress in treatment (Review). Exp Ther Med. 2023 Aug 25;26(4):481. doi: 10.3892/etm.2023.12180. eCollection 2023 Oct.

  PMID: 37745043 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Pain

Interventions

Resistance Training

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Hira Shaukat, TDPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran Amjad, Phd

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 15, 2025
• First Posted: May 23, 2025
• Study Start: June 12, 2025
• Primary Completion: September 1, 2025
• Study Completion: December 1, 2025
• Last Updated: July 4, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)