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

NCT07181421 | Not Yet Recruiting

• 1 other identifier: FUI/CTR/2025/05
• Study Type: interventional
• Target: 58
• Locations: 1 country
• Sites: 1

Brief 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

Outcome Measures

Primary Outcomes (3)

• Knee Pain

  Numeric pain rating scale will be used to measure knee pain

  4 weeks

• Knee Range of Motion

  Goniometer willl be used to measure knee range of motion

  4 weeks

• Knee Muscle Strength

  Manual Muscle Testing will be used for knee muscle strength

  4 weeks

Study Arms (2)

Tissue Flossing and Therapeutic Exercises

EXPERIMENTAL

Detailed of tissue flossing and therapeutic exercises.: The floss band will be kept on for 2 minutes, and during this time, the patient will perform the exercises with progression. After each 2-minute flossing session, the patient will rest for 2 minutes.

Procedure: Tissue flossing with Therapeutic exercises

Therapeutic Exercises only

ACTIVE COMPARATOR

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

Procedure: Therapeutic Exercises

Interventions

Tissue flossing with Therapeutic exercises PROCEDURE

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).

Tissue Flossing and Therapeutic Exercises

Therapeutic Exercises PROCEDURE

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

Therapeutic Exercises only

Eligibility Criteria

• Age: 40 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults aged 40-70 years with diagnosed knee OA (Grades 1 and 2). Unilateral knee OA or if bilateral OA is present, only the more symptomatic knee (Grade 1 or 2) Willingness to comply with the intervention protocol. Both Genders

You may not qualify if:

• Higher grade 3 and 4 knee OA. Recent knee surgeries Soft tissue injury of lower limb less than six months prior to the study Neurological or cardiovascular conditions contraindicating exercise Ongoing participation in another knee Rehabilitation program Latex allergy or Skin diseases varicose veins and Thrombosis Diabetic Neuropathy Fractures and open wounds.

Sponsors & Collaborators

• Foundation University Islamabad: lead

Study Sites (1)

Foundation University Islamabad

Islamabad, Punjab Province, 46000, Pakistan

Location

MeSH Terms

Interventions

Exercise Therapy

Intervention Hierarchy (Ancestors)

Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities

Central Study Contacts

Noor ul Aqsa, DPT

CONTACT

+923312413859; noorulaqsa2000@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 12, 2025
• First Posted: September 18, 2025
• Study Start: September 30, 2025
• Primary Completion (Estimated): August 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: September 18, 2025

Record last verified: 2025-09

Locations

PA (1)