Hold-relax and Muscle Energy Techniques in Patients With Post-traumatic Knee Stiffness

NCT07438561 | Completed

• 1 other identifier: REC/RCR & AHS/24/01103
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

The study was conducted to compare the effects of hold-relax and muscle energy technique on pain, range of motion an lower extremity function in patients with post-traumatic knee stiffness.

Conditions

Knee Discomfort

Keywords

Knee Stiffness; Range of motion; exercise; exercise therapy; muscle energy technique

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS)

  Numeric Pain Rating Scale is a subjective measure using which patient's rate their pain. It consists of 11 points, having an overall score ranging from 0 to 10, where: 0, 1 - 3, 4 - 6, 7 - 10 represents no pain, mild, moderate and the most severe pain respectively

  From enrollment to the end of the treatment at 8 weeks.

• Universal Goniometer

  Range of motion of joints are usually assessed by a device known as universal goniometer. meter has two arms stationary as well as movable arm. The Centre of the goniometer is known as fulcrum. Through goniometer in each plane joint ranges are measured.

  From enrollment to the end of the treatment at 8 weeks.

• Lower Extremity Function Scale (LEFS)

  The Lower Extremity Functional Scale (LEFS) is a 20-item self-report questionnaire assessing functionality in patients with knee and other lower limb disorders. Patients rate their difficulty with activities on a 0-4 scale (0=extreme difficulty/unable, 4=no difficulty), with a total score out of 80; higher scores indicate better function.

  From enrollment to the end of the treatment at 8 weeks.

Study Arms (2)

Hold-Relax Technique

EXPERIMENTAL

Other: Hold-Relax Technique; Other: Standard Physical Therapy

Muscle Energy Technique

ACTIVE COMPARATOR

Other: Muscle Energy Technique; Other: Standard Physical Therapy

Interventions

Hold-Relax Technique OTHER

Hold-Relax: Patient was in prone position, therapist was on the affected site, the affected knee was bent to the available and pain free range at that range therapist applied pressure and held it for 8-10 seconds repeated for 10 times. 3 sessions per week for a total of 8 weeks.

Hold-Relax Technique

Muscle Energy Technique OTHER

Muscle Energy Technique: Patient was in prone position, therapist was on the affected site, the affected knee was bent to the available and pain free range at that range therapist applied pressure and asked the patient to move his knee in extension against the resistance applied by therapist for 10 seconds. And then patient flexed his knee actively and process was repeated for 10 times. 3 sessions per week for a total of 8 weeks.

Muscle Energy Technique

Standard Physical Therapy OTHER

* Hot packs were applied to patients for a period of 10 minutes. * Mulligan mobilization techniques were performed on the knee joint. * Knee isometrics were done.

Hold-Relax Technique; Muscle Energy Technique

Eligibility Criteria

• Age: 18 Years - 35 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients who had fracture and treated either with POP or ORIF.
• Fracture healing completed.
• Both genders of age between 18-35.
• Conservative treatment of fracture with POP for minimum 6 weeks.
• NPRS more than or equal to 2.

You may not qualify if:

• Pathological fracture.
• Post-traumatic myositis ossificans.
• Ligamental or Meniscal tears.
• Any tumor in the knee region.
• Osteoarthritis.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Naseer Hospital

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (7)

• Moradi MR. The effect of a muscle energy session on increasing knee extension in People with shortness of knee posterior muscles. National University. 2020

  BACKGROUND

• Xu L, Li J, Sheng Q, Wang G. Clinical Application of Muscle Energy Technique for Knee Function Recovery After Total Knee Arthroplasty. J Pain Res. 2025 Oct 14;18:5409-5416. doi: 10.2147/JPR.S537482. eCollection 2025.

  PMID: 41114387 BACKGROUND

• Valenza MC, Torres-Sanchez I, Cabrera-Martos I, Valenza-Demet G, Cano-Cappellacci M. Acute Effects of Contract-Relax Stretching vs. TENS in Young Subjects With Anterior Knee Pain: A Randomized Controlled Trial. J Strength Cond Res. 2016 Aug;30(8):2271-8. doi: 10.1097/JSC.0000000000000215.

  PMID: 27457916 BACKGROUND

• Nazary-Moghadam S, Yahya-Zadeh A, Zare MA, Ali Mohammadi M, Marouzi P, Zeinalzadeh A. Comparison of utilizing modified hold-relax, muscle energy technique, and instrument-assisted soft tissue mobilization on hamstring muscle length in healthy athletes: Randomized controlled trial. J Bodyw Mov Ther. 2023 Jul;35:151-157. doi: 10.1016/j.jbmt.2023.04.079. Epub 2023 Apr 21.

  PMID: 37330762 BACKGROUND

• Bhosale P, Kolke Pt S. Effectiveness of instrument assisted soft tissue mobilization (IASTM) and muscle energy technique (MET) on post-operative elbow stiffness: a randomized clinical trial. J Man Manip Ther. 2023 Oct;31(5):340-348. doi: 10.1080/10669817.2022.2122372. Epub 2022 Sep 28.

  PMID: 36171728 BACKGROUND

• Balasundaram AP, Sreerama Rajan S. Short-term effects of mobilisation with movement in patients with post-traumatic stiffness of the knee joint. J Bodyw Mov Ther. 2018 Apr;22(2):498-501. doi: 10.1016/j.jbmt.2017.06.007. Epub 2017 Jun 15.

  PMID: 29861257 BACKGROUND

• Khan T, Rizvi MR, Sharma A, Ahmad F, Hasan S, Uddin S, Sidiq M, Ammari A, Iqbal A, Alghadir AH. Assessing muscle energy technique and foam roller self-myofascial release for low back pain management in two-wheeler riders. Sci Rep. 2024 May 27;14(1):12144. doi: 10.1038/s41598-024-62881-8.

  PMID: 38802553 BACKGROUND

MeSH Terms

Conditions

Motor Activity

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Ali Raza, MS-OMPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

• First Submitted: February 23, 2026
• First Posted: February 27, 2026
• Study Start: January 1, 2025
• Primary Completion: October 31, 2025
• Study Completion: October 31, 2025
• Last Updated: February 27, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)