Effects of Sahrmann's Approach Versus Conventional Treatment Oin Patients With Knee Osteoarthritis

NCT07642258 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/25/0112 Arooj
• Study Type: interventional
• Target: 40
• Locations: 1 country
• Sites: 1

Brief Summary

Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. The objective of the study will be to compare the effects of Sahrmann's approach versus conventional treatment on pain, valgus angle and functional disability in patients with knee osteoarthritis.

Conditions

Knee Osteoarthritis

Keywords

pain; functional disability; VALGUS ANGLE

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating Scale (NPRS) - Pain Assessment

  The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain." The NPRS is widely used in musculoskeletal and orthopedic conditions due to its simplicity, high responsiveness, and strong psychometric properties. It demonstrates excellent reliability (test-retest reliability ICC \> 0.80) and good construct validity in chronic pain populations including knee osteoarthritis.

  upto 4 weeks

• Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - Functional Outcome (Knee OA)

  The WOMAC Osteoarthritis Index is a disease-specific, self-administered questionnaire designed to evaluate symptoms and functional status in patients with hip and knee osteoarthritis. It consists of 24 items divided into three subscales: Pain (5 items) Stiffness (2 items) Physical Function (17 items) Each item is typically scored using a 5-point Likert scale (0 = none to 4 = extreme), or alternatively via a visual analog format depending on study design. Total scores are summed, with higher scores indicating greater pain, stiffness, and functional disability.

  upto 4 weeks

• Universal Goniometer (UG) - Valgus Angle Measurement

  The Universal Goniometer (UG) is a standard clinical instrument used to measure joint angles and assess alignment. In this study, it will be used to measure the knee valgus angle, which reflects medial-lateral alignment of the lower limb in the frontal plane. The participant is typically assessed in a standing anatomical position, with landmarks aligned at: Anterior superior iliac spine (ASIS) Center of patella Ankle/midline of tibia or second toe alignment (depending on protocol standardization) The stationary arm of the goniometer is aligned with the femur, while the movable arm follows the tibial shaft. The angle between these segments represents the dynamic or static valgus alignment, depending on whether assessment is static posture or functional task-based measurement. Changes in valgus angle will be used to assess biomechanical alignment improvements following the intervention.

  upto 4 weeks

Study Arms (2)

Sahrmann's exercises

EXPERIMENTAL

Dr. Shirley Sahrmann's Movement System Impairment (MSI) approach for knee osteoarthritis operates on the kinesiopathologic model: it asserts that repetitive faulty movement patterns and sustained improper alignments-not just age or wear-are primary drivers of joint stress and cartilage breakdown

Other: Sahrmann's exercises

Standard Physical therapy

ACTIVE COMPARATOR

Comparator group patients will receive, Conventional treatment exercises. • ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching

Other: standard physical therapy treatment

Interventions

Sahrmann's exercises OTHER

* with and without resistance band-SLR * with and without resistance band-Hip extension * with and without resistance band-clamshells * IT Band stretch * Squatting in front of mirror * with resistance band-lateral walk * Hip lateral rotation

Sahrmann's exercises

standard physical therapy treatment OTHER

Comparator group patients will receive, Conventional treatment exercises. • ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching

Standard Physical therapy

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Males and females between 40 to 60 years of age.
• Diagnosed patients of knee Osteoarthritis with grade 2.
• Valgus angle of knee \> 10°.

You may not qualify if:

• Any other inflammatory conditions.
• Rheumatoid arthritis, ankylosing spondylitis or any other auto immune disorder

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

University of Lahore Teaching Hospital, Lahore HOD Physio Department

Lahore, Punjab Province, 54000, Pakistan

Location

Related Publications (11)

• Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and Incidence of Osteoarthritis: A Population-Based Retrospective Cohort Study. J Clin Med. 2021 Sep 21;10(18):4282. doi: 10.3390/jcm10184282.

  PMID: 34575394 BACKGROUND

• Ramazanian T, Yan S, Rouzrokh P, Wyles CC, O Byrne TJ, Taunton MJ, Maradit Kremers H. Distribution and Correlates of Hip-Knee-Ankle Angle in Early Osteoarthritis and Preoperative Total Knee Arthroplasty Patients. J Arthroplasty. 2022 Jun;37(6S):S170-S175. doi: 10.1016/j.arth.2021.12.009. Epub 2022 Feb 21.

  PMID: 35210147 BACKGROUND

• Mousavi F, Kajbafvala M, Mohsenifar H, Salehi R, Hejazi A. The effect of movement system impairment-based classification treatment compared to routine physiotherapy on pain, disability, alignment, and movement impairments in individuals with tibiofemoral rotation syndrome: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2024 Apr 25;16(1):94. doi: 10.1186/s13102-024-00883-9.

  PMID: 38664767 BACKGROUND

• Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med. 2022 Oct 12;11(20):6013. doi: 10.3390/jcm11206013.

  PMID: 36294334 BACKGROUND

• Mohammad Jabbar K, Gandomi F. The effects of national academy of sports medicine and sahrmann training on foot pressure distribution in flexed posture students. Iranian Rehabilitation Journal. 2021;19(1):99-110.

  BACKGROUND

• Zamani P, Kalantari KK, Fashkhami AN, Baghban AA, Mehravar M, Yazdi MS. Efficacy of treatment based on the movement system impairment classification in people with knee pain: a study protocol. Iran Red Crescent Med J. 2022;24:e1767.

  BACKGROUND

• Nouman M, Shabnam J, Anwar S, Perveen W, Alexe DI, Sanchez-Gomez R, Sava MA, Alexe CI. Effect of Iliotibial Band Myofascial Release Combined with Valgus Correction Exercise on Pain, Range of Motion, Balance, and Quality of Life in Patients with Grade II Knee Osteoarthritis: A Randomized Clinical Trial. Life (Basel). 2024 Oct 27;14(11):1379. doi: 10.3390/life14111379.

  PMID: 39598178 BACKGROUND

• Kalunke A. A Comparative Study on the Effectiveness of Rhythmic Stabilization Technique (PNF) and Conventional Physiotherapy in the Treatment of Knee Osteoarthritis. Journal of Internal Medicine and Pharmacology (JIMP). 2024;1(03):50-8.

  BACKGROUND

• MohammedSadiq HA, Rasool MT. Effectiveness of home-based conventional exercise and cryotherapy on daily living activities in patients with knee osteoarthritis: A randomized controlled clinical trial. Medicine (Baltimore). 2023 May 5;102(18):e33678. doi: 10.1097/MD.0000000000033678.

  PMID: 37145013 BACKGROUND

• Mohamed SHP, Alatawi SF. Effectiveness of Kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial. Ir J Med Sci. 2023 Oct;192(5):2223-2233. doi: 10.1007/s11845-022-03247-9. Epub 2022 Dec 17.

  PMID: 36527538 BACKGROUND

• Arslan Y, Kul A. Effectiveness Comparison of Extracorporeal Shock Wave Therapy and Conventional Physical Therapy Modalities in Primary Knee Osteoarthritis. Turk J Osteoporos. 2022;28(2):83-90.

  BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Pain

Condition Hierarchy (Ancestors)

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

Study Officials

• Arooj Sohail, MSPT*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD*

CONTACT

03324806143; samrood.akram@riphah.edu.pk

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: June 8, 2026
• First Posted: June 11, 2026
• Study Start (Estimated): July 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): October 1, 2026
• Last Updated: June 11, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)