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Randomized Controlled Trial
. 2023 Feb 13;18(2):e0280941.
doi: 10.1371/journal.pone.0280941. eCollection 2023.

Effects of proprioceptive neuromuscular facilitation stretching in relieving pain and balancing knee loading during stepping over obstacles among older adults with knee osteoarthritis: A randomized controlled trial

Bo Gao  1 , Li Li  2 , Peixin Shen  3   4 , Zhipeng Zhou  4 , Peiming Xu  5 , Wei Sun  4 , Cui Zhang  6 , Qipeng Song  4
Affiliations
Randomized Controlled Trial

Effects of proprioceptive neuromuscular facilitation stretching in relieving pain and balancing knee loading during stepping over obstacles among older adults with knee osteoarthritis: A randomized controlled trial

Bo Gao et al. PLoS One. .

Abstract

Objective: The purpose of this study was to investigate the effects of an 8-week proprioceptive neuromuscular facilitation (PNF) stretching in relieving pain and balancing knee loading during stepping over obstacles among older people with knee osteoarthritis, and further explore the improvements in gait patterns.

Design: Thirty-two older adults (66~72 years) with KOA were recruited and randomly assigned into PNF or control groups. They received PNF stretching or health lecture series for 8 weeks. Final data analyses were conducted among 13 participants in the PNF and 14 in the control groups. At weeks 0 and 9, they were asked to step over an obstacle of 20% of their leg length. The pain scores and knee abduction moment (KAM) (primary outcomes) were analyzed by multivariate ANOVA, and the gait variables (secondary outcomes) were analyzed by two-way (group by pre-/post) ANOVAs with repeated measures.

Results: Significant interactions were detected in the pain score, first and second peaks of KAM, and crossing velocity during stepping over obstacles, and significant between-group differences of these outcomes were detected at week 9.

Conclusion: An 8-week PNF stretching could relieve pain and balance loading between knee compartments, as well as increase crossing velocity during stepping over obstacles.

Trial registration: Chinese Clinical Trial Registry: ChiCTR2100042278.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Consort diagram for flow of participants through the trial.
Fig 2
Fig 2. Diagram of the obstacle setup.
(a) Obstacle and the force platforms setup. (b) Diagram of stepping over the obstacle.
Fig 3
Fig 3. Pain score of the more affected leg.
The black dots represent the pain score of each participant in each group. The histogram with an error bar represents the mean and standard deviation of the pain score in the PNF and control groups at weeks 0 and 9. * denotes significant difference between weeks 0 and 9 in the PNF group. # denotes significant differences between PNF and control groups at week 9.
Fig 4
Fig 4. The KAM of the more affected leg.
The black line presents exemplary KAM during the support phase from the leading leg touching down on the force platform until it takes off from it. The histogram with an error bar represents the mean and standard deviation of the peak values in the PNF and control groups at weeks 0 and 9. * denotes significant differences between weeks 0 and 9 in the PNF group. # denotes significant differences between PNF and control groups at week 9.
See this image and copyright information in PMC

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