Effectiveness of proprioceptive neuromuscular facilitation patterns in comparison with general physical therapy in knee osteoarthritis

Purpose: knee osteoarthritis (KOA) is a musculoskeletal disorder accompanied by muscle imbalances, balance deficiency and proprioception impairment. The purpose of current study is to evaluate the effectiveness of proprioceptive neuromuscular facilitation (PNF) patterns on KOA patients balance and electromyography (EMG) activity in comparison with general physical therapy. Method: In this randomized control trial 28 KOA patients were randomly assigned into two equal groups (n=14); PNF group and control group. Both groups had 5 minutes of ultrasound (US) and 20 minutes of transcutaneous electrical stimulation (TENS). The PNF group performed two lower extremity patterns against a theraband; D2E and D2F. The Control group performed 3 general knee exercises three times a week for four weeks. Pain assessed through visual analog scale (VAS), performance by Western Ontario and McMaster Universities Arthritis Index (WOMAC) questionnaire, balance evaluated by Biodex Balance System and surface EMG recorded from vastusmedialis, vastuslateralis and biceps femoris. Results: Both groups revealed significant pain reduction and performance increment (P≤0.017). Overall dynamic stability was the only balance indicator improved significantly in PNF group (P≤0.05).In the control group overall dynamic stability, overall static stability and Medial/lateral dynamic stability revealed significant improvement (P≤0.017). No statistical difference were observed in EMG activity within groups. According to Mann-Whitney test, between groups comparison showed the superior efficacy of PNF group in VMO EMG activity enhancement and control group in performance progression. No other between group differences was seen. Conclusion: The PNF patterns have significant influence on muscle imbalance correction in KOA patients. General physical therapy has therapeutic effects which assumed to last short term. © 2018 Wolters Kluwer Medknow Publications. All rights reserved.