Effects of Voodoo Flossing Technique in Knee Osteoarthritis Patients

Effects of Voodoo Flossing Technique on Pain, Range of Motion and Physical Function in Patients With Knee Osteoarthritis: A Randomized Control Study

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease characterized by pain, stiffness, and reduced physical function, significantly impacting quality of life especially in elderly population. This study aims to evaluating the effectiveness of an emerging technique, known as 'Voodoo Flossing' on pain, range of motion and physical function in KOA to provide evidence-based insight of voodoo flossing as a potential therapeutic adjunct in KOA management.

This randomized controlled trial will be conducted at Riphah Rehabilitation Clinic, Lahore and Horizon Hospital Lahore in a time span of 8 months. A sample size of 42 subjects selected through non-probability convenient sampling with age group between 45 to 65 having present complain confirmed through Kellgren-Lawrence (KL) scale of grade-II will be divided into two groups, will undergo aerobic exercises, strengthening exercises and conventional physiotherapy protocol either with or without Voodoo Flossing technique.

A double blinded randomized controlled trial has been conducted to investigate the effectiveness of integrating flossing band therapy with conventional physiotherapy, anticipating outcomes of pain reduction, functional ability, and patient satisfaction. Outcomes were measured for pain (VAS), strength (Dynamometry), lower limb function (LEFS) and PFPS function (AKPS) before and after intervention stating flossing band integrated with physiotherapy as more effective treatment modality for PFPS.

A study has been conducted to check the effectiveness of voodoo flossing on pain and functional recovery in shin splint on amateur runners. Pre and post-test measurements were taken showing voodoo flossing as an effective technique for reducing pain and improving pain free activities in management of Shin Splint Syndrome in amateur runners.

A randomized control trial aimed to compare the lasting effects of the flossing band (FB) technique, dynamic stretching (DS) and static stretching (SS) on hamstring, on knee ROM, muscle activity, and proprioception to identify the most effective pre-exercise method for preventing injuries. FB group shows improvements in joint ROM and muscle activity as compared to DS and SS groups and exhibited lasting effects. Also, the proprioception observed at 30°, 60°, and 90° knee flexion had the smallest repositioning error in the FB group. Previous researches have shown positive aspects of voodoo flossing combined with physiotherapy on ankle joint, shoulder joint, shin splints, PFPS, knee ROM, proprioception, muscle functionality but evidence of its application in knee OA patients is scarce. By systematically addressing these gaps through well designed RCTs and comprehensive outcome assessments, future research can provide evidence-based insight of voodoo flossing as a potential therapeutic adjunct in KOA management. This study aims to address this existing literature gap by elucidating its potential effects on knee pain, ROM and physical function in KOA patients and making future recommendations for further study.

Inclusion Criteria:

• Age ≥ 45 and ≤ 65
• Both Male and Female
• Knee Pain persisting for at-least 3 months
• Pain severity during walking ≥ 2/10 on a Numeric Pain Rating Scale
• Walking and Balance (Mobility) problems according to Time Up & Go (TUG) test
• Poor scoring on WOMAC scale for pain, stiffness and physical activities
• Knee OA Grade II (according to Kellgren-Lawrence method)
• Participants must provide informed consent for participation in RCT

Exclusion Criteria:

• Age < 45 and > 65
• Severe Knee pain during Walking ≥ 9/10 on a Numeric Pain Rating Scale
• Knee OA Grade I, III & IV (according to Kellgren-Lawrence method)
• Physical or Mental co-morbidity severely affecting daily life of patient
• Any Contraindication to provide Exercise Therapy
• Suspicion of chronic widespread pain (i.e., pain present for at least 3 months in at least three joints including left and right side of the body, above and below the waist, and the axial skeleton)
• Participant undergone total knee arthroplasty or on waiting list for total knee arthroplasty in any knee
• Any other reasons for knee pain than knee OA (e.g., rheumatoid arthritis and gout)
• Received intraarticular injections in past 6 months because of knee pain (Hyaluronic Gel or steroid)