Bowen Technique With Retro-walking on Hamstring Flexibility in Knee Osteoarthritis

Effects of Bowen Technique With Retro-walking on Hamstring Flexibility in Knee Osteoarthritis Patients

The aim of this randomized controlled trial is to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients

The term osteoarthritis is also known as degenerative joint disease because of wear and tear process occur in articular cartilage. OA affect the joints, the tissue surrounding the joint and other connective tissue. The symptoms of knee OA is most common seen in obese and aged individuals. There are three compartment that affected in knee OA include medial, lateral and patellofemoral joint. The OA takes 10 to 15 years to develop. The pathophysiology of the OA is still under investigation. Traditionally it was considered that it was due to aging factor because wear and tear process occur in articular surfaces.

But now it's considered there are multiple factors that involve in the origin of OA include biomechanical and inflammatory factors. Knee OA is influenced by family history, age, obesity, joint shape, genu valgus and varum and inflammation by metabolic syndrome. In radiological findings wo notice that bony osteophytes, damaging of articular cartilage, sclerosis of the subchondral bone seen, and it's become severe later. Knee OA may be modified or may be unmodified. In unmodifiable include genetically or congenital. But in modifiable is excessive weight. In Modern treatment we focus on improve the function limitation and quality of life which we can improve by physiotherapy Several muscles are involved in the support of knee. The 2 major muscle groups quadriceps and hamstrings are involved in the movement and stability of the knee joint. The quadriceps and hamstrings provide the knee stability in frontal plane. In knee OA pathogenesis important muscle imbalance arise from quadriceps group of muscles or hamstring group of muscles weakness, which is usually assessed by quadriceps hamstrings ratio(Q:H). In knee OA medial compartment of tibiofemoral joint is mostly involved.

Bowen technique helps in restore the fascia disturbances and muscle imbalances. During the application of the Bowen technique, it stimulates the brain ascending neural impulses to allow the fascia changes this mechanism is called fascia plasticity.) Bowen therapy works on our body nervous system by stimulating the parasympathetic nervous system and encourage the state of relaxation and healing. Bowen moves are applied on the muscle's origin, insertion, or belly of muscles where Golgi receptors are located. Bowen therapy improves body ability to function at a cellular level.

Backward walking increases the coordination because during backward walking isometric and concentric activity both are occurred. The backward walking mechanism is different from the forward walking, in backward walking toes contact the ground first and the heel is lifted off the ground in early stance. Retro walking can minimize the burden on the joint and increase the muscle length in normal healthy individuals.

This study aims to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients.

Inclusion Criteria:

• Age 40-60 years
• Both gender: male and female
• Less than 80-degree hip flexion angle on passive SLR, Active knee extension greater than 20 indicates hamstring muscle tightness
• Kellgren and Lawrence classification (stage I and stage II)
• Bilateral hamstring tightness
• Visual analogue scale value greater than 3
• Pain duration more than 3 months

Exclusion Criteria:

• Meniscal injury or ligamentous injury
• Muscle/tendon injuries of hamstring
• Spinal Injuries and any other co- morbidity
• Any surgery, infection, trauma, pregnancy, fracture and fall
• Involvement in regular flexibility yoga program
• Patient with intra articular steroidal therapy with in last 6 months
• Patient involvement in another intervention study
• Malignancy
• Pregnancy