The current study will be a single-blinded, two-arm parallel group randomized clinical trial involving 48 participants. The trial will compare Pressure Biofeedback training with Bolster Foam Roll training. Interventions will be delivered three times per week for eight weeks. The primary outcomes will include pain intensity, functional status, and muscle activation. Assessments will be conducted at baseline (week 0), mid-intervention (week 4), post-intervention (week 8), and follow-up (week 12). The study will be conducted at the outpatient departments of Sir Ganga Ram Hospital (SGRH) and Mayo Hospital Lahore. The hypothesis is that there is a difference between Pressure Biofeedback Training and Bolster Foam Feedback Training regarding pain reduction, muscle activation, and patient-reported quality of life compared to Bolster Foam rolling training among knee osteoarthritis patients.
Inclusion Criteria:
Age between 45 and 65 years, encompassing the typical onset of symptomatic OA.
Both genders Male and Female are included.
Symptomatic patients meeting the following American College of Rheumatology criteria: average pain score ≥ 3 in the last week on the numerical rating scale, morning stiffness < 30 min, and joint crepitus
Exclusion Criteria:
History of knee surgery (TKA, HTO, ACLR) or arthroscopy in the affected knee within the last 6 months.
Intra-articular corticosteroid or hyaluronic acid injections within the last 3 months.
Neurological conditions affecting lower limb motor control (e.g., Stroke, Parkinson's, Radiculopathy).
Acute infection, tumor, or fracture around the knee joint.
Severe cognitive impairment or inability to follow visual/tactile cues.
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sahar.fatima@ubas.edu.pk
This will be a single-blinded study where the outcome assessor will be kept completely blinded to the participants' group allocation. Due to the visible nature of the feedback tools (gauge versus foam), the intervention administrators and the patients cannot be blinded
Participants will receive 45-minute sessions including warm-up and conventional physiotherapy. For targeted isometric training, participants lie supine with a Pressure Biofeedback Unit airbag under the popliteal fossa inflated to 60 mmHg. They press the knee downward to move the dial up 20-40 mmHg, holding for 10 seconds across 3 sets of 10 repetitions
Participants will receive the same 45-minute sessions with warm-up and conventional physiotherapy. For targeted isometric training, participants lie supine with a firm high-density foam bolster under the knee. They are instructed to "crush the foam" into the table to feel the resistance, holding for 10 seconds across 3 sets of 10 repetitions
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