Comparison of the effects of static and pnf hamstring stretching exercises in patients with knee osteoarthritis

Objective: To determine and compare the effects of static and PNF hamstring stretching exercises on pain, hamstring flexibility, functional status and dynamic balance in patients with knee osteoarthritis (OA). Method: A total of 36 patients between the ages of 40-75 with stage 2 and 3 knee OA were included in the study. Patients were divided into two groups as static (SHG) (n = 18) and PNF hamstring stretch (PNF-HG) (n = 18) by simple random sampling method. In addition to the standard physiotherapy program (hot pack+Ultrasound+TENS), SHG or PNF-HG (hold-relax technique) exercises were applied for a total of 15 sessions for 4 weeks. The pain intensity (Visual pain scale (VAS)), hamstring flexibility (Active Knee Extension Test (AKET)), functional status (WOMAC Osteoarthritis Index) and dynamic balance (Timed Up and Go Test (TUG)) were evaluated before treatment. Evaluations were repeated at 4th week and 3rd month period after treatment. Results: When the measurements of the SHG group before treatment, at the 4th week and 3rd month were compared, it was determined that the changes in pain intensity, AKET, WOMAC and TUG were statistically significant (p <0.05). Similarly, in the PNF-HG group, the changes in all parameters evaluated, except for TUG, were statistically significant (p <0.05). When the differences between the measurements (Δ) of the groups were compared, it was found that the decrease in pain intensity was greater in the SHG group before the treatment - at the 4th week, while the increase in the WOMAC total score between the pre-treatment and the 3rd month was higher in the PNF-HG group (p <0.05). Conclusion: Results of our study show that adding static or PNF hamstring stretching exercises with planned and progressive implementation to the exercise programs of patients with knee OA may be effective in decreasing pain intensity and improving hamstring flexibility and their functional status and also show that the effects were not superior to each other over the type of stretching. Keywords: osteoarthritis of the knee, static stretching, PNF stretching