Comparison of Neuromuscular Joint Facilitation and Quadriceps Strengthening Exercise in Knee Osteoarthritis: a Randomized Controlled Trial

Objectives: To compare the effect of neuromuscular joint facilitation (NJF) and quadriceps strengthening exercises on pain, physical function, static posture, and balance control in subjects with knee osteoarthritis. Design: Randomized controlled trial. Setting: Department of Physiotherapy, Manipal Hospitals, Bangalore. Participants: Subjects diagnosed with knee osteoarthritis according to the American College of Sports Medicine criteria. The mean age of subjects in the control group was 63.12 ± 8.08 years; in the experimental group was 61.77 ± 8.46 years. Interventions: The intervention group received NJF treatment twice a week for six weeks, and the control group received quadriceps strengthening exercises. Standard knee exercises were given as a home program to both groups. Outcome Measures: Numeric Pain Rating Scale (NPRS), 30-second chair stand (30s-CST), and single leg stance (SLS) were used to assess physical function, static posture, and balance control, respectively, at the end of the sixth week. Results: Sixty subjects were randomly allocated to intervention and control groups. The experimental and control group showed a mean difference of 3.89 and 4.17 in NPRS, 4.19 and 4.17 in 30s-CST, 6.81 and 5.71 in SLS at the end of six weeks. This change was significant within both groups (p value.000) and not significant between groups (NPRS p value.303; 30s-CST p value.09; SLS p value.525) at the end of six weeks. Conclusions: NJF and quadriceps strengthening exercises effectively reduced pain and improved physical function, static posture, and balance control in subjects with knee osteoarthritis. Both groups had the same effect on all clinical variables at six weeks of follow-up. Hence, further studies with long term follow-up are warranted.