EFFECT OF ILIOTIBIAL BAND MYOFASCIAL RELEASE ON FLEXIBILITY AND PATELLAR ALIGNMENT IN PATIENTS WITH KNEE OSTEOARTHRITIS

Background: Knee osteoarthritis (KOA) is a heterogonous disease that addresses specific problems such as iliotibial band (ITB) myofascial trigger points (MTrPs); creating undue joint stress & pain. Purpose: The purpose of this study was to investigate the effect of ITB myofascial release (MFR) techniques on its flexibility and on consequent change of patellar mal-alignment in patients with KOA; also pressure-pain threshold (PPT) was assessed as indicator of improvement. Design and methods: Parallel group randomized controlled trial; comprising four weeks intervention period. Subjects: Thirty-six KOA female patients aging between 50-59 years; were randomly distributed into two groups: Group A (control): 17 patients which were treated by exercise program, Group B (experimental): 19 patients which were treated by exercise program in addition to ITB MFR techniques. Intervention: two MFR techniques were used in combination; the ischemic compression (IC) technique and neuromuscular technique (longitudinal strokes); in addition to an evidence based exercise program. Outcomes: ITB flexibility (hip adduction angle) on digital protractor, Lateral Patellar mal-alignment using clinical technique and PPT using Wanger algometer. Results: MFR techniques had a significant effect (P-value <0.05) on all evaluated measures; although had insignificant effect when statistically compared to control group regarding ITB flexibility. Conclusion: exercise program in combination with ITB, MFR techniques have a significant effect in improving ITB flexibility, Patellar alignment and PPT in patients with KOA.