Deep Front Line Myofascial Release Versus Novel Soft Tissue Kinetic Chain Activation Technique (K-CAT) on Pain, Radiological Patellar Position and Dynamic Knee Valgus in Knee Osteoarthritis: A Randomized Clinical Trial

Abstract

Background: Knee osteoarthritis (OA) is the most common degenerative condition, afflicting large number of people globally. Fascia is a three-dimensional network of connective tissue that helps in force transmission along the myofascial chains to bone level causing malalignments and movement dysfunctions. Myofascial dysfunctions have been identified in osteoarthritis of knee as a pain-causing component. Recently, clinicians have aimed a variety of therapeutic techniques at fascia. There is a lack of literature to determine the effect of kinetic chain activation technique (K-CAT) as well as deep front line (DFL) release technique in OA knee.

Purpose: The current study aimed to determine and compare the effectiveness of DFL release and K-CAT in knee OA.

Methods: The study was a randomized clinical trial conducted in an outpatient department of a tertiary care hospital. Thirty-two (n = 32) participants between 45 and 60 years of age with knee osteo-arthritis (grades 2 and 3) were included and randomized into two groups based on selection criteria. Group A received DFL myofascial release and Group B received K-CAT, along with common conventional therapy (modality + exercises), three sesions per week for 2 weeks. Pain intensity using Numeric Pain Rating Scale, skyline view of knee radiographic parameters including lateral patellar tilt angle (LPTA) and bisect offset (BO), dynamic knee valgus (DKV) by single leg squat using Kinovea software and quality of life using Knee Injury and Osteoarthritis Outcome Score on day 1 and day 14 of intervention were assessed.
Results: Within-group analyses showed significant improvements in both the groups for pain, BO on x-ray, DKV, and Knee Injury and Osteoarthritis Outcome Score (p < 0.05). LPTA showed statistical significance only in the DFL group. However, between-group comparisons showed no statistical difference in all the outcomes (p > 0.05).

Conclusion: Both DFL myofascial release and K-CAT were found to be equally effective in alleviating pain, improving quality of life and knee malalignments.

Trial registered under Clinical Trial Registry of India (CTRI/2023/11/059388).