Comparison of Graston Technique versus Muscle Energy Technique Among Patients with Knee Osteoarthritis

Background: Limited hamstring flexibility is a frequent observation both in individuals with knee osteoarthritis and in the general population, and it is recognised as a contributing factor to limitations in activities of daily living. This study aims to evaluate and compare the effectiveness of the Graston technique and muscle energy techniques in improving hamstring flexibility and enhancing the ability to perform daily activities in patients suffering from knee osteoarthritis. Objective: To compare the Graston technique versus the muscle energy technique among patients with knee osteoarthritis. Methodology: This study was designed as a randomised clinical trial with assessor blinded and was conducted at Chaudhry Muhammad Akram Teaching Hospital in Raiwind. Diagnosed patients of knee osteoarthritis confirmed by an orthopedic surgeon and supported by radiographic evidence indicating Grade I or II, limited knee extension (less than 20 degrees), and age above 40 years were included in study. Individuals were excluded if they presented with open wounds, skin infections, or tumors, sciatica, spinal deformities, total knee replacement, or recent surgery. Hamstring flexibility was assessed using the active knee extension test, measured with a universal goniometer. The intervention involved two treatment groups: patients in Group A received therapy using the Graston technique, while those in Group B were treated with the muscle energy technique. The treatment was administered twice a week for six weeks. The normality of the data was assessed using the Shapiro-Wilk test, which confirmed a normal distribution with a p-value less than 0.05. To evaluate differences between the two groups, the independent t-test was employed, and for within-group comparisons, the paired t-test was applied. Results: The difference between the Graston technique and the muscle energy technique groups post-treatment was statistically significant for hamstring flexibility and activities of daily living (p<0.05). While the difference between the two groups post-treatment was statistically significant for hamstring flexibility and activities of daily living (p<0.05), with higher mean values for the Graston technique. Conclusion: It concludes that both treatments are effective, but the Graston technique is more effective than the muscle energy technique in improving hamstring flexibility and activities of daily living of knee osteoarthritis patients.