PNF Plus Progressive Rehabilitation for Adolescent Athletes With Osgood-Schlatter Syndrome

Osgood-Schlatter syndrome is an overuse-related condition affecting the tibial tubercle apophysis in adolescents, particularly those participating in sports involving repetitive running, jumping, and forceful quadriceps contraction. It commonly presents with anterior knee pain and tenderness around the tibial tubercle, which may interfere with sports participation and physical activity.

Conservative management generally includes activity modification and progressive rehabilitation exercises. However, additional approaches that may improve muscle flexibility, movement tolerance, and knee mobility warrant further investigation.

\*\*Study objective\*\*

The primary objective of this randomized controlled trial is to investigate the effects of combining proprioceptive neuromuscular facilitation (PNF) relaxation techniques with a progressive rehabilitation exercise programme on knee pain and range of motion in adolescent athletes with Osgood-Schlatter syndrome, compared with progressive rehabilitation exercises alone.

\*\*Study design and participants\*\*

This study uses a two-arm, parallel-group randomized controlled design involving 12 adolescent athletes with clinically diagnosed Osgood-Schlatter syndrome. Participants are allocated equally into two groups, with six participants in each group.

\*\*Intervention group: Combined PNF and progressive rehabilitation (CPRE)\*\*

Participants in the experimental group receive PNF hold-relax techniques targeting the quadriceps and hamstring muscle groups, in addition to a structured progressive rehabilitation exercise programme. The programme includes lower-limb strengthening exercises and exercises targeting the hip and core musculature.

\*\*Comparison group: Progressive rehabilitation exercises (RE)\*\*

Participants in the comparison group receive the structured progressive rehabilitation exercise programme without the additional PNF relaxation techniques.

\*\*Intervention duration and frequency\*\*

Both groups participate in rehabilitation sessions three times per week over a 12-week period. Each session lasts approximately 45-60 minutes.

\*\*Outcome assessments\*\*

Clinical assessments are performed at three time points: baseline, 6 weeks, and 12 weeks.

The principal outcomes include:

1. Knee pain: Pain intensity is assessed during the specified knee movements using a visual analogue scale (VAS).
2. Knee range of motion: Knee mobility is evaluated using goniometric measurements, including knee flexion and extension.

The study compares changes in these outcomes over time between the combined intervention group and the progressive rehabilitation group.

\*\*Data analysis\*\*

Changes in outcome measures are evaluated using a two-way mixed repeated-measures analysis of variance to examine the effects of group, time, and the group-by-time interaction. Statistical significance is evaluated using the prespecified significance level.

\*\*Potential significance\*\*

This study is intended to provide preliminary evidence regarding whether adding PNF hold-relax techniques to progressive rehabilitation exercises offers additional benefits for reducing knee pain and improving knee mobility in adolescent athletes with Osgood-Schlatter syndrome. The findings may contribute to the development of rehabilitation strategies for this population.

Participants received a combined intervention consisting of proprioceptive neuromuscular facilitation (PNF) techniques and a structured rehabilitation exercise program.

Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) · Behavioral: Rehabilitation Exercise Program

Participants received a structured rehabilitation exercise program without the addition of proprioceptive neuromuscular facilitation (PNF) techniques.

Behavioral: Proprioceptive Neuromuscular Facilitation (PNF) · Behavioral: Rehabilitation Exercise Program

Proprioceptive neuromuscular facilitation (PNF) techniques were administered to participants in the experimental group in combination with the rehabilitation exercise program. PNF was used as an additional therapeutic component of the intervention.

A structured rehabilitation exercise program administered to participants in both the experimental group (combined PNF and rehabilitation exercise group) and the active comparator group (rehabilitation exercise group alone).

Time frame: Baseline (T0), 6 weeks (T1), and 12 weeks (T2).

Pain intensity was assessed using the Visual Analogue Scale (VAS) to evaluate changes in pain severity following the intervention.

Time frame: Baseline (T0), 6 weeks (T1), and 12 weeks (T2).

Range of motion was assessed using standard universal goniometer to evaluate changes in Range of motion following the intervention.

Effect of a Combined Proprioceptive Neuromuscular Facilitation and Progressive Rehabilitation Program on Knee Pain, Rang of Motion in Adolescent Athletes With Osgood-Schlatter Syndrome: a Randomized Controlled Trial