Knee OsteoarthritisANCT07238751
Bowen Technique With Retro-walking on Hamstring Flexibility in Knee Osteoarthritis
A study testing Bowen technique with Retro-walking and Conventional Treatment in people with Knee Osteoarthritis, run by Riphah International University at 1 site in Pakistan.
Trial summary
The aim of this randomized controlled trial is to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients Read more about this study
- Who is it for?
- Ages 40 to 60 years
- Conditions the study is for
- Knee Osteoarthritis
- What is being tested?
- Bowen technique with Retro-walking and Conventional Treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 25 Oct 2025to 25 Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Age 40-60 years
- Both gender: male and female
- Less than 80-degree hip flexion angle on passive SLR, Active knee extension greater than 20 indicates hamstring muscle tightness
- Kellgren and Lawrence classification (stage I and stage II)
- Bilateral hamstring tightness
- Visual analogue scale value greater than 3
- Pain duration more than 3 months
Who cannot join
- Meniscal injury or ligamentous injury
- Muscle/tendon injuries of hamstring
- Spinal Injuries and any other co- morbidity
- Any surgery, infection, trauma, pregnancy, fracture and fall
- Involvement in regular flexibility yoga program
- Patient with intra articular steroidal therapy with in last 6 months
Show all 9Show fewer
- Patient involvement in another intervention study
- Malignancy
- Pregnancy
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
Shaafi international hospital,ISLAMABAD
Islamabad, Punjab Province, 46600
KINZA ANWAR, MS-OMPT, +92-3239735427, kinza.anwar@riphah.edu.pk
AQSA BUTT, MS-OMPT*
About this study
Official title: Effects of Bowen Technique With Retro-walking on Hamstring Flexibility in Knee Osteoarthritis Patients
The aim of this randomized controlled trial is to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients
Read the detailed description
The term osteoarthritis is also known as degenerative joint disease because of wear and tear process occur in articular cartilage. OA affect the joints, the tissue surrounding the joint and other connective tissue. The symptoms of knee OA is most common seen in obese and aged individuals. There are three compartment that affected in knee OA include medial, lateral and patellofemoral joint. The OA takes 10 to 15 years to develop. The pathophysiology of the OA is still under investigation. Traditionally it was considered that it was due to aging factor because wear and tear process occur in articular surfaces.
But now it's considered there are multiple factors that involve in the origin of OA include biomechanical and inflammatory factors. Knee OA is influenced by family history, age, obesity, joint shape, genu valgus and varum and inflammation by metabolic syndrome. In radiological findings wo notice that bony osteophytes, damaging of articular cartilage, sclerosis of the subchondral bone seen, and it's become severe later. Knee OA may be modified or may be unmodified. In unmodifiable include genetically or congenital. But in modifiable is excessive weight. In Modern treatment we focus on improve the function limitation and quality of life which we can improve by physiotherapy Several muscles are involved in the support of knee. The 2 major muscle groups quadriceps and hamstrings are involved in the movement and stability of the knee joint. The quadriceps and hamstrings provide the knee stability in frontal plane. In knee OA pathogenesis important muscle imbalance arise from quadriceps group of muscles or hamstring group of muscles weakness, which is usually assessed by quadriceps hamstrings ratio(Q:H). In knee OA medial compartment of tibiofemoral joint is mostly involved.
Bowen technique helps in restore the fascia disturbances and muscle imbalances. During the application of the Bowen technique, it stimulates the brain ascending neural impulses to allow the fascia changes this mechanism is called fascia plasticity.) Bowen therapy works on our body nervous system by stimulating the parasympathetic nervous system and encourage the state of relaxation and healing. Bowen moves are applied on the muscle's origin, insertion, or belly of muscles where Golgi receptors are located. Bowen therapy improves body ability to function at a cellular level.
Backward walking increases the coordination because during backward walking isometric and concentric activity both are occurred. The backward walking mechanism is different from the forward walking, in backward walking toes contact the ground first and the heel is lifted off the ground in early stance. Retro walking can minimize the burden on the joint and increase the muscle length in normal healthy individuals.
This study aims to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients.
- Conditions
- Knee Osteoarthritis
- Being tested
- Bowen technique with Retro-walking, Conventional Treatment
- Keywords
- Knee Osteoarthritis, Hamstring tightness, Bowen technique, Retro-walking
- Medical subject headings
- Osteoarthritis, Knee
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bowen technique with Retro-walkingOther
In initially step the patient in prone position and therapist approach on the same side of the treatment limb. Use the thumb by applying the pressure on the lateral side of the target muscle. The treatment sequence will begin with thumb gradually involve the finger. a single treatment consists of a series of specific sequences of these moves with frequent pauses 2 to 5 minutes to allow time for the body to respond. Treatment session duration 15-20 minutes occur 3 days per week, for 4 weeks. Week 1(retro-walking on flat surface for 5 minutes) week 2(retro walking on flat surface for 7 minutes) week 3(retro-walking on flat surface for 10 minutes) week 4 (retro-walking on flat surface for 15 minutes) .Conventional PT including 1- hot pack 2-isometric quadriceps exercise(1 set of 10 reps twice a day)2-SLR stretch (1set of 10 reps twice a day)4-isometric hip adduction exercise( 1 set of 10 reps twice a day)5-Terminal knee extension( 1 set of 10 reps twice a day) total duration is 3 sessions
Conventional TreatmentOther
Conventional PT including 1-. Hot pack 2- isometric quadriceps exercise (1 set of 10 reps twice a day) 3-SLR Stretch (1set of 10 reps twice a day) 4 -isometric hip adduction exercise (1 set of 10 reps twice a day) 5-Terminal knee extension (1 set of 10 reps twice a day) Total duration is 3 sessions per week for 4 consecutive weeks.
| Study group | Role | What they receive |
|---|---|---|
| Bowen technique with Retro-walking | Other | Bowen technique with Retro-walking Receives: Other: Bowen technique with Retro-walking |
| Conventional PT | Other | Conventional PT Receives: Other: Conventional Treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Visual Analogue scale VAS
The VAS is psychomotor response scales to investigate a unidimensional measure of pain intensity. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
Measured: 4 weeks
Active knee extension test
Active knee extension will use to access the flexibility of the hamstring muscle. Ask the patient to lay down in spine position while flexing the hip 90-degree, other leg down with couch and leg to be test with both hands. The goniometer will place on knee and ask the patient to extend the knee holding hip flex 90 degree
Measured: 4 weeks
SLR
A goniometer will be used to measure the range of hip flexion on passive SLR and range less than 80 degree indicate that the hamstring muscle tightness
Measured: 4 weeks
Timed Up and Go (TUG) Test
The TUG test measures the time taken by a participant to stand up from a standard chair, walk a distance of 3 meters, turn around, walk back to the chair, and sit down. It assesses dynamic balance and functional performance.
Measured: 4 weeks
Knee injury and osteoarthritis score
In KOOS include 42 items in five subscales to check different categories i.e. pain (9 items), symptoms (7 items), functions in the activity of daily living (ADLs) (17) items), sports and recreational activities (5 items), and quality of life (4 items).
Measured: 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Nov 2025
- Study start25 Oct 2025
- Primary completion20 Sep 2026 (estimated)
- Study completion25 Sep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Knee OsteoarthritisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 36 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- KINZA ANWAR, MS-OMPT, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07238751
- Sponsor's protocol ID
- Aqsa Butt
- Acronym
- A
- Status last verified
- Nov 2025
- First submitted
- 25 Sep 2025
- Last updated
- 20 Nov 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 20 Nov 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Bowen Technique With Retro-walking on Hamstring Flexibility in Knee Osteoarthritis Patients
- ClinicalTrials.gov ID
- NCT07238751
- Acronym / sponsor ID
- A / Aqsa Butt
- Conditions
- Knee Osteoarthritis
- Keywords
- Knee Osteoarthritis, Hamstring tightness, Bowen technique, Retro-walking
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 36 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 25 Oct 2025 (actual)
- Primary completion
- 20 Sep 2026 (estimated)
- Study completion
- 25 Sep 2026 (estimated)
- First posted
- 20 Nov 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this randomized controlled trial is to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients
Detailed description
The term osteoarthritis is also known as degenerative joint disease because of wear and tear process occur in articular cartilage. OA affect the joints, the tissue surrounding the joint and other connective tissue. The symptoms of knee OA is most common seen in obese and aged individuals. There are three compartment that affected in knee OA include medial, lateral and patellofemoral joint. The OA takes 10 to 15 years to develop. The pathophysiology of the OA is still under investigation. Traditionally it was considered that it was due to aging factor because wear and tear process occur in articular surfaces.
But now it's considered there are multiple factors that involve in the origin of OA include biomechanical and inflammatory factors. Knee OA is influenced by family history, age, obesity, joint shape, genu valgus and varum and inflammation by metabolic syndrome. In radiological findings wo notice that bony osteophytes, damaging of articular cartilage, sclerosis of the subchondral bone seen, and it's become severe later. Knee OA may be modified or may be unmodified. In unmodifiable include genetically or congenital. But in modifiable is excessive weight. In Modern treatment we focus on improve the function limitation and quality of life which we can improve by physiotherapy Several muscles are involved in the support of knee. The 2 major muscle groups quadriceps and hamstrings are involved in the movement and stability of the knee joint. The quadriceps and hamstrings provide the knee stability in frontal plane. In knee OA pathogenesis important muscle imbalance arise from quadriceps group of muscles or hamstring group of muscles weakness, which is usually assessed by quadriceps hamstrings ratio(Q:H). In knee OA medial compartment of tibiofemoral joint is mostly involved.
Bowen technique helps in restore the fascia disturbances and muscle imbalances. During the application of the Bowen technique, it stimulates the brain ascending neural impulses to allow the fascia changes this mechanism is called fascia plasticity.) Bowen therapy works on our body nervous system by stimulating the parasympathetic nervous system and encourage the state of relaxation and healing. Bowen moves are applied on the muscle's origin, insertion, or belly of muscles where Golgi receptors are located. Bowen therapy improves body ability to function at a cellular level.
Backward walking increases the coordination because during backward walking isometric and concentric activity both are occurred. The backward walking mechanism is different from the forward walking, in backward walking toes contact the ground first and the heel is lifted off the ground in early stance. Retro walking can minimize the burden on the joint and increase the muscle length in normal healthy individuals.
This study aims to find the effects of Bowen technique with retro-walking on hamstring flexibility, pain, dynamic mobility and knee related disability in knee Osteoarthritis patients.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Bowen technique with Retro-walking | Other | Other: Bowen technique with Retro-walkingBowen technique with Retro-walking |
| Conventional PT | Other | Other: Conventional TreatmentConventional PT |
Who may qualify
- Ages
- 40 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (7 listed)
- Age 40-60 years
- Both gender: male and female
- Less than 80-degree hip flexion angle on passive SLR, Active knee extension greater than 20 indicates hamstring muscle tightness
- Kellgren and Lawrence classification (stage I and stage II)
- Bilateral hamstring tightness
Key exclusion criteria (9 listed)
- Meniscal injury or ligamentous injury
- Muscle/tendon injuries of hamstring
- Spinal Injuries and any other co- morbidity
- Any surgery, infection, trauma, pregnancy, fracture and fall
- Involvement in regular flexibility yoga program
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bowen technique with Retro-walkingIn initially step the patient in prone position and therapist approach on the same side of the treatment limb. Use the thumb by applying the pressure on the lateral side of the target muscle. The treatment sequence will begin with thumb gradually involve the finger. a single treatment consists of a series of specific sequences of these moves with frequent pauses 2 to 5 minutes to allow time for the body to respond. Treatment session duration 15-20 minutes occur 3 days per week, for 4 weeks. Week 1(retro-walking on flat surface for 5 minutes) week 2(retro walking on flat surface for 7 minutes) week 3(retro-walking on flat surface for 10 minutes) week 4 (retro-walking on flat surface for 15 minutes) .Conventional PT including 1- hot pack 2-isometric quadriceps exercise(1 set of 10 reps twice a day)2-SLR stretch (1set of 10 reps twice a day)4-isometric hip adduction exercise( 1 set of 10 reps twice a day)5-Terminal knee extension( 1 set of 10 reps twice a day) total duration is 3 sessions | Other | Bowen technique with Retro-walking |
| Conventional TreatmentConventional PT including 1-. Hot pack 2- isometric quadriceps exercise (1 set of 10 reps twice a day) 3-SLR Stretch (1set of 10 reps twice a day) 4 -isometric hip adduction exercise (1 set of 10 reps twice a day) 5-Terminal knee extension (1 set of 10 reps twice a day) Total duration is 3 sessions per week for 4 consecutive weeks. | Other | Conventional PT |
Primary outcome
Visual Analogue scale VAS
Time frame: 4 weeks
The VAS is psychomotor response scales to investigate a unidimensional measure of pain intensity. It scores ranges from 0-10, 0 means No pain and 10 means Severe pain. Patient will be asked to verbally report the pain score.
Active knee extension test
Time frame: 4 weeks
Active knee extension will use to access the flexibility of the hamstring muscle. Ask the patient to lay down in spine position while flexing the hip 90-degree, other leg down with couch and leg to be test with both hands. The goniometer will place on knee and ask the patient to extend the knee holding hip flex 90 degree
SLR
Time frame: 4 weeks
A goniometer will be used to measure the range of hip flexion on passive SLR and range less than 80 degree indicate that the hamstring muscle tightness
Timed Up and Go (TUG) Test
Time frame: 4 weeks
The TUG test measures the time taken by a participant to stand up from a standard chair, walk a distance of 3 meters, turn around, walk back to the chair, and sit down. It assesses dynamic balance and functional performance.
Knee injury and osteoarthritis score
Time frame: 4 weeks
In KOOS include 42 items in five subscales to check different categories i.e. pain (9 items), symptoms (7 items), functions in the activity of daily living (ADLs) (17) items), sports and recreational activities (5 items), and quality of life (4 items).
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Nov 2025.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
KINZA ANWAR, MS-OMPT principal investigator
Riphah International University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Bowen technique with Retro-walking and Conventional Treatment in people with Knee Osteoarthritis, run by Riphah International University at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 20 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact KINZA ANWAR, MS-OMPT (+92-3239735427, kinza.anwar@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Visual Analogue scale VAS (time frame: 4 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Nov 2025.