title: Active, passive and proprioceptive neuromuscular facilitation stretching are comparable in improving the knee flexion range in people with total knee replacement: a randomized controlled trial.
abstract: OBJECTIVE
  To compare the immediate and medium-term effects of three stretching methods on the knee flexion range in people with a total knee replacement.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Rehabilitation hospital.
  
  
  METHODS
  117 patients were recruited and 100 (mean age: 68.43 ± 7.95 years) of them completed the study.
  
  
  METHODS
  Patients receiving total knee replacement due to knee osteoarthritis were randomly assigned into 3 groups of: active stretching (group 1, n =32), passive stretching (group 2, n =35) and proprioceptive neuromuscular facilitation stretching (group 3, n =33).
  
  
  METHODS
  The immediate change in both active and passive knee flexion range after the first treatment session and the pattern of change in these ranges throughout the 2-week study period were compared among the three groups.
  
  
  RESULTS
  All groups demonstrated significant improvement in knee ranges with time. The active range of group 1 improved by 19.9°, group 2 by 25.3° and group 3 by 22.5° throughout the 2-week period, whereas the improvements in the passive range were 18.8°, 24.5° and 22.7°, respectively. For between-group comparisons, no significant difference was found in both active (P = 0.647) and passive (P = 0.501) knee range immediately after stretching. For the changes at 2 weeks, there was also no significant difference among the groups in both active (P = 0.716) and passive (P = 0.959) knee ranges.
  
  
  CONCLUSIONS
  This study revealed that all three modes of stretching were associated with an increase in the knee flexion range of patients after total knee replacement, with no statistically significant differences between the changes seen.
authors.affiliation: Department of Physiotherapy, Tai Po Hospital and Department of Rehabilitation Sciences, Hong Kong Polytechnic University, China.
authors.forename: Tiffany P Y
authors.initials: TP
authors.lastname: Chow
authors.forename: Gabriel Y F
authors.initials: GY
authors.lastname: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052580:Muscle Stretching Exercises / Q000379:methods*; D020370:Osteoarthritis, Knee / Q000534:rehabilitation* / Q000601:surgery; D016059:Range of Motion, Articular