Knee OsteoarthritisNCT07642258
Effects of Sahrmann's Approach Versus Conventional Treatment Oin Patients With Knee Osteoarthritis
A study testing Sahrmann's exercises and standard physical therapy treatment in people with Knee Osteoarthritis, run by Riphah International University at 1 site in Pakistan.
Trial summary
Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. 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?
- Sahrmann's exercises and standard physical therapy treatment
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 40 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jul 2026to 1 Oct 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
- Males and females between 40 to 60 years of age.
- Diagnosed patients of knee Osteoarthritis with grade 2.
- Valgus angle of knee > 10°.
Who cannot join
- Any other inflammatory conditions.
- Rheumatoid arthritis, ankylosing spondylitis or any other auto immune disorder
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
University of Lahore Teaching Hospital, Lahore HOD Physio Department
Lahore, Punjab Province, 54000
About this study
Official title: Effects of Sahrmann's Approach Versus Conventional Treatment on Pain, Valgus Angle and Functional Disability in Patients With Knee Osteoarthritis
Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. The objective of the study will be to compare the effects of Sahrmann's approach versus conventional treatment on pain, valgus angle and functional disability in patients with knee osteoarthritis.
Read the detailed description
This randomized controlled trial will be conducted at Sehat Medical Complex, Hanjarwal and Sir Ganga Ram Hospital, Lahore. Sample size of the study will be 40. We will include the patients of age between 40-60 years, with diagnosis of knee osteoarthritis of grade 2, their pain intensity should be 3 points on NPRS and with gradual onset of pain from past 3 months, with valgus angle of knee > 10° and a positive HKA angle > 1° of valgus knee OA on radiographs. All the participants will be randomly divided into two groups. GROUP A which will be EXPERIMENTAL GROUP, will receive Sahrmann's approach protocol and GROUP B which will be CONTROL GROUP, will receive conventional treatment. Both groups will receive baseline treatment including hot pack/cold pack, TENS and basic exercises. The study will be comparing the effects of both treatments after 4 weeks, with 3 sessions per week on alternate days. Patients will be assessed by Numeric pain rating scale (NPRS) for pain, by Universal Goniometer (UG) for the assessment of valgus angle and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functioning of knee. Statistical Analysis will be done by statistical package for social sciences SPSS version 26.
- Conditions
- Knee Osteoarthritis
- Being tested
- Sahrmann's exercises, standard physical therapy treatment
- Keywords
- pain, functional disability, VALGUS ANGLE
- Medical subject headings
- Osteoarthritis, Knee, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Sahrmann's exercisesOther
- with and without resistance band-SLR
- with and without resistance band-Hip extension
- with and without resistance band-clamshells
- IT Band stretch
- Squatting in front of mirror
- with resistance band-lateral walk
- Hip lateral rotation
standard physical therapy treatmentOther
Comparator group patients will receive, Conventional treatment exercises.
- ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching
| Study group | Role | What they receive |
|---|---|---|
| Sahrmann's exercises | Experimental | Dr. Shirley Sahrmann's Movement System Impairment (MSI) approach for knee osteoarthritis operates on the kinesiopathologic model: it asserts that repetitive faulty movement patterns and sustained improper alignments-not just age or wear-are primary drivers of joint stress and cartilage breakdown Receives: Other: Sahrmann's exercises |
| Standard Physical therapy | Active comparator | Comparator group patients will receive, Conventional treatment exercises.
• ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching Receives: Other: standard physical therapy treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale (NPRS) - Pain Assessment
The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain."
The NPRS is widely used in musculoskeletal and orthopedic conditions due to its simplicity, high responsiveness, and strong psychometric properties. It demonstrates excellent reliability (test-retest reliability ICC > 0.80) and good construct validity in chronic pain populations including knee osteoarthritis.
Measured: upto 4 weeks
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - Functional Outcome (Knee OA)
The WOMAC Osteoarthritis Index is a disease-specific, self-administered questionnaire designed to evaluate symptoms and functional status in patients with hip and knee osteoarthritis.
It consists of 24 items divided into three subscales:
Pain (5 items) Stiffness (2 items) Physical Function (17 items)
Each item is typically scored using a 5-point Likert scale (0 = none to 4 = extreme), or alternatively via a visual analog format depending on study design. Total scores are summed, with higher scores indicating greater pain, stiffness, and functional disability.
Measured: upto 4 weeks
Universal Goniometer (UG) - Valgus Angle Measurement
The Universal Goniometer (UG) is a standard clinical instrument used to measure joint angles and assess alignment. In this study, it will be used to measure the knee valgus angle, which reflects medial-lateral alignment of the lower limb in the frontal plane.
The participant is typically assessed in a standing anatomical position, with landmarks aligned at:
Anterior superior iliac spine (ASIS) Center of patella Ankle/midline of tibia or second toe alignment (depending on protocol standardization)
The stationary arm of the goniometer is aligned with the femur, while the movable arm follows the tibial shaft. The angle between these segments represents the dynamic or static valgus alignment, depending on whether assessment is static posture or functional task-based measurement.
Changes in valgus angle will be used to assess biomechanical alignment improvements following the intervention.
Measured: upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jun 2026
- Study start1 Jul 2026 (estimated)
- Primary completion1 Sep 2026 (estimated)
- Study completion1 Oct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for Knee OsteoarthritisStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- 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
- Outcomes assessor
- Enrolment
- 40 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Arooj Sohail, MSPT*, Principal investigator, Riphah International University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07642258
- Sponsor's protocol ID
- REC/RCR&AHS/25/0112 Arooj
- Status last verified
- Jun 2026
- First submitted
- 8 Jun 2026
- Last updated
- 11 Jun 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and Incidence of Osteoarthritis: A Population-Based Retrospective Cohort Study. J Clin Med. 2021 Sep 21;10(18):4282. doi: 10.3390/jcm10184282.
PubMed 34575394Ramazanian T, Yan S, Rouzrokh P, Wyles CC, O Byrne TJ, Taunton MJ, Maradit Kremers H. Distribution and Correlates of Hip-Knee-Ankle Angle in Early Osteoarthritis and Preoperative Total Knee Arthroplasty Patients. J Arthroplasty. 2022 Jun;37(6S):S170-S175. doi: 10.1016/j.arth.2021.12.009. Epub 2022 Feb 21.
PubMed 35210147Mousavi F, Kajbafvala M, Mohsenifar H, Salehi R, Hejazi A. The effect of movement system impairment-based classification treatment compared to routine physiotherapy on pain, disability, alignment, and movement impairments in individuals with tibiofemoral rotation syndrome: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2024 Apr 25;16(1):94. doi: 10.1186/s13102-024-00883-9.
PubMed 38664767Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med. 2022 Oct 12;11(20):6013. doi: 10.3390/jcm11206013.
PubMed 36294334Mohammad Jabbar K, Gandomi F. The effects of national academy of sports medicine and sahrmann training on foot pressure distribution in flexed posture students. Iranian Rehabilitation Journal. 2021;19(1):99-110.
Zamani P, Kalantari KK, Fashkhami AN, Baghban AA, Mehravar M, Yazdi MS. Efficacy of treatment based on the movement system impairment classification in people with knee pain: a study protocol. Iran Red Crescent Med J. 2022;24:e1767.
Nouman M, Shabnam J, Anwar S, Perveen W, Alexe DI, Sanchez-Gomez R, Sava MA, Alexe CI. Effect of Iliotibial Band Myofascial Release Combined with Valgus Correction Exercise on Pain, Range of Motion, Balance, and Quality of Life in Patients with Grade II Knee Osteoarthritis: A Randomized Clinical Trial. Life (Basel). 2024 Oct 27;14(11):1379. doi: 10.3390/life14111379.
PubMed 39598178Kalunke A. A Comparative Study on the Effectiveness of Rhythmic Stabilization Technique (PNF) and Conventional Physiotherapy in the Treatment of Knee Osteoarthritis. Journal of Internal Medicine and Pharmacology (JIMP). 2024;1(03):50-8.
MohammedSadiq HA, Rasool MT. Effectiveness of home-based conventional exercise and cryotherapy on daily living activities in patients with knee osteoarthritis: A randomized controlled clinical trial. Medicine (Baltimore). 2023 May 5;102(18):e33678. doi: 10.1097/MD.0000000000033678.
PubMed 37145013Mohamed SHP, Alatawi SF. Effectiveness of Kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial. Ir J Med Sci. 2023 Oct;192(5):2223-2233. doi: 10.1007/s11845-022-03247-9. Epub 2022 Dec 17.
PubMed 36527538Arslan Y, Kul A. Effectiveness Comparison of Extracorporeal Shock Wave Therapy and Conventional Physical Therapy Modalities in Primary Knee Osteoarthritis. Turk J Osteoporos. 2022;28(2):83-90.
Study at a glance
From the registry record, last updated by the sponsor on 11 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Sahrmann's Approach Versus Conventional Treatment on Pain, Valgus Angle and Functional Disability in Patients With Knee Osteoarthritis
- ClinicalTrials.gov ID
- NCT07642258
- Acronym / sponsor ID
- REC/RCR&AHS/25/0112 Arooj
- Conditions
- Knee Osteoarthritis
- Keywords
- pain, functional disability, VALGUS ANGLE
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 40 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 1 Jul 2026 (estimated)
- Primary completion
- 1 Sep 2026 (estimated)
- Study completion
- 1 Oct 2026 (estimated)
- First posted
- 11 Jun 2026 (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.
Osteoarthritis (OA) of the knee, also referred to as degenerative joint disease, is normally due to wear and tear and progressive cartilage loss in the articular cartilage. Osteoarthritis is most prevalent condition among older adults. The objective of the study will be to compare the effects of Sahrmann's approach versus conventional treatment on pain, valgus angle and functional disability in patients with knee osteoarthritis.
Detailed description
This randomized controlled trial will be conducted at Sehat Medical Complex, Hanjarwal and Sir Ganga Ram Hospital, Lahore. Sample size of the study will be 40. We will include the patients of age between 40-60 years, with diagnosis of knee osteoarthritis of grade 2, their pain intensity should be 3 points on NPRS and with gradual onset of pain from past 3 months, with valgus angle of knee > 10° and a positive HKA angle > 1° of valgus knee OA on radiographs. All the participants will be randomly divided into two groups. GROUP A which will be EXPERIMENTAL GROUP, will receive Sahrmann's approach protocol and GROUP B which will be CONTROL GROUP, will receive conventional treatment. Both groups will receive baseline treatment including hot pack/cold pack, TENS and basic exercises. The study will be comparing the effects of both treatments after 4 weeks, with 3 sessions per week on alternate days. Patients will be assessed by Numeric pain rating scale (NPRS) for pain, by Universal Goniometer (UG) for the assessment of valgus angle and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for functioning of knee. Statistical Analysis will be done by statistical package for social sciences SPSS version 26.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Sahrmann's exercises | Experimental | Other: Sahrmann's exercisesDr. Shirley Sahrmann's Movement System Impairment (MSI) approach for knee osteoarthritis operates on the kinesiopathologic model: it asserts that repetitive faulty movement patterns and sustained improper alignments-not just age or wear-are primary drivers of joint stress and cartilage breakdown |
| Standard Physical therapy | Active comparator | Other: standard physical therapy treatmentComparator group patients will receive, Conventional treatment exercises. • ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching |
Who may qualify
- Ages
- 40 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Males and females between 40 to 60 years of age.
- Diagnosed patients of knee Osteoarthritis with grade 2.
- Valgus angle of knee > 10°.
Key exclusion criteria (2 listed)
- Any other inflammatory conditions.
- Rheumatoid arthritis, ankylosing spondylitis or any other auto immune disorder
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 |
|---|---|---|
| Sahrmann's exercises* with and without resistance band-SLR * with and without resistance band-Hip extension * with and without resistance band-clamshells * IT Band stretch * Squatting in front of mirror * with resistance band-lateral walk * Hip lateral rotation | Other | Sahrmann's exercises |
| standard physical therapy treatmentComparator group patients will receive, Conventional treatment exercises. • ROMs, SLR, VMO's and Quadriceps strengthening, Partial squatting, Terminal knee extension ROM, ITB, Hamstrings and gastrocnemius stretching | Other | Standard Physical therapy |
Primary outcome
Numeric Pain Rating Scale (NPRS) - Pain Assessment
Time frame: upto 4 weeks
The Numeric Pain Rating Scale (NPRS) is a unidimensional, patient-reported outcome measure used to assess pain intensity. Participants are asked to rate their current pain level, or average pain over a specified recall period (e.g., past 24 hours or past week), using an 11-point scale ranging from 0 to 10, where 0 indicates "no pain" and 10 indicates "worst imaginable pain." The NPRS is widely used in musculoskeletal and orthopedic conditions due to its simplicity, high responsiveness, and strong psychometric properties. It demonstrates excellent reliability (test-retest reliability ICC > 0.80) and good construct validity in chronic pain populations including knee osteoarthritis.
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) - Functional Outcome (Knee OA)
Time frame: upto 4 weeks
The WOMAC Osteoarthritis Index is a disease-specific, self-administered questionnaire designed to evaluate symptoms and functional status in patients with hip and knee osteoarthritis. It consists of 24 items divided into three subscales: Pain (5 items) Stiffness (2 items) Physical Function (17 items) Each item is typically scored using a 5-point Likert scale (0 = none to 4 = extreme), or alternatively via a visual analog format depending on study design. Total scores are summed, with higher scores indicating greater pain, stiffness, and functional disability.
Universal Goniometer (UG) - Valgus Angle Measurement
Time frame: upto 4 weeks
The Universal Goniometer (UG) is a standard clinical instrument used to measure joint angles and assess alignment. In this study, it will be used to measure the knee valgus angle, which reflects medial-lateral alignment of the lower limb in the frontal plane. The participant is typically assessed in a standing anatomical position, with landmarks aligned at: Anterior superior iliac spine (ASIS) Center of patella Ankle/midline of tibia or second toe alignment (depending on protocol standardization) The stationary arm of the goniometer is aligned with the femur, while the movable arm follows the tibial shaft. The angle between these segments represents the dynamic or static valgus alignment, depending on whether assessment is static posture or functional task-based measurement. Changes in valgus angle will be used to assess biomechanical alignment improvements following the intervention.
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 11 Jun 2026.
- Background: PubMed 34575394Hamood R, Tirosh M, Fallach N, Chodick G, Eisenberg E, Lubovsky O. Prevalence and Incidence of Osteoarthritis: A Population-Based Retrospective Cohort Study. J Clin Med. 2021 Sep 21;10(18):4282. doi: 10.3390/jcm10184282.
- Background: PubMed 35210147Ramazanian T, Yan S, Rouzrokh P, Wyles CC, O Byrne TJ, Taunton MJ, Maradit Kremers H. Distribution and Correlates of Hip-Knee-Ankle Angle in Early Osteoarthritis and Preoperative Total Knee Arthroplasty Patients. J Arthroplasty. 2022 Jun;37(6S):S170-S175. doi: 10.1016/j.arth.2021.12.009. Epub 2022 Feb 21.
- Background: PubMed 38664767Mousavi F, Kajbafvala M, Mohsenifar H, Salehi R, Hejazi A. The effect of movement system impairment-based classification treatment compared to routine physiotherapy on pain, disability, alignment, and movement impairments in individuals with tibiofemoral rotation syndrome: a randomized controlled trial. BMC Sports Sci Med Rehabil. 2024 Apr 25;16(1):94. doi: 10.1186/s13102-024-00883-9.
- Background: PubMed 36294334Coaccioli S, Sarzi-Puttini P, Zis P, Rinonapoli G, Varrassi G. Osteoarthritis: New Insight on Its Pathophysiology. J Clin Med. 2022 Oct 12;11(20):6013. doi: 10.3390/jcm11206013.
- BackgroundMohammad Jabbar K, Gandomi F. The effects of national academy of sports medicine and sahrmann training on foot pressure distribution in flexed posture students. Iranian Rehabilitation Journal. 2021;19(1):99-110.
- BackgroundZamani P, Kalantari KK, Fashkhami AN, Baghban AA, Mehravar M, Yazdi MS. Efficacy of treatment based on the movement system impairment classification in people with knee pain: a study protocol. Iran Red Crescent Med J. 2022;24:e1767.
- Background: PubMed 39598178Nouman M, Shabnam J, Anwar S, Perveen W, Alexe DI, Sanchez-Gomez R, Sava MA, Alexe CI. Effect of Iliotibial Band Myofascial Release Combined with Valgus Correction Exercise on Pain, Range of Motion, Balance, and Quality of Life in Patients with Grade II Knee Osteoarthritis: A Randomized Clinical Trial. Life (Basel). 2024 Oct 27;14(11):1379. doi: 10.3390/life14111379.
- BackgroundKalunke A. A Comparative Study on the Effectiveness of Rhythmic Stabilization Technique (PNF) and Conventional Physiotherapy in the Treatment of Knee Osteoarthritis. Journal of Internal Medicine and Pharmacology (JIMP). 2024;1(03):50-8.
- Background: PubMed 37145013MohammedSadiq HA, Rasool MT. Effectiveness of home-based conventional exercise and cryotherapy on daily living activities in patients with knee osteoarthritis: A randomized controlled clinical trial. Medicine (Baltimore). 2023 May 5;102(18):e33678. doi: 10.1097/MD.0000000000033678.
- Background: PubMed 36527538Mohamed SHP, Alatawi SF. Effectiveness of Kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial. Ir J Med Sci. 2023 Oct;192(5):2223-2233. doi: 10.1007/s11845-022-03247-9. Epub 2022 Dec 17.
- BackgroundArslan Y, Kul A. Effectiveness Comparison of Extracorporeal Shock Wave Therapy and Conventional Physical Therapy Modalities in Primary Knee Osteoarthritis. Turk J Osteoporos. 2022;28(2):83-90.
- 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.
Arooj Sohail, MSPT* 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 Sahrmann's exercises and standard physical therapy 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 3 inclusion and 2 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: opening soon, as of the sponsor's last update on 11 Jun 2026. 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 Samrood Akram, PhD* (03324806143, samrood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale (NPRS) - Pain Assessment (time frame: upto 4 weeks). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07642258, which also lists 11 linked publications.
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 11 Jun 2026.