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.
