Effect of Low-Load Long-Duration Stretch on Range of Motion in Post-Operative Knee Conditions

Background Post-operative knee stiffness is a common complication following surgical fixation of fractures around the knee joint, leading to reduced range of motion, pain, and functional limitations. Early physiotherapy intervention is essential to restore mobility and improve function. Low-load long-duration stretch (LLLDS) is a prolonged stretching technique that enhances soft tissue extensibility and joint mobility with minimal discomfort. This study aimed to evaluate the effect of LLLDS on knee range of motion, pain, and functional outcomes in post-operative knee patients. Objectives To evaluate the effectiveness of low-load long-duration stretch on knee range of motion, pain reduction, and functional outcomes in post-operative knee conditions and to compare its effectiveness with conventional physiotherapy. Methods A randomized controlled experimental study was conducted at Krishna College of Physiotherapy, Karad, India. Thirty-six individuals were assessed for eligibility, of whom six were excluded before randomization. The remaining 30 participants were randomly allocated to the experimental group (n=15) and control group (n=15). Six participants were subsequently lost to follow-up or excluded after allocation, resulting in 24 participants (12 per group) completing the study. Participants aged 20-60 years who had undergone surgical fixation around the knee joint and completed six weeks of immobilization were included. They were randomly allocated to an experimental group (LLLDS with conventional physiotherapy) and a control group (conventional physiotherapy alone), with 12 participants in each group. Outcome measures included the Numerical Pain Rating Scale (NPRS), knee range of motion using a universal goniometer, and the Lysholm Knee Scoring Scale. Interventions were administered for four weeks. Paired t-test and unpaired t-test were used for statistical analysis. Results Both groups demonstrated statistically significant improvements in pain, knee range of motion, and functional outcomes following the four-week intervention (p<0.0001). The experimental group demonstrated lower post-intervention pain scores on the Numerical Pain Rating Scale (2.10±0.82 vs. 4.20±0.90; p=0.015), greater knee range of motion (106.33±2.93° vs. 103.50±2.68°; p=0.021), and higher Lysholm Knee Scoring Scale scores (88.75±6.40 vs. 84.10±6.85; p=0.039) compared with the control group. These findings suggest that adding LLLDS to conventional physiotherapy may provide additional benefits in reducing pain, improving knee mobility, and enhancing functional outcomes in post-operative knee conditions. Conclusion Low-load long-duration stretch combined with conventional physiotherapy is more effective than conventional physiotherapy alone in improving knee range of motion, reducing pain, and enhancing functional outcomes in post-operative knee conditions.