Effect of uphill treadmill exercise on standard therapy to hamstrings tightness in patients with knee osteoarthritis at Dr. Soetomo General Hospital Surabaya

Introduction: Knee osteoarthritis causes excessive muscle contraction during walking, increased muscle tension in patients accompanied by changes in muscle stiffness related to hamstring tightness. Straight Leg Raise (SLR) is a measurement used to assess hamstring tightness using a gravity inclinometer. Objective: To evaluate the effect of uphill treadmill exercise as an addition to standard therapy on hamstrings tightness in patients with grade II-III knee osteoarthritis at Dr. Soetomo General Hospital Surabaya. Methodology: The control group received standard therapy (TENS and Q-bench) while the treatment group received standard therapy plus uphill treadmill exercise (8-degree inclination, speed 1.1 m/s, 30 minutes, 2x/week, for 5 weeks). Hamstring tightness was evaluated using SLR with a gravity inclinometer at three points: pre-intervention, post-intervention, and 20 days after the final exercise. Results: The treatment group's value compared to the control group in early-late right ΔHT (p=0.029; Cohen's D=0.78) and early-late left P ΔHT (p=0.02; Cohen's D=1.12). Discussion: Uphill treadmill exercise added to standard therapy significantly improved hamstring tightness in both legs with moderate to large effect sizes. The eccentric contractions during inclined walking likely contributed to reduced muscle tension and improved flexibility. Conclusions: Additional uphill treadmill exercise produced meaningful changes in hamstring tightness in both legs for patients with grade II-III knee OA compared to standard therapy alone.