Effectiveness of Integrated Neuromuscular Inhibition Technique Compared with Local Vibration Therapy on Iliotibial Band Tightness as an Adjunct in the Treatment of Knee Osteoarthritis

Abstract Background: Osteoarthritis (OA) is a common degenerative disorder of synovial joints, leading to knee pain, stiffness, reduced mobility, and impaired quality of life. Iliotibial band (ITB) tightness and associated myofascial pain may further aggravate symptoms in individuals with knee OA. Conventional physiotherapy commonly includes stretching and strengthening exercises. Local vibration therapy (LVT) facilitates muscle relaxation, enhances circulation, and reduces soft-tissue tension through the tonic vibration reflex. Integrated neuromuscular inhibition technique (INIT), which combines ischemic compression, positional release, and muscle energy techniques, has been shown to deactivate trigger points and reduce muscle tightness. However, limited evidence exists comparing the effectiveness of LVT and INIT for managing ITB tightness in individuals with knee OA. Objectives: To compare the effectiveness of INIT and LVT on ITB tightness in individuals with knee OA. Materials and Methods: Forty-six participants aged 50–70 years with knee OA and ITB tightness were recruited and were randomly assigned to the LVT (Group A) and INIT (Group B). Outcome measures included Ober’s test, the visual analog scale (VAS), the Timed Up and Go (TUG) test, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Assessments were conducted before and after the intervention period. Results: Both groups demonstrated significant improvements in VAS, TUG, and WOMAC scores ( P < 0.001). Group A exhibited greater overall improvement than Group B. Although pain reduction was greater in Group A, the between-group difference was not statistically significant ( P = 0.11). Functional mobility, measured using the TUG test ( P = 0.01), and overall joint function, measured using the WOMAC ( P = 0.02), improved significantly more in Group A. Conclusion: Both INIT and LVT, when combined with conventional physiotherapy, effectively improve pain, mobility, and joint function in individuals with knee OA. However, LVT demonstrated relatively superior outcomes.