Effectiveness of Manual Therapy and Neuromuscular Training in the Management of Knee Osteoarthritis

University of Tabuk

Status: Completed

Conditions: Knee Osteoarthritis

Treatments: Device: Transcutaneous Electrical Nerve Stimulation (TENS); Other: Manual therapy techniques

Study type: Interventional

Funder types: Other

Identifiers

NCT05659849

UT-217-68-2022

Details and patient eligibility

About

The purpose of the study is to compare the short-term effectiveness of manual therapy with neuromuscular training and conventional physical therapy with neuromuscular training in patients with knee osteoarthritis.

Full description

Knee osteoarthritis (OA) is a major public health problem, characterized by progressive degeneration and loss of articular cartilage, resulting in pain, limitation of movement, imbalance, functional disability, and diminished patient quality of life. Regular participation in physical activity has been recognized for several years as being beneficial in the management of knee OA. The role and effectiveness of manual therapy techniques and conventional physical therapy are evident from the existing literature, but no comparison was found for the combination of neuromuscular training (NMT) in patients with knee OA. Thus, the aim of this study is to compare the short-term effectiveness of manual therapy (MT) versus conventional physical therapy (CPT) with NMT in the management of knee OA after six weeks of treatment.

Enrollment: 60 patients

Sex: All

Ages: 40 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Complaining of knee pain that has lasted longer than 3 months.
• Pain level that is medium (pain score greater than or equal to 4).
• No knee injuries.
• Treatment not received in another physical therapy clinic in the past three months.
• Painful range of motion in the knee.

Exclusion criteria

• History of knee surgery
• A systemic arthritic condition
• Any other muscular, joint, or neurological condition affecting lower limb function.
• Received physical therapy or an intra-articular injection in the knee within the past 3 months.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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60 participants in 2 patient groups

Manual therapy with Neuromuscular training

Experimental group

Description:

Manual physical therapy is intended to improve musculoskeletal function and pain by addressing impaired kinematics of the joint. Passive Joint Mobilization (PJM) was applied to knee distraction and dorsal glides, ventral glides, and patellar glides in all directions, which were applied at a rate of two to three oscillations per second for 1-2 min. Each direction was repeated three to six times. Neuromuscular training (NEMEX-TJR training program): (2 times per week for 6 weeks) The neuromuscular training program consists of 3 parts: warming up, a circuit program, and cooling down. The program is performed twice a week for 6 weeks, with each session lasts for 60 minutes.

Treatment:

Other: Manual therapy techniques

Conventional physical therapy with Neuromuscular training

Experimental group

Description:

Physical therapists use a variety of transcutaneous electrical nerve stimulation (TENS) applications to reduce or alleviate pain for individuals with Knee OA. TENS (symmetrical biphasic waveform, frequency 32-50 Hz, pulse width 80 microseconds) for the same amount of time and the same number of days. The TENS electrodes were applied on the medial and lateral superior, as well as the medial and lateral inferior, borders of the patella. Care was taken not to place TENS electrodes on the quadriceps muscles or muscles of the anterior leg. Neuromuscular training (NEMEX-TJR training program): (2 times per week for 6 weeks) The neuromuscular training program consists of 3 parts: warming up, a circuit program, and cooling down. The program is performed twice a week for 6 weeks, with each session lasts for 60 minutes.

Treatment:

Device: Transcutaneous Electrical Nerve Stimulation (TENS)