End-range Mobilization on Knee Osteoarthritis

University of Pecs

Status: Completed

Conditions: Osteo Arthritis Knee

Treatments: Procedure: Conservative therapy; Procedure: Manual therapy

Study type: Interventional

Funder types: Other

Identifiers

NCT04270253

PozsgaiMMaitlandKnee

Details and patient eligibility

About

Different manual therapy techniques and conservative therapy have been used separately for alleviation of pain and improvement of physical function in patients with knee osteoarthritis (KOA). However, no study has reported the effect of combination of these treatment modalities in the management of KOA. The aim of this study was to investigate the effect of end-range mobilization added to conservative therapy versus conservative therapy alone on decrease of pain and improvement of functional status in KOA.

Full description

Knee osteoarthritis (KOA) is a musculoskeletal condition affecting older people. It is characterized by pain and loss of physical function, which has a negative impact on patients' quality of life. The different international guidelines recommend several non-invasive treatment modalities for the management of KOA. Conservative therapy including land-based exercises, aquatic exercises, Transcutaneous Electro Neuro Stimulation (TENS) therapy and balneotherapy has been reported positively in the management of patients with KOA (1, 2). Manual therapy is also a preferred treatment modality with the aim of alleviation of pain, improvement of joint mobility and therefore the physical condition (1, 2). Out of manual therapy techniques, end-range mobilization is a well applied treatment technique in the management of different musculoskeletal conditions (3). Till date, the effect of end-range mobilization has not been investigated so far in knee OA.

Therefore, the aim of this study was to investigate the effect of end-range mobilization added to conservative therapy versus conservative therapy alone on decrease of pain and improvement of functional status in KOA.

Enrollment: 30 patients

Sex: All

Ages: 60 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• KOA according to the American College of Rheumatology
• categorization as End Of Range Problem based on Maitland's classification.
• at least half year existing and at least 3 pain scores measured with Visual Analogue Scale (VAS) during weight-bearing activities
• bilateral, moderate-to-severe symptomatic tibiofemoral knee OA with radiographic evidence
• at least 90 degree passive knee flexion range
• sufficient mental status

Exclusion criteria

• acute inflammation of the knee
• intraarticular injections within the last 3 months
• total knee replacement in the opposite side
• class II. obesity (body mass index, BMI>35kg/m2)
• severe degenerative lumbar spine disease (e.g. spondylolisthesis)
• systemic inflammatory arthritic or neurological condition
• physiotherapy and other balneotherapy attendance within 6 months
• contraindication for conservative and manual therapy
• unstable heart condition
• complex regional pain syndrome

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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30 participants in 2 patient groups

End-range mobilization

Experimental group

Description:

End-range mobilization applied 6 times for 2\*2 min in end-range of flexion and extension end-range of the tibiofemoral and patellofemoral joint beside the same conservative therapy, as used for the Control

Treatment:

Procedure: Conservative therapy

Procedure: Manual therapy

Control

Active Comparator group

Description:

Conservative therapy including aquatic exercises (5-times), land-based exercises (3-times), balneotherapy (5-times) and TENS therapy (3-times)

Treatment:

Procedure: Conservative therapy