Is manual therapy for stiff knees using lessons learned from 4D motion analysis more effective than traditional manual therapy?

Not Applicable

Completed

• Conditions: Stiff Knees; Physical Medicine / Rehabilitation - Physiotherapy; Musculoskeletal - Other muscular and skeletal disorders; Musculoskeletal - Osteoarthritis

• Registration Number: ACTRN12618000230257
• Lead Sponsor: niversity of Canberra

Brief Summary

Background: Manual therapy to treat joint stiffness was based on a 1950's concept of movement. Now when we use imaging to examine the knee, we see the tibia (shin) comes forward to allow the knee to bend fully. Objective: To compare mobilisations pushing (anterior to posterior glide) compared to pulling (posterior to anterior glide) the shin, to increase the bend in the knee and provide data to for a later clinical trial. Design: Pilot study preparing for a double-blinded, randomised controlled trial. Methods: Adults with less than 120° knee bend, without inflammatory arthritis or previous surgery to the stiff knee, were randomised into two groups. Participants received four sessions of push or pull treatment below the knee and a corresponding home exercise program. Outcomes were knee bend measured using a digital device, pain scale, Patient Specific Functional Scale (PSFS) and the Knee injury and Osteoarthritis Outcome Score (KOOS). Results: Twenty-nine participants were randomised (14 and 15 in each group). The 'pull' treatment resulted in a greater increase in knee bend than the 'push' treatment by 16° compared to 9°. There were no differences between the groups for pain, function or knee score. Based on these data, a future clinical trial would need at least 33 participants in each group. Preliminary results show that a 'pull' treatment to the knee may be more effective and a full scale clinical trial may be worthwhile to confirm this.

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2018-02-12
• Study Completion: 2018-08-30
• Last Update Posted: 15 July 2019

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 29

Inclusion Criteria

Individuals with restricted knee flexion ROM
- Aged >18
- Stiffness duration of at least 7 days

Exclusion Criteria

- Knee pain > 8/10 on Numeric Rating Scale
- Chronic Regional Pain Syndrome (CRPS)
- Anxiety related to manual therapy
- Total Knee Replacement on the affected side
- Inflammatory Arthritis
- Anterior or posterior cruciate ligament graft surgery.
- Knee reconstruction or previous ligament rupture on the affected side
- Acute locked meniscus
- Initiation of opioid analgaesia or corticosteroid injection within the past 7 days.

Study & Design

• Study Type: Interventional
• Study Design: Not specified