Effect of Mulligans mobilization with movement versus biopsychosocial pain education along with exercises in individuals diagnosed with chronic osteoarthritis of knee - A randomized controlled trial

Osteoarthritis (OA) of Knee is a prevalent musculoskeletal condition affecting older people, producing pain, physical disability, and reduced quality of life. OA is associated with joint pain, functional limitation and deformity and it incurs articular cartilage degeneration, osteophyte formation in joints, reduced joint space and subchondral sclerosis. Patient with OA knee reported pain and difficulty in everyday activities such as ascending and descending stairs, squatting, kneeling, rising from a chair and getting in and out of a car.

OA of the knee can cause the muscles in the thighs to weaken, and this weakness can make the joint feel unstable and could cause the knee to give way when a person put weight on it. Quadriceps, hamstrings, and hip muscles are significantly impaired in subjects with knee OA compared with age-matched controls. Mobilization and exercises are considered the most effective, non-drug treatment for reducing pain and improving movement in patients with osteoarthritis.

This study aims to find out which treatment technique will be effective in managing pain and disability, improving ROM and functional performance among patients with chronic Osteoarthritis of Knee.

The patients will be selected for the study based on the Inclusion and Exclusion criteria. Both male and female patients diagnosed with chronic osteoarthritis of knee will be involved in the study. Informed consent will be obtained from the patients who meet the criteria after a detailed orientation by the primary researcher.

This study is a double blinded randomized controlled trial. The participants in the Group A will receive Mulligans Mobilization with Movement, Exercise program includes active range-of-motion (AROM) exercises and strengthening exercises for the knee, hip and ankle, and functional exercises that mimic activities of daily living will be given. Hot packs for 20 minutes will be provided as standard care. The time spent for each session would be 60 minutes. One (01) session per day and 3 sessions per week for 4 consecutive weeks will be provided. The participants in the Group B will receive Biopsychosocial pain education, same Exercises mentioned in Group A and Hot packs. Duration - 60 min per session, One (01) session per day and 3 sessions per week for 4 consecutive weeks will be provided. The participants in the Group C will receive Exercises mentioned as in Group A and Hot packs. One (01) session per day and 3 sessions per week for 4 consecutive weeks will be provided.

Both primary and secondary outcome measures will be taken before the first day of the intervention and immediately after the 4 weeks of intervention and after 1 month follow up period.