MedPath

Effect of Combined Interventions on Pressure Pain Threshold

Not Applicable
Completed
Conditions
Osteo Arthritis Knee
Interventions
Procedure: Non end-range mobilization
Procedure: end-range mobilization
Procedure: Control
Registration Number
NCT04312035
Lead Sponsor
University of Pecs
Brief Summary

The effect of mobilizations on decrease of peripheral and central sensitivity has been proven in KOA. Furthermore, the effect of conservative therapy has also been proven in the increase of pain threshold in KOA. However, no study has investigated the effect of these interventions combined till date in KOA.

The aim of the present study is to investigate the short-term and long-term effect of end-range mobilization in addition to conservative therapy on decrease of pressure pain threshold in KOA.

Detailed Description

The positive effect of different manual mobilizations have been proven in the management of knee osteoarthritis (KOA). Pressure pain threshold, as a measure of somatosensory function, is a well-applied measurement technique for the pain perception in KOA. The effect of mobilizations on decrease of peripheral and central sensitivity has been proven in KOA. Furthermore, few studies has revealed the effect of conservative therapy as an effective intervention in the increase of pain threshold. However, no study has investigated the effect of these interventions combined till date in KOA, which could give a long-lasting effect in the decrease of sensitization in KOA.

Therefore, the aim of the present study is to investigate the short-term and long-term effect of end-range mobilization in addition to conservative therapy on decrease of pressure pain threshold in KOA.

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
60
Inclusion Criteria
  • clinical classification criteria of knee osteoarthritis according to the American College of Rheumatology
  • categorization as End of Range Problem based on Maitland manual therapy
  • unilateral/bilateral moderate-to-severe symptomatic tibiofemoral KOA with radiographic evidence of Kellgren-Lawrence scale 2 or 3
  • pain during weight-bearing activities at least within 6 months
  • at least 90° knee flexion
  • sufficient mental status
Exclusion Criteria
  • acute inflammation of the knee
  • total knee replacement in the opposite side
  • class II. obesity (body mass index>35kg/m2)
  • severe degenerative lumbar spine disease (e.g. spondylolisthesis)
  • systemic inflammatory arthritic or neurological condition
  • physiotherapy/balneotherapy attendance or manual therapy within 3 months
  • intraarticular injections in the prior 12 months
  • use of walking aid
  • contraindication for manual therapy
  • complex regional pain syndrome
  • cognitive impairment

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Non end-range mobilizationNon end-range mobilizationNon end-range mobilization performed in loose-packed position of the knee joint
End-range mobilizationend-range mobilizationEnd-range mobilization performed in end-position of the knee joint
ControlControlSham technique performed in loose-packed position of the knee joint
Primary Outcome Measures
NameTimeMethod
change of peripheral sensitivityfollowing 3-month

peripheral sensitivity (pressure pain threshold) assessed at the local knee

Secondary Outcome Measures
NameTimeMethod
change of central sensitivityfollowing 3-month

central sensitivity (pressure pain threshold) assessed at the ipsilateral m. extensor carpi radialis longus

change of Timed Up and Go testfollowing 3-month

short test for measuring physical performance

change of pain intensity during physical performancefollowing 3-week rehabilitation

pain intensity measured during the previously mentioned physical performance test using the 0-10 Numerating Pain Rating Scale, where 0 indicate no pain and 10 indicate worst imaginable pain

change of pain during physical performancefollowing 3-month

pain intensity measured during the previously mentioned physical performance test using the 0-10 Numerating Pain Rating Scale, where 0 indicate no pain and 10 indicate worst imaginable pain

degree of knee flexion during passive movement at the onset of knee painfollowing 3-month

measurement of degree of knee flexion during passive movement at the onset of knee pain

change of general pain intensityfollowing 3-month

general pain intensity from the previous week using the Visual Analogue Scale

strength of resistance of passive knee flexion at the onset of knee painfollowing 3-month

measurement of strength of resistance arising from the anterior located tissues around the knee during passive knee flexion at the onset of pain

Trial Locations

Locations (1)

Miklós Pozsgai

🇭🇺

Harkány, Please Select, Hungary

© Copyright 2025. All Rights Reserved by MedPath