Effectiveness of Muscle Energy Techniques and Mulligan Mobilization Along With Conventional Physical Therapy in Knee Joint Osteoarthritis Patients

Not Applicable

Recruiting

• Conditions: Knee Osteoarthritis

• Registration Number: NCT06954363
• Lead Sponsor: Khyber Medical University Peshawar

Brief Summary

This study aims to evaluate the effectiveness of integrating Muscle Energy Technique (MET) and Mulligan Mobilization with conventional physical therapy in the management of knee osteoarthritis (OA), with a specific focus on improving hamstring flexibility and reducing functional limitations. The findings will help inform clinical decision-making and enhance patient outcomes in OA rehabilitation.

Detailed Description

Osteoarthritis (OA) is a progressive degenerative joint disease characterized by the destruction of articular cartilage and the formation of bone spurs, leading to pain, joint stiffness, and decreased functional mobility. While its exact cause remains unknown, factors such as age, sex, obesity, sedentary lifestyle, genetics, bone density, smoking, and joint location contribute significantly to its development. As patients experience pain and reduced joint mobility, they often limit movement, particularly of the knee, resulting in muscular tightness-most notably in the hamstring, a two-joint muscle.

Globally, OA is a major public health concern, with knee OA affecting approximately 250 million people in 2010, including 18% of women and 9.6% of men over 60. It has substantial economic impacts, such as costing the United States 1-2.5% of its GDP and Spain €4.7 billion in 2007. Regional data from South Asia show higher prevalence in rural populations, emphasizing the disease's widespread burden.

Physical therapy has been shown to be highly effective in managing knee OA symptoms. Several randomized controlled trials support the use of techniques like Muscle Energy Technique (MET) and Mulligan Mobilization. MET has demonstrated superior efficacy compared to static stretching and whole-body vibration in improving hamstring flexibility and reducing stiffness. Similarly, Mulligan Mobilization, particularly when combined with supervised exercises, has shown better outcomes than Maitland mobilization in improving flexibility and function in OA patients.

However, current literature presents conflicting evidence regarding the individual efficacy of MET and Mulligan Mobilization. This study seeks to address these inconsistencies by investigating the effectiveness of integrating both MET and Mulligan Mobilization with conventional physical therapy in treating knee OA. The goal is to provide evidence-based insights that can guide clinicians in optimizing therapeutic strategies for better functional outcomes and enhanced quality of life for patients with knee osteoarthritis.

Study Timeline

• Status Verified: 2025-04
• Study Start: 2025-04-01
• Study First Submitted: 2025-04-24
• Study First Submitted QC: 2025-04-24
• Last Update Submitted: 2025-04-24
• Study First Posted: 2025-05-01
• Last Update Posted: 2025-05-01
• Primary Completion: 2025-10
• Study Completion: 2025-11

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 24

Inclusion Criteria

• Diagnosed cases of osteoarthritis (Grade 1 to 3)
• X-ray showing Grades I to III on Kellgren Lawrence scale of Osteoarthritis.
• Residents of Peshawar verified via NADRA CNIC
• Both genders will be included with unilateral or bilateral knee involvement.
• Age group 40 and above.
• Duration of Knee pain for more than 3 months.

Exclusion Criteria

• History of any previously known neurological conditions i.e. stroke, peripheral neuropathy
• Fractures in treatment limb.
• Suspicious of malignancy around the knee joint.
• Recent under gone surgery
• Recent Intra-articular injection.
• Significant comorbid diseases and disabilities are excluded from the study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Primary Outcome Measures

Name	Time	Method
Hamstring Flexibility Measured by Goniometer	Baseline (Day 1) and Post-treatment (End of Week 3)	Hamstring range of motion (ROM) will be assessed using a goniometer before and after the intervention. The change in ROM will be used to evaluate effectiveness. Outcome improvement categories: Mild Increase: 5-10 degrees; Moderate Increase: 10-15 degrees; Marked Increase: \>15 degrees
Change in Pain Score Using Knee Osteoarthritis Outcome Score-12 questionnaire Questionnaire	Baseline (Day 1) and Post-treatment (End of Week 3)	The function in daily activities subscale of Knee Osteoarthritis Outcome Score-12 questionnaire will assess participants' ability to perform routine activities before and after the intervention.
Change in Knee-Related Quality of Life Using Knee Osteoarthritis Outcome Score-12 questionnaire	Baseline (Day 1) and Post-treatment (End of Week 3)	The quality of life (QOL) subscale of KOOS-12 will evaluate the impact of osteoarthritis on participants' knee-related wellbeing pre- and post-treatment.
Change in Activity of Daily Living Function Using KOOS-12	Baseline (Day 1) and Post-treatment (End of Week 3)	The function in daily activities subscale of KOOS-12 will assess participants' ability to perform routine activities before and after the intervention.

Trial Locations

Locations (3)

Hayatabad Medical Complex Peshawar; 🇵🇰 Peshawar, KPK, Pakistan

Alkhidmat Hospital Peshawar; 🇵🇰 Peshawar, KPK, Pakistan

Bibi Zahida Memorial Hospital, NCS University System; 🇵🇰 Peshawar, KPK, Pakistan