Mulligan Manual Therapy and Trunk Stabilization Exercises Versus Isometric Knee Strengthening on Knee Osteoarthritis
- Conditions
- Osteoarthritis, Knee
- Interventions
- Other: Mulligan Joint mobilizationOther: Knee strengthening groupOther: Trunk stabilization group
- Registration Number
- NCT04099017
- Lead Sponsor
- Dow University of Health Sciences
- Brief Summary
Knee joint arthritis posses a serious health problem and caring for an individual with knee osteoarthritis (KOA) produces a great burden on society. Knee joint pain is associated with physical activity while performing various activities of daily living (ADL) in patients with early and severe osteoarthritis (OA). In addition to knee pain, physical function or daily activity is strongly influenced by the severity of Osteoarthritis of the knee. Mulligan joint mobilization with movement provides evident effects on decreasing the pain and restoring the joint biomechanics. Trunk stabilization exercise will improve the stability of trunk which distributes the weight of body evenly on both feets. The aim of this study is to determine the effects of mulligan joint mobilization and trunk stabilization exercise on pain, disability and submaximal exercise performance in KOA.
- Detailed Description
A randomized control trial will be conducted at IPM\&R on 60 subjects with knee osteoarthritis and age between 40-60 years. Initial screening of the subjects will be carried out by the referring consultant. Subjects who fulfilled the study criteria will be recruited using computer generated random sampling after explaining the study objective and taken written informed consent. All participants will be evaluated using visual analogue scale, Knee injury and Osteoarthritis Outcome Score and 6-minute walk test for pain severity, functional limitation and submaximal exercise capacity at 1st, 3rd and 6th week. The subjects will be allocated into three groups through computer generated random allocation. Group 1 will receive mulligan mobilization with kinesiotaping and knee strengthening. Group 2 will receive trunk stabilization exercise, knee strengthening and Kinesiotaping. Group 3 will receive knee strengthening along with kinesiotaping. A drop-out rate of 9 will be taken. Recorded data will be entered and analysed using SPSS version 21. Mean and SD will be calculated of quantitative variables like age, pain, knee related function, submaximal exercise capacity and stair climb by using repeated measure ANOVA. For pair wise comparison, post hoc tukey will be applied. Value of equal to or less than 0.05 will be considered significant.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 60
-
- Both gender (female and male) patients
- Age between 40 - 60
- Knee osteoarthritis Grade I & II on Kellgren and Lawrence (K/L) criteria
- Prediagnosed case of knee OA as per the American College of Rheumatology (ACR).
- Known skin allergies
- Sensory-motor dysfunction of lower extremity
- Severe joint deformity of lower extremity
- Post Traumatic Arthritis
- Constitutional Symptoms (Fever, Malaise, Weight Loss and high blood pressure)
- Knee Intraarticular injection in past 3 months
- Acute low back pain
- History of spinal surgery
- Subject using assistive devices for ambulation i.e. cane, walkers, sticks
- Refused to give consent
- Body Mass Index > 30 kg/m2
- Received physiotherapy treatment in the past 3 months
- Visual Analogue Scale <4
- Patellofemoral joint arthritis will be excluded
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Mulligan mobilization group Mulligan Joint mobilization This study ARM will received Mulligan joint mobilization and concomitant therapies in this group. The following are the brief detail of therapy 1. Mulligan joint mobilization in Non-weight bearing (NWB): 2. Knee strengthening 3. Kinesiotaping Knee strengthening group Knee strengthening group This study ARM will received Knee strengthening exercises and concomitant therapies in this group. The following are the brief detail of therapy: 1. Knee strengthening i. Isometric quadriceps exercise ii. Straight leg raising (SLR) exercise: 2. Kinesio-taping: Trunk stabilization group Trunk stabilization group This study ARM will received Trunk stabilization exercises and concomitant therapies in this group. The following are the brief detail of therapy: 1. Trunk stabilization i. modified supermen extension exercise ii. Back bridge: iii. Unilateral back bridge: Iv. lateral step up: 2. Knee strengthening i. Isometric quadriceps exercise: ii. Straight leg raising (SLR) exercise: 3. Kinesiotaping:
- Primary Outcome Measures
Name Time Method Change from baseline Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 weeks baseline and post intervention (week 6 - the analysis will be conducted on the first week immediately after the end of the training The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self reported specific joint measure developed to assess a broad spectrum of patients with knee injuries and OA, for pain and other symptoms, function in daily life, function in sports and recreation, and quality of knee-related life, being easy to use, evaluating the short- and long-term health problems related to the knee joint.
The KOOS contains 42 items covering five subscales: pain, other symptoms, activities of daily living, sport and leisure activities and quality of life. A score of 0 (extreme problems) 100 (smoothly) can be obtained separately for each sub-range.
- Secondary Outcome Measures
Name Time Method Knee injury and Osteoarthritis Outcome Score (KOOS) baseline, 3 weeks and 6 weeks The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self reported specific joint measure developed to assess a broad spectrum of patients with knee injuries and OA, for pain and other symptoms, function in daily life, function in sports and recreation, and quality of knee-related life, being easy to use, evaluating the short- and long-term health problems related to the knee joint.
The KOOS contains 42 items covering five subscales: pain, other symptoms, activities of daily living, sport and leisure activities and quality of life. A score of 0 (extreme problems) 100 (smoothly) can be obtained separately for each sub-range.Stairs Climb Test baseline, 3 weeks and 6 weeks Stair climb test is used to measure the total time taken by the participant to ascend and descend stair onto with a step length of 16-cm (ICC=0.90). If safety is of concern, the assessor should guard behind the participant going up the stairs and to the side coming down the stairs. If there is no concern for safety, the tester should remain at the start/finish position on the ground landing
6 Minute Walk Test baseline, 3 weeks and 6 weeks The 6-min walk test (6 MWT) is a submaximal exercise test that entails measurement of distance walked over a span of 6 minutes. Bright colour tapes will be used to mark the 12m walkway at each end. It will be ensured that the environment will be free from hazards and readings will be recorded by blind assessor. Participant will be instructed to wear comfortable shoes.
Visual Analogue Scale baseline, 3 weeks and 6 weeks It measures the subjective of pain ranges from 10-cm lines with defined cut off scores. The correlation between vertical and horizontal orientations of the VAS is 0.99 . Aggregate score ranges for this screening tool starting with 0-10. Scores between 0-4 means mild pain. Scores between 4-7 indicates moderate pain. Scores between 7-10 means severe pain. pain severity will be assessed at rest and during stairs ascending and descending
Trial Locations
- Locations (1)
Dow University of Health Sciences & Institute of Physical Medicine and Rehabilitation
🇵🇰Karachi, Sindh, Pakistan