Mulligan Manual Therapy and Trunk Stabilization Exercises Versus Isometric Knee Strengthening on Knee Osteoarthritis
Condition: Osteoarthritis, Knee
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

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.
    

Intervention name(s): Mulligan Joint mobilization; Trunk stabilization group; Knee strengthening group
Intervention type(s): Other; Other; Other
Intervention description(s): This study ARM will received Mulligan joint mobilization and concomitant therapies in this group.
The following are the brief detail of therapy
Mulligan joint mobilization in Non-weight bearing (NWB) to weight-bearing (WB) 6 -10 Reps and 3 sets/ session.
Procedural detail:
Joint mobilization will be performed in sagittal, frontal and transverse direction, following glide will be preferred will depend on patient adherence to the joint mobilization. Mobilization will be progress from NWB to WB according to patient compliance 27
Knee strengthening Type of exercise: Knee Isometric Strengthening exercises. Intensity: 10 reps Frequency: At 1st week one set of all knee exercise will be performed then it will be progressed to 2 sets at 3 weeks, and these exercises will be progressed to three sets until the 6 weeks
Kinesiotaping:; This study ARM will received Trunk stabilization exercises and concomitant therapies in this group.
The following are the brief detail of therapy:
Trunk stabilization Area: Trunk Type of exercise: Stabilization exercise Intensity: 6-8 reps Frequency: 3 sets per session and 30 second duration break between sets
Procedural detail:
i. modified supermen extension exercise ii. Back bridge: iii. Unilateral back bridge:
Iv. lateral step up:
Knee strengthening Area: Knee Joint Type of exercise: Knee Isometric Strengthening exercises. Intensity: 10 reps Frequency: At 1st week one set of all knee exercise will be performed then it will be progressed to 2 sets at 3 weeks, and these exercises will be progressed to three sets until the 6 weeks
Procedural detail:
i. Isometric quadriceps exercise: ii. Straight leg raising (SLR) exercise:
Kinesiotaping:; This study ARM will received Knee strengthening exercises and concomitant therapies in this group.
The following are the brief detail of therapy:
Knee strengthening Area: Knee Joint Type of exercise: Knee Isometric Strengthening exercises. Intensity: 10 reps Frequency: At 1st week one set of all knee exercise will be performed then it will be progressed to 2 sets at 3 weeks, and these exercises will be progressed to three sets until the 6 weeks
Procedural detail:
i. Isometric quadriceps exercise ii. Straight leg raising (SLR) exercise:
Kinesio-taping:
Muscle stretch method will be applied which involves one Y and two I straps: The Y-shaped tape base will be affixed over the top of patella then pulls up his/her knee to its maximum bending capacity then both end of Y strip is placed around the patella ending on the tibial tuberosity. Then reinforcing I-tape will be affixed at the origin and insertion of MCL and LCL. Tape will be change in every session.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: manual therapy; kinesiotape; Excercise therapies; isometric contraction; muscle strength