Comparison of Intermittent Compression-decompression With Glides for Knee Osteoarthritis
Condition: Knee Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional

Summary: 
      the aim of this study is to compare the effects of intermittent compression decompression
      with glides with conventional physical therapy in patients having knee osteoarthritis. there
      are three groups in which patient will be allocated randomly. group A will receive treatment
      technique intermittent compression decompression with glides only while group B will be
      treated with conventional physical therapy protocol whereas group c patients will receive
      combination of intermittent compression decompression with glides along with conventional
      physical therapy protocol. Pre and post treatment data will be collected by using
      questionnaires WOMAC and KOOS. treatment will be given 3 times a week for 4 weeks.
    

Detailed description: 
      Most prevalent musculoskeletal age-related disorder worldwide is Osteoarthritis whose
      prevalence is supposed to rise in elderly population as it ages. knee pain is common issue
      contributing to OA in older population increasing with the increase of risk factor obesity
      and as population ages. People with Knee OA experience reduced movement, frequent chronic
      pain along with strength and balance compromising and face limitations in daily activities.
      Radio graphs of patients with knee OA show changes in lateral and medical tibiofemoral joints
      along with patellofemoral joint. Currently, 40% people aged above 75 years are affected with
      knee OA. In US, 28% adults older than 45 years of age and 37% older than 65 years of age are
      affected with knee OA. Knee osteoarthritis is a major age-related health problem and is
      leading cause of pain and disability in people.

      Radiographic evidence of osteoarthritis is present in the majority of people over age 65; 80%
      of those over 75, Approximately 11% of those over 65 have symptomatic osteoarthritis of the
      knee Current guidelines recommend nonpharmacologic methods, such as physical therapy, as
      first-line options in the management of OA. Currently there is no medically effective
      treatment available. NSAIDS and acetaminophens are widely used to treat this but sometimes
      they fail to relieve symptoms leading to more adverse effects. Physical therapy is considered
      as an essential element in alleviating pain and improving physical functioning, but the data
      is limited. Exercise has showed improvement is walking speed, strength, functions
      self-efficacy along with pain alleviation during activities and enables to reduce limitation
      of daily. It is an urgent need to identify new effective treatment and techniques for
      patients with Knee OA as it is urgent health and clinical priority. Physiotherapy
      interventions commonly prescribed for the knee OA management includes electrotherapy along
      with knee isometric exercises but these are not as effective as in OA cartilage damages to as
      extent along with limited blood flow and reduced metabolic activity. These interventions are
      not enough to promote healing response of cartilage. Is supposed to promote osteoblastic
      activity, thus improving symptoms along with delaying the degeneration process Intermittent
      compression and decompression with glides has significant results in improving symptoms
      associated with knee OA along with betterment of quality of life. This technique is believed
      to delay and prevent surgical interventions as well as is cost effective treatment for
      patients suffering from knee OA.

      Mobilization of knee joint includes the mobilization of tibiofemoral joint. This includes
      anterior and posterior glides with compression and decompression. Mobilization is a passive
      procedure performed to improve pain, increase range of motion and increase functional
      capability of patient, because optimal stimulus for the regeneration of the joint cartilage
      is intermittent compression and decompression with gliding. Manual physical therapy has also
      been reported to inhibit and modulate pain, induce a controlled inflammatory response that
      initiates healing and influences processing of pain, and alter acute inflammation in response
      to exercise. These could all contribute to decreased pain from muscle contract ion, improving
      tolerance for exercise. Joint mobilizations also modulate proprioceptive input to joint
      structures, prime the joint and surrounding muscles for optimal response to strengthening
      programs, improve muscle control and reaction times. Intermittent compression and
      decompression along with gliding of articular cartilage during moderate exercise activities
      allows synovial fluid to nourish the joint and remove waste products. This movement can also
      lead to thickening and increased resilience in the cartilage. Exercise also leads to
      increased muscle and ligamentous strength that provides stability to the joint.

      Damaged articular cartilage has less healing capacity due to its low metabolic activity and
      limited blood circulation which permit limited response to injury. This cartilage lesion is
      sometime very progressive. Therefore, its early intervention is aimed to limit this
      progressive lesion to articular cartilage which is may be critical for decreasing the
      disability and chronic pain associated with osteoarthritis .Compressive forces applied on the
      knee joint pushes the fluid out of cartilage and during decompression it is reabsorbed, this
      phenomenon helps in the regeneration of cartilage by means of supplying nutrients and oxygen.
      Physical therapy interventions included are electrotherapy along with knee isometric
      exercises for management of osteoarthritis. But these interventions are not so effective and
      do not help in regeneration of the cartilage. Intermittent compression and decompression with
      glide helps to activate osteoblastic activity and improve the symptoms of osteoarthritis thus
      delaying the process of degeneration. The study is concerned with finding the effects of
      intermittent compression and decompression with glides for the knee osteoarthritis .Treatment
      technique in this research will substantially help to improve all the important outcomes as
      per literature evident .i.e. pain, disability, range of motion in patients with knee
      osteoarthritis. It will add innovative intervention to existing literature which will be
      helpful in improving quality of life in patients with knee OA.
    

Intervention name(s): intermittent compression-decompression with glides; Conventional Physical Therapy; conventional physical therapy and intermittent compression-decompression with glides
Intervention type(s): Other; Other; Other
Intervention description(s): Patients in this group will be given only intermittent compression and decompression with glides. Traction (decompression applied at knee joint with anteroposterior glide followed by compression for about 6 minutes (30 glides, 10 seconds compression and vice versa), for the duration of 4 weeks (3 days a week, alternate days); In this group conventional therapy will be given according to below mentioned protocol for 4 weeks (3 days a week, alternate days).
Hot pack /TENS for 10 minutes
Stretching: Hamstring(10x) and calf (10x)
Strengthening of periarticular muscles especially the quadriceps (straight leg raising, pillow squeeze-isometric and dynamic); Patients in this group will receive the combination of conventional physical therapy and intermittent compression and decompression with glides, for 4 weeks (3 days a week, alternate days).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment