Clinical trial NCT06751095: Effects Of Maitland's Mobilization At Mid Versus End Range In Knee Osteoarthritis Patients
Official title: Effects Of Maitland's Mobilization At Mid Versus End Range On Pain, Range Of Motion And Functional Disability In Patients With Knee Osteoarthritis.
Study type: INTERVENTIONAL
Overall status: NOT_YET_RECRUITING
Phase: NA
Conditions: Knee Osteoarthritis
Keywords: joint range of motion
knee osteoarthritis
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-12-27
Enrollment: 44
Sex: ALL
Minimum age (years): 40
Maximum age (years): 60
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Knee Osteoarthritis (OA) is the most common form of arthritis affecting mostly elderly people contributing to major cause of disability worldwide.In knee osteoarthritis Maitland's manual therapy technique could be the most effective technique among all in decreasing pain sensitivity and increasing range of motion in knee OA.The aim of this study to compare effects of Maitland's mobilization at mid range versus end range on pain. range of motion and functional disability in patients with knee OA, providing useful insights for healthcare professionals to optimize treatment strategies and enhance outcomes in this context.

Detailed description: Knee Osteoarthritis (OA) is the most common form of arthritis affecting mostly elderly people contributing to major cause of disability worldwide.In knee osteoarthritis Maitland's manual therapy technique could be the most effective technique among all in decreasing pain sensitivity and increasing range of motion in knee OA.The aim of this study to compare effects of Maitland's mobilization at mid range versus end range on pain. range of motion and functional disability in patients with knee OA, providing useful insights for healthcare professionals to optimize treatment strategies and enhance outcomes in this context.

This Randomized Clinical Trial will be conducted at DHQ Gujrat through consecutive sampling technique on 44 patients which will be allocated using simple random sampling through sealed opaque enveloped into (Group A and Group B).Maitland's mobilization at end range(Group A) incorporates the end range Maitland's mobilization,strengthening exercises, knee isometrics, transcutaneous electrical stimulation(TENS) and heating pad .

Maitland's mobilization in Mid range (Group B) will be treated with Mid range Maitland's mobilization, TENS,strengthening exercises,knee isometrics and heating pad.Outcomes, encompassing pain levels, range of motion(ROM), and functional disability will be evaluated through Visual analogue scale (VAS),Goniometer and WOMAC scale.The treatment plan spans 4 weeks, comprising 3 sessions per week. Data will be analyzed during SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups. Data will be collected at baseline and after 4 weeks of follow up.

Eligibility criteria: Inclusion Criteria:

* Participants with age between 40 to 60 years.
* Participants of both genders will be included.
* Patient with unilateral/bilateral symptomatic tibiofemoral knee OA.
* Patient suffering from stiffness less than 30 minutes
* Patients with radiologically diagnosed case of grade 2 knee OA according to the Kellgren and Lawrence scale
* Patients with reported peak knee pain of \>3 on visual analogue scale (VAS)

Exclusion Criteria:

* Participants with acute inflammation of knee
* Participants with severe degenerative lumbar spine disease e.g spondylolisthesis
* Participants with systemic inflammatory arthritic or neurological conditions
* Participants with intraarticular injection in the prior 3 months
* Participants with unstable heart condition
* Participants with received physical therapy of knee in last 3 months

Primary outcomes:
measure: Numeric Pain Rating Scale
timeFrame: 4 Weeks
Secondary outcomes:
measure: WOMAC Osteoarthritis INDEX
timeFrame: 4 weeks
measure: Universal Goniometer
timeFrame: 4 weeks
Other outcomes:
Locations:
Study officials:
affiliation: Riphah International University
name: Zainab Amjad Dr., DPT
role: PRINCIPAL_INVESTIGATOR
References:
citation: Suzuki Y, Iijima H, Tashiro Y, Kajiwara Y, Zeidan H, Shimoura K, Nishida Y, Bito T, Nakai K, Tatsumi M, Yoshimi S, Tsuboyama T, Aoyama T. Home exercise therapy to improve muscle strength and joint flexibility effectively treats pre-radiographic knee OA in community-dwelling elderly: a randomized controlled trial. Clin Rheumatol. 2019 Jan;38(1):133-141. doi: 10.1007/s10067-018-4263-3. Epub 2018 Aug 30.
citation: Steultjens MP, Dekker J, van Baar ME, Oostendorp RA, Bijlsma JW. Range of joint motion and disability in patients with osteoarthritis of the knee or hip. Rheumatology (Oxford). 2000 Sep;39(9):955-61. doi: 10.1093/rheumatology/39.9.955.
citation: Pozsgai M, Udvaracz K, Peter IA, Than P, Nusser N. Effect of single end-range and not end-range Maitland mobilization on pressure pain threshold and functional measures in knee osteoarthritis: randomised, controlled clinical trial. Eur J Phys Rehabil Med. 2022 Oct;58(5):774-783. doi: 10.23736/S1973-9087.22.07506-2. Epub 2022 Sep 12.