Clinical trial NCT02390336: Mobilization With Movement in Patients With Osteoarthritis of the Hip
Official title: The Immediate Effects of Mulligan Mobilization With Movement Technique in Pain, Range of Motion and Physical Function in Patients With Osteoarthritis of the Hip
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Osteoarthritis Hip
Joint Disease
Musculoskeletal Diseases
Pathologic Processes
Keywords: Osteoarthritis of the hip
Pain
Range of Motion
Physical Function
Manual Therapy
Lead sponsor: Escola Superior de Tecnologia da Saúde do Porto
Sponsor class: OTHER
First posted: 2015-03-17
Enrollment: 40
Sex: ALL
Minimum age (years): 50
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The concept of mobilization with movement, also referred to as a Mulligan mobilization, has not been studied in patients with hip osteoarthritis, subsisting questions about the possible effects in this population. The aim of this randomized controlled study is to compare the immediate effects of Mulligan mobilization with movement technique of pain, range of motion and physical function in patients with osteoarthritis of the hip.

Detailed description: Mulligan original theory for the efficacy of a Mobilization With Movement (MWM) is based on the concept associated with a "positional joint failure," which occurs due to injury and may lead to a change in the joint alignment and hence its biomechanical resulting in symptoms such as pain, joint stiffness or weakness. To perform the MWM technique it is required to implement many criteria. During execution is applied an maintained accessory glide in order to correct the positional fault, while a physiological movement or action that usually caused the pain is performed actively or passively. A key component for the MWM is that pain should always be reduced and / or eliminated during application.

All study participants will be submitted to an initial assessment protocol to determine the intensity of pain, the range of motion (ROM) in flexion and internal rotation of the hip and the collection of physical function parameters. After that, the intervention will be performed for each group, and then the re-evaluation will be carried out (final evaluation), pain intensity, ROM and physical function tests..

Eligibility criteria: Inclusion Criteria:

clinical criteria for the diagnosis of osteoarthritis of the hip (sensitivity 86% and specificity 75%) are:

* Medial hip rotation ≥15º, pain during medial rotation of the hip, morning fatigue in hip\> 60 minutes and older than 50 years or
* Medial hip rotation \<15, hip flexion ≤ 115

Exclusion Criteria:

* Previous surgery or hip replacement or knee joint
* Another surgery in the lower extremities performed within 6 months, rheumatoid arthritis
* Uncontrolled hypertension or risk (moderate - high) of cardiac complications during exercise
* Disability unrelated to the hip or knee to prevent the safe participation during exercise, appliance of manual therapy or during march: vision problems affecting mobility, body weight equal to or greater than 155 kg, primary neurogenic disorder or significantly limitation of the lumbar level,advanced osteoporosis with manual therapy or other treatment technique that may interfere with the study
* With inability to understand the instructions and complete the study assessments

Primary outcomes:
measure: Changes in the intensity of hip pain before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
Secondary outcomes:
measure: Changes in the range of motion for the hip flexion before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
measure: Changes in the range of motion for the medial hip rotation before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
measure: Changes in the performing time of the physical function test timed up and go before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
measure: Changes in the repetitions of the physical function test 30 seg sit to stand before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
measure: Changes in the performing time of the physical function test 40 m. self placed walk before and after the treatment
timeFrame: participants will be assessed before and after intervention (interval: 15-20 minutes)
Other outcomes:
Locations:
Study officials:
affiliation: Polytechnic Institute of Porto (Portugal)
name: Natália Campelo, PhD
role: STUDY_DIRECTOR
affiliation: Polytechnic Institute of Porto (Portugal)
name: Francisco Neto, MSc
role: STUDY_DIRECTOR
affiliation: Polytechnic Institute of Porto (Portugal)
name: Carlos Beselga, MSc
role: PRINCIPAL_INVESTIGATOR
affiliation: University of Salamanca (Spain)
name: Francisco A Sendín, PhD
role: STUDY_DIRECTOR
References:
citation: Vicenzino B, Paungmali A, Teys P. Mulligan's mobilization-with-movement, positional faults and pain relief: current concepts from a critical review of literature. Man Ther. 2007 May;12(2):98-108. doi: 10.1016/j.math.2006.07.012. Epub 2006 Sep 7.
citation: Hoeksma HL, Dekker J, Ronday HK, Breedveld FC, Van den Ende CH. Manual therapy in osteoarthritis of the hip: outcome in subgroups of patients. Rheumatology (Oxford). 2005 Apr;44(4):461-4. doi: 10.1093/rheumatology/keh482. Epub 2005 Feb 3.
citation: Botha-Scheepers S, Riyazi N, Kroon HM, Scharloo M, Houwing-Duistermaat JJ, Slagboom E, Rosendaal FR, Breedveld FC, Kloppenburg M. Activity limitations in the lower extremities in patients with osteoarthritis: the modifying effects of illness perceptions and mental health. Osteoarthritis Cartilage. 2006 Nov;14(11):1104-10. doi: 10.1016/j.joca.2006.04.011. Epub 2006 Jun 5.
citation: French HP, Cusack T, Brennan A, Caffrey A, Conroy R, Cuddy V, FitzGerald OM, Fitzpatrick M, Gilsenan C, Kane D, O'Connell PG, White B, McCarthy GM. Exercise and manual physiotherapy arthritis research trial (EMPART) for osteoarthritis of the hip: a multicenter randomized controlled trial. Arch Phys Med Rehabil. 2013 Feb;94(2):302-14. doi: 10.1016/j.apmr.2012.09.030. Epub 2012 Oct 16.
citation: Hando BR, Gill NW, Walker MJ, Garber M. Short- and long-term clinical outcomes following a standardized protocol of orthopedic manual physical therapy and exercise in individuals with osteoarthritis of the hip: a case series. J Man Manip Ther. 2012 Nov;20(4):192-200. doi: 10.1179/2042618612Y.0000000013.
citation: Beselga C, Neto F, Alburquerque-Sendin F, Hall T, Oliveira-Campelo N. Immediate effects of hip mobilization with movement in patients with hip osteoarthritis: A randomised controlled trial. Man Ther. 2016 Apr;22:80-5. doi: 10.1016/j.math.2015.10.007. Epub 2015 Oct 31.