Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Efficacy of Mulligan's Mobilization with Movement on Pain, Disability, and Range of Motion in Patients with Knee Osteoarthritis: A Randomized Controlled Pilot Study


Affiliations
1 Cairo University, Egypt
     

   Subscribe/Renew Journal


Objective: To investigate the effect adding mobilization with movement (MWM) technique to the traditional physical therapy program of knee osteoarthritis. Design: Randomized controlled pilot study. Setting: Outpatient clinic Faculty of physical therapy, Cairo University. Subjects: Thirty patients with knee OA, participated in the study with ages ranged from 30-60 years. Intervention: They were randomly assigned into two groups. Group (A) consisted of fifteen patients who received a traditional physiotherapy program, Group (B) consisted of fifteen patients who received traditional physical therapy program +MWM. Treatment for both groups was three times a week for four weeks. Main measures: The assessment was conducted at the beginning of first session and at the end of last session. Pain intensity was measured by the visual analogue scale. WOMAC was used to assess patient. ROM of knee joint was assessed using The Guymon electrogoniometer. Results: For pain intensity and knee range of motion, there were significant differences between groups in favor of the group B with p< 0.05. For disability, there was no significant difference between groups. Conclusions: MWM should be added to the traditional program for knee osteoarthritis.

Keywords

Mobilization with movement, Exercises, Osteoarthritis
Subscription Login to verify subscription
User
Notifications
Font Size


  • Osiri M., Welch V. “Transcutaneous electrical nerve stimulation for knee osteoarthritis”. Arch Phys Med Rehab 2002; 86: 1221-1226.
  • Doherty M, Mazieres B, Le BM EULAR recommendations for the treatment of osteoarthritis of the knee in general practice. Bristol-Myers Squibb and Laboratoires UPSA. 2003.130.1-7.
  • Wilkie R, Peat G, Thomas E et al. Factors associated with restricted mobility outside the home in community-dwelling adults aged 50 years and older with knee pain: an example of use of an international classification of functioning to investigate participation restriction. Arthritis Care & Research 2007;57: 1381–1389.
  • 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; 12:98–108.
  • Backstrom K. Mobilization with movement as an adjunct intervention in a patient with complicated De Quervain’s tenosynovitis: a case report. Journal of Orthopaedic and Sports Physical Therapy 2002; 32:86–97.
  • Kochar M, Dogra A. Effectiveness of a specific physiotherpay regimen on patients with tennis elbow. Physiotherapy 2002; 88:333–341.
  • Scaringe J, Kawaoka C, Studt T. Improved shoulder function after using spinal mobilisation with arm movement in a 50 year old golfer with shoulder, arm and neck pain. Topics in Clinical Chiropractic 2002; 9:44–53.
  • Exelby L. The locked lumbar facet joint: intervention using mobilizations with movement. Manual Therapy 2001;
  • (2):116–121.
  • Folk B. Traumatic thumb injury management using mobilization with movement. Manual Therapy 2001; 6(3):178–182.
  • Miller J. Case study: Mulligan concept management of ‘‘tennis elbow’’. Orthopaedic Division Review 2000; 3:45–47.
  • O’Brien T, Vicenzino B. A study of the effects of Mulligan’s mobilization with movement treatment of lateral ankle pain using a case study design. Manual Therapy 1998; 3(2):78–84.
  • Vicenzino B, Wright A. Effects of a novel manipulative physiotherapy technique on tennis elbow: a single case study. Manual Therapy 1995; 1(1):30–35.
  • Mulligan B. Manual Therapy. 6th ed. Wellington. NZ: Plane View Services Ltd., 2006.
  • Wilson E. The Mulligan concept: NAGS, SNAGS and mobilizations with movement. J Bodywork Movement Ther 2001; 5:81– 89.
  • Englund M.The role of bio mechanics in the initiation and progression of O.A of the knee best practice and research. Clinical Rhomatology, 2010; 24:39-46.
  • Price D, McGrath P.,Rafili A.,Buckingham B “The Validity of visual analogue scale as ratio scale for choronic and experiamental pain.1983:17 :45-56.
  • Bellamy N, Buchanan WW, et al. Validation study of WOMAC: A health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15: 1833-1840.
  • Bellamy N, Kean WF, Buchnan WW, et al. Double blind randomized controlled trail Of sodium meclofenamate (Meclomen) and diclofenac sodium (voltaren). post validation reapplication of WOMAC osteoarthritis index. J rhumatol. 1992,19.153-159 .
  • Christian H. Precision and accuracy of an electrogoniometer. J Manipulative Physio ther 1999;22:10-14.
  • Nuhr M, Hoerauf K, Bertalanffy A, et al. Active warming during emergency transport relieves acute low back pain. Spine, 2004; 29: 499-503.
  • Gail D, Nancy E, Robert L, et al. “Effectiveness of manual physical therapy & exercise in OA of the knee. Annals of Int Med 2005; 132:173-181.
  • Williamson L, Wyatt MR, Yein K, et al. Severe knee osteoarthritis: a randomized controlled trial of acupuncture, physiotherapy (supervised exercise) and standard management for patients awaiting knee replacement. Rheumatology 2007;46: 1445–1449.
  • Yip YB, Wit JW, Fung KKY, et al. Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: an experimental study. Patient Education Counseling 2007; 65:113–121.
  • Fransen M, Nairn L, Winstanley J, et al. The Physical Activity for Osteoarthritis Management . A randomised controlled clinical trial evaluating hydrotherapy and Tai Chi classes. Arthritis Care and Research 2007;57:407–414.
  • Mikesky AE, Mazzuca SA, Brandt KD, et al. Effects of strength training on the incidence and progression of knee osteoarthritis. Arthritis Care and Research 2006; 55:690–699.
  • Hay EM, Foster NE, Thomas E, et al. Effectiveness of community physiotherapy and enhanced pharmacy review for knee pain in people aged over 55 presenting to primary care: pragmatic randomised trial. BMJ 2006;333:995.
  • Bennell KL, Himan RS, Metcalf BR, et al. Efficacy of physiotherapy management of knee joint osteoarthritis: a randomised, double blind, placebo controlled trial. Annals of the Rheumatic Diseases 2005;64:906–912.
  • Van Gool CH, Penninx BW, Kempen GI, et al., Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. Arthritis Care and Research 2005;53:24–32.
  • Huang M H, Yang R C, Lee C L, et al. Preliminary results of integrated therapy for patients with knee osteoarthritis. Arthritis Care and Research 2005;53:812–820.
  • Keefe FJ, Blumenthal J, Baucom D, et al. Effects of spouse-assisted coping skills training and exercise training in patients with osteoarthritic knee pain: a randomized controlled study. Pain 2004;110:539–549.
  • Hughes SL, Seymour RB, Campbell R, et al. Impact of the Fit and Strong intervention on older adults with osteoarthritis. The Gerontologist 2004;44:217–228.
  • Bobbert MF, Hollander AP, Huijing PA. Factors in delayed onset muscle sorenesss of man. Medicine and Science in Sports and Exercise 1986;18:75–81.
  • Atamaz F, Kirazli Y, Akkoc Y, et al. A comparison of two different intra-articular hyaluronan drugs and physical therapy in the management of knee osteoarthritis. Rheumatology International 2006;26:873–878.
  • Ozdincler AR, Yeldan I, Kinali P. The effects of closed kinetic chain exercise on pain and functional performance of patients with knee osteoarthritis. The Pain Clinic 2005;1:107–115.
  • Lin SY, Davey RC, Cochrane T. Community rehabilitation for older adults with osteoarthritis of the lower limb: a controlled clinical trial. Clinical Rehabilitation 2004;18:92–101.
  • Messier SP, Loeser RF, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis. Arthritis and Rheumatism 2004;50:1501–1510.
  • Thompson FE, Whitney JD, Bennett K. Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. Journal of Advanced Nursing 2006;57:141–152.
  • Gur H, Cakin N, Akova Bet al. Concentric versus combined concentric-eccentric isokinetic traning: effects on functional capacity and symptoms in patients with osteoarthrosis of the knee. Arch Phys Med Rehabil 2002, 83: 308-316.
  • Wyatt FB, Milam S, Manske RC, et al. The effects of aquatic and traditional exercise programs on persons with knee osteoarthritis. Journal of Strengthening Research 2001;15:337–340.
  • Hopman-Rock M, Westhoff M. The effects of a health educational and exercise program for older adults with osteoarthritis of the hip or knee. Journal of Rheumatology 2000;27:1947–1954.
  • Huang M H, Lin Y S, Yang R C, et al. comparison of various therapeutic exercises on the functional status of patients with knee osteoarthritis. Seminars in Arthritis and Rheumatism 2003;
  • :398–406.
  • Vicenzino B, Paungmali A, Buratowski S, et al. Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia. Manual Therapy 2001; 6:205–212.
  • Paungmali A, O’Leary S, Souvlis T, et al. Naloxone fails to antagonize initial hypoalgesic effect of a manual therapy treatment for lateral epicondylalgia. J Man Manip Ther 2004; 27: 180–185.
  • Abbott JH. Mobilization with movement applied to the elbow affects shoulder range of movement in subjects with lateral epicondylalgia. Man Ther 2001;6:170–177.
  • Horton SJ. Acute locked thoracic spine: treatment with a modified SNAG. Manual Therapy 2002; 7:103–107.
  • Mulligan BR. Manual therapy. 5th ed. New Zealand Plane View Services Ltd, 2003; 51-66.

Abstract Views: 2527

PDF Views: 0




  • Efficacy of Mulligan's Mobilization with Movement on Pain, Disability, and Range of Motion in Patients with Knee Osteoarthritis: A Randomized Controlled Pilot Study

Abstract Views: 2527  |  PDF Views: 0

Authors

Reda Abdel Razek
Cairo University, Egypt
Magdolin M. Shenouda
Cairo University, Egypt

Abstract


Objective: To investigate the effect adding mobilization with movement (MWM) technique to the traditional physical therapy program of knee osteoarthritis. Design: Randomized controlled pilot study. Setting: Outpatient clinic Faculty of physical therapy, Cairo University. Subjects: Thirty patients with knee OA, participated in the study with ages ranged from 30-60 years. Intervention: They were randomly assigned into two groups. Group (A) consisted of fifteen patients who received a traditional physiotherapy program, Group (B) consisted of fifteen patients who received traditional physical therapy program +MWM. Treatment for both groups was three times a week for four weeks. Main measures: The assessment was conducted at the beginning of first session and at the end of last session. Pain intensity was measured by the visual analogue scale. WOMAC was used to assess patient. ROM of knee joint was assessed using The Guymon electrogoniometer. Results: For pain intensity and knee range of motion, there were significant differences between groups in favor of the group B with p< 0.05. For disability, there was no significant difference between groups. Conclusions: MWM should be added to the traditional program for knee osteoarthritis.

Keywords


Mobilization with movement, Exercises, Osteoarthritis

References