Effectiveness of Tibio-Femoral Manual Traction and Tibial Rotation in Patients with Knee Osteoarthritis For Improving Pain and Functional Abilities: A Comparison of Two Mobilization Techniques
Tibio-Femoral Manual Traction And Tibial Rotation in Knee Osteoarthritis
DOI:
https://doi.org/10.54393/pbmj.v5i1.194Keywords:
knee osteoarthritis, tibio-femoral manual traction, tibial rotation, functional abilities, PianAbstract
Knee osteoarthritis is becoming an increasingly evident cause of pain and functional disabilities throughout the world especially in women. It is a degenerative disease leading to changes in kinetic chain of lower limb. The role of manual therapy to treat this condition is under least discussion; especially the practice of Mulligan’s concept of manual therapy in improvement of this condition is almost negligible in Pakistan.
Objective: To compare the effectiveness of two different mobilization techniques: - tibia-femoral manual traction and tibial rotation in patients with knee osteoarthritis for improving pain and functional abilities
Methodology: This quasi experimental study with duration of 3 months was conducted after approval from the concerned institutes of study. A sample size of 42 was calculated using G power software for experimental sample size estimation. Participants with grade II-III osteoarthritis, medial side knee osteoarthritis, at least one symptomatic knee, and stiffness in knee were included, whereas participants with recent knee injury, knee strain, congenital knee deformity and ay previous knee surgery were excluded from the study. The data was collected after taking informed consent from the participant. Participants of study were divided into two groups, 21 group A osteoarthritis patients received mobilization with tibio-femoral manual traction intervention, while 21 group B patients received mobilization with tibial rotation.Two outcome measurement tools were used. Data regarding pain was gathered through McGill pain questionnaire, whereas data related to functional abilities was collected using WOMAC osteoarthritis index
Results: Mean improvement in pain of Group A is 12.10 7.25 and Group B is 11.71 6.82 with P-value=0.862. Whereas improvement in functional abilities in group A is 10.62 7.97 and Group B is 35.68 10.68 with P-value= <0.001
Conclusion: Mobilization with tibio-femoral manual traction and tibial rotation were equally effective in improving pain. Whereas both techniques were effective in improving functional abilities but mobilization with tibial rotation is more effective as compared to mobilization with tibio-femoral manual traction
References
Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, et al. Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000;133(8):635-46.
https://doi.org/10.7326/0003-4819-133-8-200010170-00016
Buckwalter J, Mankin H. Articular cartilage: degeneration and osteoarthritis, repair, regeneration, and transplantation. Instr Course Lect. 1997;47:487-504.
Felson DT. Epidemiology of hip and knee osteoarthritis. Epidemiol Rev. 1987;10:1-28.
https://doi.org/10.1093/oxfordjournals.epirev.a036019
Arendt-Nielsen L, Nie H, Laursen MB, Laursen BS, Madeleine P, Simonsen OH, et al. Sensitization in patients with painful knee osteoarthritis. Pain. 2010;149(3):573-81.
https://doi.org/10.1016/j.pain.2010.04.003
O'Reilly SC, Jones A, Muir KR, Doherty M. Quadriceps weakness in knee osteoarthritis: the effect on pain and disability. Ann Rheum Dis. 1998;57(10):588-94.
https://doi.org/10.1136/ard.57.10.588
Rakel B, Vance C, Zimmerman MB, Petsas-Blodgett N, Amendola A, Sluka KA. Mechanical hyperalgesia and reduced quality of life occur in people with mild knee osteoarthritis pain. The Clinical journal of pain. 2015;31(4):315-22.
https://doi.org/10.1097/AJP.0000000000000116
Mündermann A, Dyrby CO, Andriacchi TP. Secondary gait changes in patients with medial compartment knee osteoarthritis: increased load at the ankle, knee, and hip during walking. Arthritis & Rheumatology. 2005;52(9):2835-44.
https://doi.org/10.1002/art.21262
Jordan J, Luta G, Renner J, Dragomir A, Hochberg M, Fryer J. Knee pain and knee osteoarthritis severity in self-reported task specific disability: the Johnston County Osteoarthritis Project. The Journal of rheumatology. 1997;24(7):1344-9.
Sharma L, Song J, Felson DT, Shamiyeh E, Dunlop DD. The role of knee alignment in disease progression and functional decline in knee osteoarthritis. JAMA. 2001;286(2):188-95.
https://doi.org/10.1001/jama.286.2.188
Ettinger WH, Afable RF. Physical disability from knee osteoarthritis: the role of exercise as an intervention. Med Sci Sports Exerc. 1994.
https://doi.org/10.1249/00005768-199412000-00004
Shenouda MMS. Efficacy of Extracorporeal Shock Wave Therapy Versus Mobilization with Movement on Pain, Disability and Range of Motion In Patients With knee Osteoarthritis. Bulletin of Faculty of Physical Therapy. 2013;18(1).
Takasaki H, Hall T, Jull G. Immediate and short-term effects of Mulligan's mobilization with movement on knee pain and disability associated with knee osteoarthritis-A prospective case series. Physiotherapy theory and practice. 2013;29(2):87-95.
https://doi.org/10.3109/09593985.2012.702854
Gupta RK, Heggannavar A. QUANTITATIVE EFFECTS OF PROPRIOCEPTIVE EXERCISES AND MULLIGAN'S MWM IN SUBJECTS WITH OSTEOARTHRITIS KNEE-A RANDOMIZED CONTROLLED TRIAL. International Journal of Therapies and Rehabilitation Research. 2015;4(4):191-200.
https://doi.org/10.5455/ijtrr.00000088
Courtney CA, Steffen AD, Fernández-De-Las-Peñas C, Kim J, Chmell SJ. Joint mobilization enhances mechanisms of conditioned pain modulation in individuals with osteoarthritis of the knee. J Orthop Sports Phys Ther. 2016;46(3):168-76.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 Pakistan BioMedical Journal
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments editor@pakistanbmj.com