Alkhawajah H.1, Alshami A.2
1University of Dammam / King Fahd Hospital of the University, Physical Therapy, Khobar, Saudi Arabia, 2University of Dammam, Physical Therapy, Dammam, Saudi Arabia
Background: Pain and functional limitation are the most common symptoms associated with knee osteoarthritis (OA). Manual therapy is often used to reduce pain and improve function. However, there is little evidence confirming its efficacy on knee OA.
Purpose: To investigate the effect of mobilization with movement (MWM) on pain and function among patients with knee OA.
Methods: This study was a randomized double-blind experimental design. Adult patients with knee OA of grade II and above were recruited from King Fahd Hospital of the University in Khobar, Saudi Arabia to receive either MWM treatment or sham MWM. Each patient in the treatment group was assessed to receive individually patient-specific pain-free directional MWM glide, either on weight-bearing or non-weight-bearing position. The outcome measures included: Visual analog scale (VAS), Western Ontario and McMaster Universities (WOMAC) index, pressure pain threshold (PPT), thermal perception and pain thresholds, standard goniometer, hand-held dynamometer, and 3-meter timed up and go. The measurements were taken at baseline, immediately after intervention, and 2 days later for carry-over effect.
Results: Thirty-eight (age 57 ± 8 years, 24 males, 14 females, chronicity 60 ± 40 months). The MWM resulted in significant improvements immediately post-intervention and after 2 days in VAS (p ≤ 0.013), PPT at knee (p 0.001), PPT at shoulder (p ≤ 0.035), knee flexion range of motion (ROM) (p ≤ 0.005), knee flexion muscle strength (p 0.001), knee extension muscle strength (p 0.001), and 3-meter timed up and go (p 0.001). WOMAC scores, thermal perception and cold thresholds at both knee and shoulder, and knee extension ROM did not change at any stage after MWM.
Conclusion(s): MWM treatment provided both local and widespread hypoalgesic effects, increased knee flexion ROM, increased knee flexion and extension muscle strength, and improve physical function (walking) which lasted at least 2 days.
Implications: This study introduces a safe, non-invasive, and cost-effective treatment method that may reduce pain, improve functional activities, and improve quality of life.
Funding acknowledgements: Not funded. Acknowledgement goes to University of Dammam for making their facilities available throughout this study.
Topic: Musculoskeletal: lower limb
Ethics approval: This study was approved by Institutional Review Board (IRB) at the University of Dammam (IRB Number: IRB-2014-04-323), Saudi Arabia.
All authors, affiliations and abstracts have been published as submitted.
