Long term efficacy of mobilisation with movement on pain and functional status in patients with knee osteoarthritis: a randomised clinical trial

Abstract

Objectives: To evaluate the long term effect of mobilisation with movement on disability, pain and function in subjects with symptomatic knee osteoarthritis Design: A randomised controlled trial. Setting: A general hospital Subjects: Forty adults with knee osteoarthritis (grade 1–3 Kellgren–Lawrence scale). Interventions: The experimental group received mobilisation with movement and usual care (exercise and moist heat) while the control group received usual care alone in six sessions over two weeks. Main Measures: The primary outcome was the Western Ontario McMaster University Osteoarthritis index, higher scores indicating greater disability. Pain intensity over 24 hours and during sit to stand were measured on a 10 centimetre visual analogue scale. Functional outcomes were the timed up and go test, the 12 step stair test, and knee range of motion. Patient satisfaction was measured on an 11 point numerical rating scale. Variables were evaluated blind pre- and post intervention, and at three and six months follow-up. Results: Thirty five participants completed the study. At each follow-up including six-months, significant differences were found between groups favouring those receiving mobilisation with movement for all variables except knee mobility. The primary outcome disability showed a mean difference of 7.4 points (95% confidence interval, 4.5 to 10.3) at six-months and a mean difference of 13.6 points (95% confidence interval, 9.3 to 17.9) at three-months follow-up. Conclusion: In patients with symptomatic knee osteoarthritis, the addition of mobilisation with movement provided clinically significant improvements in disability, pain, functional activities and patient satisfaction six months later.

Effectiveness of Mobilization with Movement on the Management of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials

“…Overall, 704 participants with knee OA aged from 40 to 70 years were included. The average age of the participants ranged from 47.47 ± (0.61) to 58.5 ± (4.36) in the experimental group [ 38 , 44 ] and 47.47 ± (0.61) to 59.4 ± (6.57) [ 38 , 44 ] in the control group. The follow-up duration of the experimental and control group ranged from two days to twelve months [ 36 , 40 ], with the majority of the studies having a follow-up duration of around two to three weeks.…”

“…The mean PEDro score of the studies was 6.7 (range: 5–9) ( Table 3 ). Two trials [ 36 , 44 ] scored 8, and four trials [ 5 , 35 , 39 , 40 ] scored 9 on the PEDro scale, which was the highest possible score given the intervention, as it would not be feasible to blind clinicians.…”

“…In study performance bias, merely 3 of the randomized controlled trials were found to be double-blinded and the other remaining articles are single-blinded. Six randomized controlled trials conducted by Lalnunpuii et al [ 5 ], Rao et al [ 35 ], Kaya Mutlu et al [ 36 ], Bhagat et al [ 39 ], Alkhawajah and Alshami [ 40 ], and Nigam et al [ 44 ] had a blinded outcome assessor.…”

“…The outcome measures for each of the fifteen trials are presented in Table 2 All the studies included outcome measures for pain and functional disability status. The pain intensity was measured by the Visual Analogue Scale (VAS) in eleven studies [ 5 , 31 – 34 , 36 – 38 , 40 , 42 , 44 ], Numerical Pain Rating Scale (NPRS) in three studies [ 35 , 39 , 43 ], and KOOS in one study [ 41 ]. Functional disability status was measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) in ten studies [ 5 , 31 – 33 , 36 – 38 , 40 , 43 , 44 ], Time Up and Go in three studies [ 35 , 39 , 44 ], and 6-minute walk test in one trial [ 34 ] for subjects with knee OA.…”

“…e effects of MWM intervention in subjects with knee OA are summarized in Table 2. Out of the 15 included trials, 14 of them reported that knee pain was significantly improved in the MWM groups compared to the control group [5,31,[33][34][35][36][37][38][39][40][41][42][43][44]. Only one study reported that the MWM group had no improvement in knee pain compared to the control groups [32].…”