None listed
Conditions
Brief summary
Knee stiffness is treated using exercise and manual therapy. Manual therapy techniques utilize accessory movements to increase the range of movement of joints. The accessory movements aim to replicate those that occur during the normal joint movement. In order to increase knee flexion, the accessory movement is a posterior glide achieved by applying pressure to the top of the tibia in an anterior to posterior direction. This is based on the concave/convex rule which is applied to all joints. However, recent 4D in vivo kinematic modelling conducted by our group indicates that posterior to anterior pressures better replicate knee joint movement at the end of flexion. The aim of this study is to compare the results of both techniques in patients presenting with stiff knees. The aim of this as a pilot study, is to explore the feasibility of running this study, as well as collect data on effect size, responsiveness to intervention, and information on dose-response to inform a later clinical trial. The primary outcome is change in knee flexion range and secondary outcomes include measures of pain and function. The clinical significance of this project is to change practice in physiotherapy to ensure the most effective manual therapy techniques will be used to restore movement and relieving pain.
Interventions
Knee Mobilization to increase knee flexion ROM. Grade 3 Posterior-Anterior (PA) joint glide with medial rotation performed on stiff knee performed at a dosage of 3 x 30 oscillations. Participants will undergo 4 face-to-face physiotherapy treatment sessions (1 x 1 hour and 1 x 30 minutes during the first week, and 2 x 30 minutes during the second week). This intervention will be delivered by either a registered physiotherapist or a student physiotherapist under the supervision of a registered phy
Knee Mobilization to increase knee flexion ROM. Grade 3 Posterior-Anterior (PA) joint glide with medial rotation performed on stiff knee performed at a dosage of 3 x 30 oscillations. Participants will undergo 4 face-to-face physiotherapy treatment sessions (1 x 1 hour and 1 x 30 minutes during the first week, and 2 x 30 minutes during the second week). This intervention will be delivered by either a registered physiotherapist or a student physiotherapist under the supervision of a registered physiotherapist. Participants will also be given a home exercise program of a self-mobilization in the direction of treatment (PA). This will will be performed with the patient in supine, a towel roll positioned in the knee crease and a towel around the ankle, pulling the knee into maximal passive flexion and oscillating for 10 seconds. Participants will be asked to perform this 2o times, twice a day and will be asked to complete a logbook to assess adherence to the home exercise program.
Sponsors
University of Canberra
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
- Individuals with restricted knee flexion ROM - Aged >18 - Stiffness duration of at least 7 days
Exclusion criteria
- Knee pain > 8/10 on Numeric Rating Scale - Chronic Regional Pain Syndrome (CRPS) - Anxiety related to manual therapy - Total Knee Replacement on the affected side - Inflammatory Arthritis - Anterior or posterior cruciate ligament graft surgery. - Knee reconstruction or previous ligament rupture on the affected side - Acute locked meniscus - Initiation of opioid analgaesia or corticosteroid injection within the past 7 days.
Outcome results
None listed