Knee Osteoarthritis
Conditions
Keywords
Musculoskeletal Manipulations, Osteoarthritis, Knee, Pain Threshold
Brief summary
Pain in knee osteoarthritis (OA) represents increased pain intensity due to peripheral and central sensitivity. Pressure pain threshold (PPT) is a widely applied (used) method for measuring the magnitude of peripheral and central sensitivity in knee OA. Among several manual therapy techniques increasing PPT in knee OA, the effect of end-range mobilization has not been evaluated so far. The aim of this study was to investigate the immediate effect of end-range mobilization compared to placebo on increase of PPT and some function-related measures.
Detailed description
Knee osteoarthritis (OA) is the most common form of arthritis contributing to a major cause of disability worldwide. Although many mechanisms may contribute to knee pain severity, the patient-reported hyperalgesia can be attributed to peripheral and central sensitivity in knee OA. Pressure pain threshold (PPT) measurement is a simple and commonly applied method for measuring somatosensory function in musculoskeletal disorders, just as in knee OA. Many trials have shown a lower PPT value in knee OA underlining the presence of peripheral and central sensitivity compared to healthy controls. Manual therapy techniques, as a preferred treatment option, may not only alleviate pain, but also increase pain tolerance to locally applied mechanical pressure. Positive results of different manual therapy techniques on increase of PPT has been reported in knee OA. End-range manual therapy is an option for the decrease of sensitivity in knee OA; however, the effect of end-range mobilization has not been evaluated so far in knee OA.
Interventions
PROCEDUREEnd-range mobilization
End-range mobilization performed in end-range of the tibiofemoral joints' flexion and extension
PROCEDUREPlacebo technique
Hands-on technique performed in end-range of the tibiofemoral joints' flexion and extension
Sponsors
University of Pecs
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
FEMALE
Age
60 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* the clinical classification criteria of knee OA according to the American College of Rheumatology * Categorization of patients as End Of Range Problem based on Maitland manual therapy * female patients aged between 60 and 80 years * uni/bilateral moderate-to-severe symptomatic tibiofemoral knee osteoarthritis with radiographic evidence of Kellgren-Lawrence scale 2 or 3 * pain during weight-bearing activities at least within 6 months * at least 90° knee flexion * sufficient mental status.
Exclusion criteria
* acute inflammation of the knee * total knee replacement in the opposite side * severe degenerative lumbar spine disease (e.g. spondylolisthesis) * systemic inflammatory arthritic or neurological condition * physiotherapy/balneotherapy attendance or manual therapy within 3 months * intraarticular injections in the prior 12 months * use of walking aids * contraindication for manual therapy * complex regional pain syndrome * cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| PPT of the knee | 30 minutes | pressure pain threshold at the knee |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PPT of the m. Extensor Carpi Radialis Longus (ECRL) | 30 minutes | pressure pain threshold at the ECRL |
| General Pain Intensity | 30 minutes | General Pain Intensity measured with Visual Analogue Scale (VAS) |
| Timed Up and Go test | 30 minutes | Timed Up and Go test measuring functional capacity |
| Pain intensity during Timed Up and Go test | 30 minutes | associated pain intensity during the Timed Up and Go test |
| Passive tension of the knee | 30 minutes | Passive tension of the knee at the beginning of pain |
Countries
Hungary
Outcome results
None listed