Osteo Arthritis Knee
Conditions
Keywords
Musculoskeletal Manipulations, Osteoarthritis, Knee, Pain Threshold, Conservative Treatment
Brief summary
The effect of mobilizations on decrease of peripheral and central sensitivity has been proven in KOA. Furthermore, the effect of conservative therapy has also been proven in the increase of pain threshold in KOA. However, no study has investigated the effect of these interventions combined till date in KOA. The aim of the present study is to investigate the short-term and long-term effect of end-range mobilization in addition to conservative therapy on decrease of pressure pain threshold in KOA.
Detailed description
The positive effect of different manual mobilizations have been proven in the management of knee osteoarthritis (KOA). Pressure pain threshold, as a measure of somatosensory function, is a well-applied measurement technique for the pain perception in KOA. The effect of mobilizations on decrease of peripheral and central sensitivity has been proven in KOA. Furthermore, few studies has revealed the effect of conservative therapy as an effective intervention in the increase of pain threshold. However, no study has investigated the effect of these interventions combined till date in KOA, which could give a long-lasting effect in the decrease of sensitization in KOA. Therefore, the aim of the present study is to investigate the short-term and long-term effect of end-range mobilization in addition to conservative therapy on decrease of pressure pain threshold in KOA.
Interventions
PROCEDUREend-range mobilization
accessory technique applied on the tibiofemoral joint with the aim of increasing extensibility of the periarticular tissues
PROCEDURENon end-range mobilization
accessory technique applied on the tibiofemoral joint with the aim of alleviating pain
PROCEDUREControl
hands-on cutaneous technique
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
* clinical classification criteria of knee osteoarthritis according to the American College of Rheumatology * categorization as End of Range Problem based on Maitland manual therapy * unilateral/bilateral moderate-to-severe symptomatic tibiofemoral KOA 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 * class II. obesity (body mass index\>35kg/m2) * 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 aid * contraindication for manual therapy * complex regional pain syndrome * cognitive impairment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| change of peripheral sensitivity | following 3-week rehabilitation | peripheral sensitivity (pressure pain threshold) assessed at the local knee |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| change of general pain intensity | following 3-week rehabilitation | general pain intensity from the previous week using the Visual Analogue Scale |
| change of Timed Up and Go test | following 3-week rehabilitation | short test for measuring physical performance |
| change of pain intensity during physical performance | following 3-week rehabilitation | pain intensity measured during the previously mentioned physical performance test using the 0-10 Numerating Pain Rating Scale, where 0 indicate no pain and 10 indicate worst imaginable pain |
| change of central sensitivity | following 3-week rehabilitation | central sensitivity (pressure pain threshold) assessed at the ipsilateral m. extensor carpi radialis longus |
| degree of knee flexion during passive movement at the onset of knee pain | following 3-week rehabilitation | measurement of degree of knee flexion during passive movement at the onset of knee pain |
| strength of resistance of passive knee flexion at the onset of knee pain | following 3-week rehabilitation | measurement of strength of resistance arising from the anterior located tissues around the knee during passive knee flexion at the onset of pain |
| change of pain during physical performance | following 3-month | pain intensity measured during the previously mentioned physical performance test using the 0-10 Numerating Pain Rating Scale, where 0 indicate no pain and 10 indicate worst imaginable pain |
Countries
Hungary
Outcome results
None listed