Immediate effects of Mulligan's techniques on pain and functional mobility in individuals with knee osteoarthritis: A randomized control trial.
BACKGROUND AND PURPOSE
Mulligan's mobilization with movement was shown to be effective when implemented in multimodal therapy for knee osteoarthritis. However, no study has evaluated the Mulligan's technique in isolation and compared the relative effectiveness with sham-controlled interventions. Hence, the present study examined the immediate effects of Mulligan's techniques with sham mobilization on the numerical pain rating scale (NPRS) and timed up and go (TUG) test in individuals with knee osteoarthritis.


METHODS
Thirty participants (mean age: 55.3 ± 8.3 years) with symptoms at the knee and radiographic diagnosis of knee osteoarthritis were randomized into sham (n = 15) and intervention (n = 15) groups. The intervention (I) group received Mulligan's mobilization glides that resulted in relative pain relief for three sets of 10 repetitions. For the sham (S) group, the therapist's hand was placed over the joint surfaces mimicking the pain-relieving glides, without providing the gliding force. The outcome measures NPRS and TUG were recorded by a blinded assessor pre- and post-intervention.


RESULTS
Statistically significant differences were identified between the groups in post-intervention median (interquartile range) NPRS (I group: 4.00 [2.00-5.00]; S group: 6.00 [4.00-7.00]) and TUG scores (I group: 10.9 [9.43-10.45]; S group: 13.18 [10.38-16.00]) with the intervention group demonstrating better outcomes (p < .05). Within-group, the post-intervention scores of NPRS and TUG were significantly lower (p < .05) compared to the pre-intervention scores in the intervention group. In the sham group, a statistically significant pre-post change was noticed only in the NPRS scores but not in the TUG scores.


CONCLUSION
Mulligan's techniques were effective in improving pain and functional mobility in individuals with knee osteoarthritis. The underlying mechanisms for observed effects must be examined further, as participants reported pain relief following sham mobilization.
['Bhagat|Madhura|M|https://orcid.org/0000-0002-9778-1805', 'Neelapala|Y V Raghava|YVR|https://orcid.org/0000-0002-9650-3926', 'Gangavelli|Ranganath|R|https://orcid.org/0000-0002-7329-4180']
D005260:Female D006801:Humans D007717:Knee D007719:Knee Joint D008297:Male D008875:Middle Aged D026201:Musculoskeletal Manipulations D020370:Osteoarthritis, Knee D059408:Pain Management D011237:Predictive Value of Tests D016059:Range of Motion, Articular D020127:Recovery of Function D016896:Treatment Outcome
arthralgia manual therapies physical therapy techniques sham treatment