]>
IRCT20210121050099N1 IRCT 2021-01-25 Abbas Fadhil Taher Effects of Mulligan and Muscle Energy Techniques on Knee Osteoarthritis. Comparison of Effects of Mulligan Techniques and Muscle Energy Technique (MET) on Pain and Function in Knee Osteoarthritis. 2021-01-19 anticipated 30 Complete https://irct.ir/trial/53830 interventional Randomization: Randomized, Blinding: Not blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: The simple random allocation technique will be used to distribute those patients into a group of intervention; each subject has the opportunity to choose the intervention group randomly by pick up a small piece of paper out of 30 pieces (15 for MWM and 15 for MET) which contains the assigned interventions. N/A chronic knee osteoarthritis. Intervention 1: Intervention group A: Mulligan mobilization with movement technique, physiotherapy manual exercises technique. 15 subjects in this group will have mulligan mobilization with movement in these different positions (prone and standing), according to pain laterality, plus conventional exercises therapy. I. Subjects suffering from pain or more pain in the lateral aspect of the knee will receive the following intervention each session; 1) lateral glide mobilization by using belt with active knee extension and flexion in prone position, 3 sets with 6 repetitions for extension and flexion in each set, 30 seconds rest between each set. 2) External rotation glide in standing position. with weight bearing and active knee flexion and extension The intervention continues with three sets of the MWM, of 6 repetitions in flexion and extension each set. 3) conventional knee osteoarthritis exercises; •Quadriceps isometric strengthening exercises; subject lay in supine position. • Straight leg raising exercise. 4) All of subjects will do home exercises program. This program includes conventional exercises such as quadriceps isometric strengthening, straight leg raising, hamstring curls-up and hip abduction exercises. Each exercise is done for 3 sets in each day with 30 repetitions and each repetition will last for 10 seconds muscle contraction period. II. Subjects suffering from pain in the medial aspect of the knee will receive the following intervention;1) medial glide mobilization in prone position by using belt with active knee extension and flexion, 3 sets with 6 repetitions for extension and flexion each set, 30 seconds rest between each set. With similar above procedures. The only difference is the direction of gliding. 2) Internal rotation in standing position with weight bearing and active knee flexion. The same procedure in I 2 with the difference in internal rotation gliding. 3) Conventional knee osteoarthritis exercises; quadriceps isometric strengthening exercises and straight leg raising Home active conventional osteoarthritis exercises. Intervention 2: Intervention group B: muscle energy manual exercises technique MET. physiotherapy manual exercises technique. 15 subjects in this group will receive Post isometric relaxation of Muscle energy technique as following; I. Quadriceps MET contraction of quadriceps with only 20% of maximum voluntary contraction strength in extension against therapist’s resistance for 7-10 seconds, and followed by patient’s exhalation, the therapist stretches the muscle for 30 seconds. Then a new end position is found and ask the patient to repeat isometric contraction again, repeated this technique for 3-4 times. II.Hamstring MET hold the hamstring isometric for 7-10 sec and followed by exhalation therapist stretch the muscle 30 second, to straighten the knee towards the new barrier. Repeating this technique until no further gain is possible (usually one or two repetitions achieve the maximum degree of lengthening available at any one session) for 3-4 time. III. Tensor fascia lata (TFL) MET Patient asked to abduct leg against resistance (using less than a 25% strength, slowly take your leg back towards the midline, against my resistance).• After contraction ceases, and patient relaxes, during patient’s exhalation, the leg should be taken to or through the new restriction barrier (into adduction past the barrier) to stretch the muscular fibers of TFL (the upper third structure).• Care taken to ensure that pelvis is not tilted during stretch.• Stability is achieved by therapist pressure maintained against flexed knee/thigh.• Entire process should be repeated several times or until no further gain is possible IV. Conventional osteoarthritis exercises (quadriceps isometric strengthening sets and straight leg raising exercises).V. All of patients will do home exercises program. This program includes conventional exercises such as quadriceps isometric strengthening, straight leg raising, hamstring curls-up and hip abduction exercises. Each exercise is done for 3 sets in each day with 30 repetitions and each repetition will last for 10 seconds muscle contraction period. Undecided - It is not yet known if there will be a plan to make this available Justification or reason for indecision in sharing IPD is not yet
public Abbas Taher
Enghilab
Tehran Iraq 76984 +964 21 058 3318 abasfq@gmail.com Tehran University of Medical Sciences scientific Abbas Taher
Enghilab
Tehran Iraq 76984 +964 21 058 3318 abasfq@gmail.com Tehran University of Medical Sciences Iraq • Patients with Chronic unilateral (preferably) or bilateral (intervention will be to dominant side) knee osteoarthritis confirmed by x-ray, Without ligament pathology or injury (grade II and grade III of Kellegren and Lawrence classification).(50) • patients are independently mobile. • BMI must be ≤ 30. • Visual Analogue Scale must be ≥4 • Knee Extension lack ≥20 degrees • Willingness to participate and follow the treatment schedule. • Patients will be in study if they have no concomitant disease affecting the knee, e.g. rheumatoid arthritis, recent injury, and/or surgery to the knee and had received intra- articular corticosteroid during the last 6 months 35 years 60 years Both • Absent for two or more continuous sessions. • Patients who have pathological fractures, revision surgeries, associated ipsilateral injuries, and neurovascular disorders will be excluded from the study. Patients who are not satisfied to continue the treatment. M17 Osteoarthritis of knee Rehabilitation Rehabilitation Intervention group A: Mulligan mobilization with movement technique, physiotherapy manual exercises technique. 15 subjects in this group will have mulligan mobilization with movement in these different positions (prone and standing), according to pain laterality, plus conventional exercises therapy. I. Subjects suffering from pain or more pain in the lateral aspect of the knee will receive the following intervention each session; 1) lateral glide mobilization by using belt with active knee extension and flexion in prone position, 3 sets with 6 repetitions for extension and flexion in each set, 30 seconds rest between each set. 2) External rotation glide in standing position. with weight bearing and active knee flexion and extension The intervention continues with three sets of the MWM, of 6 repetitions in flexion and extension each set. 3) conventional knee osteoarthritis exercises; •Quadriceps isometric strengthening exercises; subject lay in supine position. • Straight leg raising exercise. 4) All of subjects will do home exercises program. This program includes conventional exercises such as quadriceps isometric strengthening, straight leg raising, hamstring curls-up and hip abduction exercises. Each exercise is done for 3 sets in each day with 30 repetitions and each repetition will last for 10 seconds muscle contraction period. II. Subjects suffering from pain in the medial aspect of the knee will receive the following intervention;1) medial glide mobilization in prone position by using belt with active knee extension and flexion, 3 sets with 6 repetitions for extension and flexion each set, 30 seconds rest between each set. With similar above procedures. The only difference is the direction of gliding. 2) Internal rotation in standing position with weight bearing and active knee flexion. The same procedure in I 2 with the difference in internal rotation gliding. 3) Conventional knee osteoarthritis exercises; quadriceps isometric strengthening exercises and straight leg raising Home active conventional osteoarthritis exercises. Intervention group B: muscle energy manual exercises technique MET. physiotherapy manual exercises technique. 15 subjects in this group will receive Post isometric relaxation of Muscle energy technique as following; I. Quadriceps MET contraction of quadriceps with only 20% of maximum voluntary contraction strength in extension against therapist’s resistance for 7-10 seconds, and followed by patient’s exhalation, the therapist stretches the muscle for 30 seconds. Then a new end position is found and ask the patient to repeat isometric contraction again, repeated this technique for 3-4 times. II.Hamstring MET hold the hamstring isometric for 7-10 sec and followed by exhalation therapist stretch the muscle 30 second, to straighten the knee towards the new barrier. Repeating this technique until no further gain is possible (usually one or two repetitions achieve the maximum degree of lengthening available at any one session) for 3-4 time. III. Tensor fascia lata (TFL) MET Patient asked to abduct leg against resistance (using less than a 25% strength, slowly take your leg back towards the midline, against my resistance).• After contraction ceases, and patient relaxes, during patient’s exhalation, the leg should be taken to or through the new restriction barrier (into adduction past the barrier) to stretch the muscular fibers of TFL (the upper third structure).• Care taken to ensure that pelvis is not tilted during stretch.• Stability is achieved by therapist pressure maintained against flexed knee/thigh.• Entire process should be repeated several times or until no further gain is possible IV. Conventional osteoarthritis exercises (quadriceps isometric strengthening sets and straight leg raising exercises).V. All of patients will do home exercises program. This program includes conventional exercises such as quadriceps isometric strengthening, straight leg raising, hamstring curls-up and hip abduction exercises. Each exercise is done for 3 sets in each day with 30 repetitions and each repetition will last for 10 seconds muscle contraction period. Patients' opinion about thier knees. Timepoint: before first session, after third one and 4 weeks after the last session. Method of measurement: Knee Injury and Osteoarthritis Outcome Score (KOOS) Arabic version (Questionnaire). Abbas Fadhil Taher Approved 2021-01-18 Tehran university medical sciences. Ethics Committee of Nursing Midwifery and rehabilitation. enghilab tehran Tehran Iran (Islamic Republic of)