Impact of Mulligan Squeeze Technique on Meniscal Derangement in Knee Osteoarthritis Patients

NCT ID: NCT06391047

Last Updated: 2024-04-30

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 26 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-02-02
• Study Completion Date: 2024-04-25

Brief Summary

The objective of this study is to find out the effects of Mulligan's Squeeze technique added as a complementary treatment to the conventional physiotherapy for the management of meniscal derangement in knee osteoarthritis patients.

Detailed Description

This study was performed to determine the consequences of conventional physical therapy with and without Mulligan's Squeeze technique for meniscal derangement treatment in patients with knee osteoarthritis. This research study was a randomized controlled trial. The sample size was of 26 subjects. The subjects were nominated in accordance to the inclusion and exclusion criteria. They were equally and randomly divided into two groups. One group received Mulligan's Squeeze technique along with conventional physiotherapy exercises, with hot pack prior to the exercise session. The control group was only given conventional therapy exercises with hot pack application prior to any exercise. The treatment was given for two weeks and a total of six sessions, three sessions each week. The primary outcome measures were Numerical Pain Rating Scale (NPRS) for pain rating and goniometer to record range of knee flexion. The secondary outcome measures were Patient-specific functional scale (PSFS) and Knee-injury osteoarthritis outcome score (KOOS). The measurements were taken at baseline, at end of first week and after the second week. The data was analyzed by using IBM SPSS software version 27.

Conditions

Osteoarthritis, Knee; Knee Injuries; Meniscus; Derangement; Meniscus Tear; Meniscus Lesion

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Group A

Group A was given hot pack at knee joint for 10-15min. Then the Mulligan's Squeeze Technique was applied. The patient in supine lying. The therapist placed thumb on joint line tenderness of knee. With the other thumb, the therapist reinforced the first thumb. The patient was asked to slowly flex knee. The therapist maintaining the thumb contact, applied the force centrally. The force was increased progressively as the knee moved towards full range of available flexion. At the end range, the therapist assisted the tibia to move towards more flexion with ulnar border of their hand. This position was maintained for a few seconds and the overpressure was applied. Then patient was asked to perform knee extension. As the knee moved towards extension the force applied from both thumbs was progressively reduced. At maximal extension, no force was applied. This was repeated 10 times in each set with total 3 sets. After this stretching and strengthening exercises were performed by patient.

Group Type: EXPERIMENTAL

Mulligan's Squeeze Technique - manual therapy

Intervention Type: OTHER

This technique was introduced by Brian R. Mulligan. In this technique the therapist places thumb along the tender joint margin and applies force centrally. The patient actively flexes knee and therapist progressively enhances force and at end applies overpressure. This force is decreased as knee moves towards extension. This method helps to maintain the meniscus in its normal position and corrects the derangement of meniscus.

Conventional Physiotherapy

Intervention Type: OTHER

It includes stretching and strengthening exercises of muscles of the knee joint.

Group B

Group B was given hot pack at knee joint for 10-15min. Then they were asked to perform stretching and strengthening exercises of the knee with at least 10 repetitions in each set and a total two sets in a day.

Group Type: ACTIVE_COMPARATOR

Conventional Physiotherapy

Intervention Type: OTHER

It includes stretching and strengthening exercises of muscles of the knee joint.

Interventions

Mulligan's Squeeze Technique - manual therapy

This technique was introduced by Brian R. Mulligan. In this technique the therapist places thumb along the tender joint margin and applies force centrally. The patient actively flexes knee and therapist progressively enhances force and at end applies overpressure. This force is decreased as knee moves towards extension. This method helps to maintain the meniscus in its normal position and corrects the derangement of meniscus.

Intervention Type: OTHER

Conventional Physiotherapy

It includes stretching and strengthening exercises of muscles of the knee joint.

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• • Pain during maximal knee flexion, pain when maximal extension of knee occurs

• Both genders were taken; male and female
• Age between 30 to 55 years
• Tenderness along the line of joint
• Complain or history of abnormal clicking sounds and/or popping of knee
• If any of the mentioned special tests are positive: "Apley's compression and distraction test", the "Disco test or Thessaly's test" with almost 20° flexed position of knee, and "McMurray's test"
• Participants who were willing to take part in the study

Exclusion Criteria

• • Presence of any knee co-morbidities

• Knee OA of Grade 4
• ACL or some other knee ligament injury/tears
• Contusion present on knee, fracture of knee
• Knee dislocation
• Knee instability due to any ligamentous injury
• Constant pain or discomfort due to underlying reasons (e.g. hyper-algesia), and any other wound or ailment
• Participant not willing to be a part of the study

• Minimum Eligible Age: 30 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

University of Faisalabad

OTHER

Sponsor Role: lead

Responsible Party

Dr Izza Ayub; PT

Dr Izza Ayub;PT Lecturer

Responsibility Role: PRINCIPAL_INVESTIGATOR

Locations

Allied Hospital

Faisalābad, Punjab Province, Pakistan

Countries

Pakistan

Other Identifiers

TUF/DR/SA/MSPP/2024/383

Identifier Type: -

Identifier Source: org_study_id