Mulligan and Maitland Techniques in Post PRP Knee Osteoarthritis

NCT ID: NCT06460168

Last Updated: 2025-07-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 36 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-12-15
• Study Completion Date: 2025-06-11

Brief Summary

Knee osteoarthritis (OA) is a major cause of disability nowadays. Osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. It is most common in elderly people and can be divided into two types, primary and secondary. Platelet-rich plasma (PRP) is an autologous blood product that contains a high concentration of platelets, specifically, 3 to 5 times that of normal blood. PRP contains a high concentration of autogenous growth factors, including vascular endothelial growth factor, platelet-derived growth factor, and transforming growth factor-β, which promote the proliferation of chondrocytes and the synthesis of the extracellular matrix. PRP is increasingly being used in the field of sports injury because of its simple preparation method, low cost, and high degree of safety A randomized clinical trial will be conducted at Ibne Sina Hospital,Multan. Non probability convenience sampling technique will be applied to enroll patients who will be allocated through computerized randomization into group A & group B to collect data. Sample size will be 36. This will be allocated to three groups through lottery method. Group A will be given MWM and group B will be given Maitland techniques while Group C will receive only baseline treatment. The study will be completed within the time duration of ten months. Primary Outcome measures of the research will be Pain, Range of motion, functional status. Data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Detailed Description

A study conducted since 2022 evaluated the comparative effects of muscle energy and mobilization with movement techniques for knee pain, Range of motion and functional disability in patients with knee Osteoarthritis.A randomized clinical trial was conducted at Physiotherapy Department of Bakhtawar Amin College of Rehabilitation Sciences, Multan. Patients of age 40-60 years with active pain for more than 3 months diagnosed with Grade I, II and III of knee osteoarthritis by orthopedic surgeon according to Kellgren and Lawrence Scale and on basis of radiograph were included. Patients with knee osteoarthritis of grade IV, history of fracture dislocation or radiating pain were excluded. Sixty-eight (68) patients were equally divided in two groups Mulligan group and METs group. Pain intensity was 0.19 (p<0.01), WOMAC score was 0.007(p<0.01) Knee flexion was 0.110(P<0.995) and Knee extension deficit score was 0.087 (P<0.998). Coefficient alpha for with in group subject effect for pain, functional disability and knee flexion and extension deficit is (P≤0.05). Both techniques post isometric relaxation technique of METs and mobilization with movement technique of Mulligans significantly reduced pain, functional disability and symptoms .

Since 2022 conducted a study to find out find whether neuromuscular stimulation of vastus medialis oblique (VMO) in combination with Maitland's mobilization and exercises was more effective as compared to Maitland's mobilization with exercises alone in patients with knee OA. Sixty patients with knee OA were purposively selected and randomly distributed to two groups that received an intervention for eight weeks. Group A patients received Maitland's mobilization in combination with exercises and group B patients received the same intervention as group A in combination with neuromuscular stimulation of VMO muscle. Both groups showed significant (P<0.05) within-group improvement in the knee pain levels and stiffness as reflected by NPRS and WOMAC index.

Another study conducted in 2020 investigate the effectiveness of Mulligan's mobilization with movement (MWM) and Myofascial release on pain, range of motion and functional abilities in patients with knee osteoarthritis. A purposive sample of 30 patients from two major hospitals of Faisalabad was randomly divided into two treatment groups. Group A, received Mulligan's MWM and group B received Myofascial release. Electrotherapy and exercise program was the same for both groups. The interventional program was of two weeks (five days a week, once a day). lease were effective for knee osteoarthritis in terms of pain, range of motion, and for functional abilities. However, Mulligan's MWM produced more quick outcomes than Myofascial release.

One study conducted in 2019 study is to determine the outcome and efficacy of Mulligan's mobilization with movement (MWM) with Maitland mobilization along with conventional therapy in the patients with knee osteoarthritis (OA). randomized controlled trial study was performed at the Department of Physiotherapy, Mayo Hospital, Lahore, Pakistan. Sixty-two patients were selected for the study. MWM was introduced in half of the patients and Maitland mobilizations in the second half for 2 weeks.

Conditions

Knee Osteoarthritis

Study Design

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

Study Groups

Mulligan(MWM) Technique

Group of post prp knee osteoarthritis patients are given Mulligan (MWM) Mobilization technique

Group Type: EXPERIMENTAL

Mulligan(MWM) MobilizationTechnique

Intervention Type: OTHER

Mulligan Mobilization program in MWM , a therapist-applied pain free accessory gliding force combined with active movement.

No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session) No of repetitions; 3 sets for 10 repetitions with 1 minute rest between sets.

Maitland Technique

Patients are given Maitland Mobilization technique.

Group Type: ACTIVE_COMPARATOR

Maitland Mobilization technique

Intervention Type: OTHER

will receive (Maitland mobilization program manipulative physiotherapy in which chain of oscillatory joint mobilization grades l-lV based on the pathological limit of tissue are used) In this, the exercises will be performed in 3 sets and 10 repetitions with 5-10s hold and 30s to 1min rest between repetitions.

No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session)

Baseline treatment

This group are given baseline treatment.

Group Type: NO_INTERVENTION

No interventions assigned to this group

Interventions

Mulligan(MWM) MobilizationTechnique

Mulligan Mobilization program in MWM , a therapist-applied pain free accessory gliding force combined with active movement.

No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session) No of repetitions; 3 sets for 10 repetitions with 1 minute rest between sets.

Intervention Type: OTHER

Maitland Mobilization technique

will receive (Maitland mobilization program manipulative physiotherapy in which chain of oscillatory joint mobilization grades l-lV based on the pathological limit of tissue are used) In this, the exercises will be performed in 3 sets and 10 repetitions with 5-10s hold and 30s to 1min rest between repetitions.

No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session)

Intervention Type: OTHER

Eligibility Criteria

Inclusion Criteria

• Age group 28-55 years
• Male and female
• Grade 2,3,4 of knee osteoarthritis
• Post PRP Osteoarthritic knee joints included
• After 1st month of Post PRP, patients will be included in study

Exclusion Criteria

• History of surgery of the affected knee
• Infection
• Malignancy
• Non Osteoarthritic joints excluded

• Minimum Eligible Age: 28 Years
• Maximum Eligible Age: 55 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Muqaddas Shareef, DPT

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Ibne Sina Hospital Multan

Multan, Punjab Province, Pakistan

Countries

Pakistan

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Other Identifiers

REC/RCR&AHS/23/01102

Identifier Type: -

Identifier Source: org_study_id