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

April 25, 2024 updated by: Dr Izza Ayub; PT, University of Faisalabad

The Impact of Mulligan Squeeze Technique as an Adjunct to Conventional Physiotherapy on Meniscal Derangement in Knee Osteoarthritis Patients

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.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

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.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
26

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
    • Punjab
      • Faisalābad, Punjab, Pakistan, 38000
        • Allied Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

Yes

Description

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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: 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.
Other: 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.
Other: Conventional Physiotherapy
It includes stretching and strengthening exercises of muscles of the knee joint.
Active Comparator: 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.
Other: Conventional Physiotherapy
It includes stretching and strengthening exercises of muscles of the knee joint.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Numerical Pain Rating Scale (NPRS)
Time Frame: Readings were taken at baseline, after 1st week and at end of 2nd week.
It was used to record the level of knee pain
Readings were taken at baseline, after 1st week and at end of 2nd week.
Goniometer
Time Frame: Readings were taken at baseline, after 1st week and at end of 2nd week.
It was used to find out the range of movement of knee flexion.
Readings were taken at baseline, after 1st week and at end of 2nd week.

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Patient Specific Functional Scale (PSFS)
Time Frame: Readings were taken at baseline, after 1st week and at end of 2nd week.
It was used to find out the independence level and dysfunction level of patient.
Readings were taken at baseline, after 1st week and at end of 2nd week.
Knee injury and osteoarthritis outcome score (KOOS)
Time Frame: Readings were taken at baseline, after 1st week and at end of 2nd week.
It is a scale designed specifically for knee problems. It has forty-two questions that cover several aspects of the problems related to knee.
Readings were taken at baseline, after 1st week and at end of 2nd week.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
University of Faisalabad

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 2, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
April 22, 2024

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 25, 2024

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
April 25, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 25, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
April 30, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 30, 2024

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 25, 2024

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
April 1, 2024

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • TUF/DR/SA/MSPP/2024/383

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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