Effects of Mulligan's Pain Release Phenomenon and Kaltenborn Mobilizations on Knee Osteoarthritis

February 4, 2026 updated by: Riphah International University

Comparative Effects of Mulligan's Pain Release Phenomenon and Kaltenborn Mobilizations on Pain, Range of Motion And Disability in Patients With Knee Osteoarthritis.

Knee osteoarthritis is a degenerative condition that is prevalent in older population and is associated with pain, stiffness, decreased range of motion and impaired function. Physical therapy techniques, such as Mulligan's Pain Release Phenomenon and Kaltenborn Mobilization are used to alleviate patient's symptoms.

A Randomized Clinical Trial was conducted at SAP Rehab Center (Saira Memorial hospital) and Pak Health Care, Lahore. 44 participants age between 40-65 years with Knee Osteoarthritis were randomly assigned into 2 groups. Both groups underwent treatment three times a week for total of six weeks. Group A received treatment through Mulligan's Pain Release Phenomenon along with conventional exercises. Group B received treatment through Kaltenborn mobilization and conventional exercises. Convectional treatment started with hot pack for 10 minutes followed by ultrasound for 8 minute, the program indcluded a series of exercises (Hamstring stretch, Gastrocnemius Stretch, Soleus Stretch and Rectus femoris Stretch all for 3 set with 10 repetitions and 10 seconds hold. Quadricep setting exercises 1 set with 10 repetitions, Full arc extension and Straight leg raises 1 set and 10 repetitions. the exercises program ended with cycling for 2 minutes. Outcome measures were conducted through NPRS for pain, WOMAC for functional disability, Universal Goniometer for range of motion at baseline and after 6 weeks. Data was analyzed through SPSS software version 27.

The aim of the study is to compare the effects of Mulligan's Pain Release Phenomenon and Kaltenborn Mobilization on pain, disability and range of motion in patients with early Knee Osteoarthritis.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The objective of my study is to determine the comparative effects of Mulligan's Pain Release Phenomenon and Kaltenborn Mobilization on pain, disability and range of motion in patients with early Knee Osteoarthritis.

Study Type

Interventional

Enrollment (Actual)

44

Phase

  • 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 Province
      • Lahore, Punjab Province, Pakistan, 54000
        • SAP Rehab Center

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

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age included between 40-65 years
  • NPRS pain rating above 3
  • Both Genders
  • Diagnosed with Grade 1 and Grade 2 knee osteoarthritis
  • Unilateral knee pain
  • Pain for more than 3 months
  • Decrease range of motion

Exclusion Criteria:

  • Age more than 60 years
  • Bilateral knee pain
  • Patellofemoral pain syndrome
  • Rheumatoid Arthritis
  • Fracture or ligamentous injury of lower extremity
  • Any trauma, burn, infection or tumor around the knee
  • Total knee replacement

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: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Mulligan's pain release phenomenon
22 participants were allocated into Experimental group A, Mulligans Pain release compression were performed for 5 repetitions with 20-30 seconds hold with 5 seconds rest. Convectional treatment included hot pack for 10 mins and ultrasound for 8 mins. Exercises includes stretches for Hamstring, Gastrocnemius, Soleus and Rectus femoris for 3 set with 10 repetitions and 10 seconds hold. Quadricep setting exercise, Full arc extension and Straight leg raises was done for 1 set of 10 repetitions and cycling was performed for 2 minutes. A total of 18 sessions were conducted for 6 weeks with 3 sessions scheduled every week. Outcome measures were measured in week 1 before the treatment and after 6 weeks of treatment.
Other: Mulligan's pain release phenomenon
Experimental Group A was given Mulligan's pain release phenomenon compression techniques along with conventional therapy for 3 sessions per week for 6 weeks in total. After Hot pack for 10 mins and Ultrasound for 8 mins participants performed series of exercises included targeted muscles stretchings (Hamstrings, Quadriceps, Soleus and Rectus femoris) 10 repetitions x 3 sets and 10 seconds hold. Quadricep setting exercise, Full arc extension and Straight leg raises for 10 repetitions x 1 set followed by cycling for 2 mins.
Experimental: Kaltenborn mobilization with traction
22 participants were allocated into Experimental group B, Kaltenborn grade III mobilization with traction were performed for 10 repetitions with 3 sets treatment included hot pack for 10 mins and ultrasound for 8 mins. Exercises includes stretches for Hamstring, Gastrocnemius, Soleus and Rectus femoris for 3 set with 10 repetitions and 10 seconds hold. Quadricep setting exercise, Full arc extension and Straight leg raises was done for 1 set of 10 repetitions and cycling was performed for 2 minutes. A total of 18 sessions were conducted for 6 weeks with 3 sessions scheduled every week. Outcome measures were measured in week 1 before the treatment and after 6 weeks of treatment.
Other: Kaltenborn mobilization with traction
Experimental Group b was given grade III Kaltenborn mobilization with traction along with conventional therapy for 3 sessions per week for 6 weeks in total. After Hot pack for 10 mins and Ultrasound for 8 mins participants performed series of exercises included targeted muscles stretchings (Hamstrings, Quadriceps, Soleus and Rectus femoris) 10 repetitions x 3 sets and 10 seconds hold. Quadricep setting exercise, Full arc extension and Straight leg raises for 10 repetitions x 1 set followed by cycling for 2 mins.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale (NPRS)
Time Frame: 6 weeks
The Numeric Pain Rating Scale is a uni dimensional measure of pain severity in adults, including those with chronic pain caused by rheumatic disorders. It is a 11 point numeric scale ranging from "0" representing no pain and "10" worst pain possible. In this questionnaire the respondent selects a whole number from 0-10 that best reflects their intensity of pain, 1-3 means mild pain, 4-6 indicates moderate and 7-10 means severe pain.
6 weeks
Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)
Time Frame: 6 weeks
Western Ontario and McMaster Universities Osteoarthritis Index is widely used is evaluation of hip and knee osteoarthritis. This questionnaire have 24 items with 3 sub scales, measure pain (5 items), stiffness (2 items) and and physical function (17 items).
6 weeks
ROM Knee (Flexion)
Time Frame: 6 weeks
Change from Baseline ROM of Knee Flexion was taken with the help of Universal Goniometer
6 weeks
ROM Knee (Extension)
Time Frame: 6 weeks
Change from Baseline ROM of Knee Extension was taken with the help of Universal Goniometer
6 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Ameena Amjad, Ph.D, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

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)

June 30, 2025

Primary Completion (Actual)

October 3, 2025

Study Completion (Actual)

October 3, 2025

Study Registration Dates

First Submitted

February 4, 2026

First Submitted That Met QC Criteria

February 4, 2026

First Posted (Actual)

February 11, 2026

Study Record Updates

Last Update Posted (Actual)

February 11, 2026

Last Update Submitted That Met QC Criteria

February 4, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0199

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

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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