Effects of the Egoscue Exercises With and Without Mwm Among Patients With Knee Osteoarthritis

June 8, 2026 updated by: Riphah International University

Effects of the Egoscue Exercises With and Without Mwm on Pain, Range of Motion, Balance, and Quality of Life Among Patients With Knee Osteoarthritis

Knee osteoarthritis is a common degenerative joint disorder characterized by joint pain, stiffness, limited mobility, and reduced quality of life. It primarily affects the elderly population and poses a major burden on functional independence and healthcare resources. While various physiotherapy approaches have shown benefits in managing KOA symptoms, Mulligan's Mobilization with Movement is a manual therapy technique that has gained clinical attention for improving pain and joint mechanics. Similarly, Egoscue postural alignment exercises, which focus on restoring musculoskeletal balance through corrective movement patterns, have shown potential in addressing chronic pain and postural dysfunction, though evidence remains limited in knee osteoarthritis populations. This study aims to evaluate the effects of Egoscue exercises with and without MWM on pain, range of motion, balance, and quality of life in patients with knee osteoarthritis

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This single-blinded randomized clinical trial will be conducted at Riphah Clinic and Sir Ganga Ram Hospital, Lahore, over 10 months following ethical approval. A total of 56 participants, diagnosed with KOA based on clinical criteria, will be recruited using non probability purposive sampling and randomly assigned to two groups. Group A will receive Egoscue exercises, MWM, and conventional physiotherapy exercises, while Group B will receive Egoscue exercises and conventional physiotherapy only. Each group will undergo treatment five times per week for 3 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), range of motion (Goniometry), balance (Timed Up and Go Test), and quality of life (EQ-5D-5L). Data will be analyzed using SPSS to determine the comparative effectiveness of the interventions in improving functional and clinical outcomes among KOA.

Study Type

Interventional

Enrollment (Estimated)

56

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 Contact

Study Locations

  • Pakistan
    • Punjab Province
      • Lahore, Punjab Province, Pakistan, 54920

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

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • • Patients aged between 40-60 years (15)

    • Both male and female genders
    • Clinical and radiographic diagnosis of knee OA (Kellgren-Lawrence Grade II osteoarthritis)

Exclusion Criteria:

  • • Any fracture or other injury (18)

    • Any inflammatory disease (Rheumatoid arthritis, gout) (18)
    • Any neuropathy or neurological issue (18)
    • History of knee surgery (18)
    • Participation in other physical therapy programs within the last 3 months

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
Intervention / Treatment
Experimental: Egoscue exercises with MWM
Combining the Egoscue Method and Mobilization with Movement (MWM) for knee osteoarthritis (OA) is a powerful, evidence-based approach. Egoscue corrective exercises restore whole-body postural alignment, while MWM-a manual therapy technique pioneered by Brian Mulligan-corrects joint positional faults by actively moving the knee pain-free.
Other: Egoscue exercises with MWM
The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. Mobilization with Movement (MWM) will be implemented after completing the Egoscue routine. This will include a medial tibial glide that is done in a non-weight bearing (NWB) position.
Active Comparator: Egoscue Exercises without MWM
The Egoscue Method approach for knee osteoarthritis (OA) focuses on improving alignment, hip function, ankle mobility, and muscle balance rather than strengthening the knee in isolation.
Other: Egoscue exercises without MWM
The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. The exercises will be done with great caution of body alignment and posture

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Numeric Pain Rating Scale for pain
Time Frame: upto 4 weeks
The Numerical Pain Rating Scale (NPRS) is an 11-point scale, in which patients rate their pain in levels ranging between 0 (no pain) and 10 (worst imaginable pain). It is common because it is simple, has high test-retest reliability (ICC = 0.95) and responsiveness in musculoskeletal disorders, such as in knee osteoarthritis. A minimum of 2 points on NPRS is termed the minimal clinically important difference (MCID) on patients with musculoskeletal pain even with KOA.
upto 4 weeks
Goniometer for ROM
Time Frame: Upto 4 weeks
Goniometry is a clinical instrument that can be used to evaluate the joint angles both in active and passive range of motion. It is said to be valid in knee flexion and extension (ICC values range between 0.85 and 0.99 with respect to experience of examiners), with a standard error of measurement of approximately 3-5 degrees. The MCID of range of motion may depend on the improvement in the range of motion; the range of improvement of at least 5-10 degrees in the knee flexion or extension is usually regarded as clinically significant in patients with KOA
Upto 4 weeks
Timed Up and Go - TUG Test
Time Frame: Upto 4 weeks
Timed Up and Go (TUG) test refers to the time that the person requires to be seated on a chair, stand up, walk three meters, turn around, walk back, and reseat. It is a valid and reliable (ICC = 0.99) indicator of dynamic balance and functional mobility, with a sensitivity of 87% and specificity of 87% of predicting fall risk in older people. TUG is frequently employed to evaluate the improvement of balance and fall prevention in KOA patients. A difference of about 0.8 to 1.4 seconds is reported to be an MCID in older adults and KOA populations, which is a significant reduction in mobility and risk of falls
Upto 4 weeks
Euro Qol-5D-5L
Time Frame: Upto 4 weeks
The EQ-5D is a standardized instrument that assesses the quality of life related to health in five dimensions which are mobility, self-care, normal activities, pain/discomfort and anxiety/depression. It is well-construct valid and test-retest reliable (ICC = 0.86 -0.90), and sensitive to clinical changes in chronic arthritis such as osteoarthritis. In the case of musculoskeletal and osteoarthritis patients, the EQ-5D index score should be changed by at least 0.074, which is the minimal rate of improvement in the health-related quality of life
Upto 4 weeks

Collaborators and Investigators

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

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Rahat Afzal, MS-OMPT, Governement Teaching Hospital Shahdara Lahore.

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 (Estimated)

May 30, 2026

Primary Completion (Estimated)

June 30, 2026

Study Completion (Estimated)

August 30, 2026

Study Registration Dates

First Submitted

June 8, 2026

First Submitted That Met QC Criteria

June 8, 2026

First Posted (Actual)

June 12, 2026

Study Record Updates

Last Update Posted (Actual)

June 12, 2026

Last Update Submitted That Met QC Criteria

June 8, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR&AHS/25/0123 Malyka

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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