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Effectiveness of Joint Distraction Versus Passive End Range Overpressure in Osteoarthritis:

14. juli 2026 oppdatert av: Dr Noreen Sher Muhammad, University of Faisalabad

Comparative Effectiveness of Joint Distraction Versus Passive End Range Overpressure in Managing Knee Osteoarthritis: A Randomized Clinical Trial

Knee osteoarthritis was a common degenerative joint condition that caused pain, stiffness, reduced range of motion, and functional limitations. This study compared two manual therapy techniques: Joint Distraction and Passive Joint End-Range Overpressure. The goal was to determine which technique was more effective at reducing pain, improving knee range of motion, enhancing function, and improving quality of life in patients with knee osteoarthritis. Participants were randomly assigned to receive either Joint Distraction or Passive Joint End-Range Overpressure for 4 weeks.

Studieoversikt

Detaljert beskrivelse

This study was a randomized clinical trial. A sample of 26 participants aged 40-60 with Grade 2 or Grade 3 Knee Osteoarthritis was recruited from DHQ Hospital and Madinah Teaching Hospital Faisalabad. Participants were randomly assigned to two groups (n=13 each). Group A received the Joint Distraction Technique involving sustained traction of the knee joint for 20 minutes at the patient's perceived threshold. Group B received Passive Joint End-Range Overpressure involving Maitland Grade IV mobilization for 3 minutes, twice, with a 30-second rest interval. Both groups received a 10-minute hot pack before their respective techniques. Interventions occurred 3 times per week for 4 weeks (12 sessions total). Outcome measures included the Visual Analogue Scale (VAS), Goniometer, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Scale (KOOS), measured at baseline and after 4 weeks.

Studietype

Intervensjonell

Registrering (Faktiske)

26

Fase

  • Ikke aktuelt

Kontakter og plasseringer

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Studiesteder

    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 3800
        • The University of Faisalabad

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Voksen

Tar imot friske frivillige

Nei

Beskrivelse

Inclusion Criteria

  • Patients diagnosed with Grade 2 or Grade 3 Knee Osteoarthritis.
  • A Kellgren-Lawrence Grade (KLG) of at least 2.
  • Age between 40-60 years.
  • Knee pain for at least 6 months.
  • A minimum pain score of 3 on the Visual Analogue Scale (VAS).

Exclusion Criteria

  • Acute inflammation.
  • Total Knee Replacement (TKR) surgery.
  • Any lumbar spine disease (disc herniation or lumbar stenosis).
  • Intra-articular injection.
  • Recent tibia or femur fracture.
  • Any systemic inflammatory arthritic condition or neurological condition (e.g., rheumatoid arthritis or stroke).

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: GROUP A
The joint distraction is the manual approach in knee osteoarthritis. This is very efficient in managing pain, to increase range of motion and reduce stiffness of joint due to osteoarthritis.

The joint distraction is the manual approach in knee osteoarthritis. This is very efficient in managing pain, to increase range of motion and reduce stiffness of joint due to osteoarthritis. A specialized greave would be created to distract the knee joint.

Using a platform beneath the lower leg to create counterpressure, the knee would be put in flexion while sustained traction will be performed for 20 minutes while the patient would be in a supine posture. In each session, the traction would be adjusted to the patients' perceived threshold. The least amount of work that caused patients to get distracted would be employed as a diversion

Eksperimentell: GROUP B
The passive joint end-range overpressure is the technique of Maitland grade IV which is performed passively. End-range Individual Maitland mobilizations were carried out at the tibiofemoral joint.
The passive joint end-range overpressure is the technique of Maitland grade IV which is performed passively. End-range Individual Maitland mobilizations were carried out at the tibiofemoral joint. Depending on the patient's level of pain and tolerance, an oscillatory accessory approach using Grade III or IV was carried out. Patients positioned their knees in their true end range while lying supine on the plinth. The most limited or reproducible knee pain was caused by the accessory approach that was employed. By moving the therapist's body without making any additional movements, the physical contact accurately replicated the hand position of the mobilization. For three minutes, Maitland mobilization was carried out twice at a rate of one oscillation every one or two seconds, with a 30-second break in between

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
pain intensity
Tidsramme: 4 months

Primary Outcome Measure Pain Tool Used: Visual Analogue Scale (VAS)

The Visual Analogue Scale (VAS) was used to assess the patient's pain level. Participants were asked to rate their pain on a scale from 0 to 10.

0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe pain This scale was used to categorize the intensity of pain experienced by patients with knee osteoarthritis.

4 months

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Quality of Life / Broader Function
Tidsramme: 4 months

Quality of Life / Broader Function Tool Used: KOOS Questionnaire (Knee Injury and Osteoarthritis Outcome Scale.

The KOOS questionnaire was used to assess:

Pain Symptoms Activities of Daily Living (ADLs) Sport and Recreation Function Knee-related Quality of Life

It contains 42 items divided into five sections:

Pain = 9 items Symptoms = 7 items Activities of Daily Living = 17 items Sport and Recreation Function = 5 items Quality of Life = 4 items

Each item is scored from 0 to 4.

Maximum score:

42 items × 4 = 168

Interpretation (Percentage Based):

< 40% = Extreme disability 40-59% = Severe problems 60-79% = Moderate problems 80-99% = Mild disability This questionnaire evaluates the overall impact of knee osteoarthritis on function and quality of life.4 months

4 months
Disability
Tidsramme: 4 months

Secondary Outcome Measures

1) Osteoarthritis Symptoms and Functions Tool Used: WOMAC Questionnaire (Western Ontario McMaster Universities Osteoarthritis Index)

The WOMAC questionnaire was used to assess:

Pain Stiffness Physical function

It contains 24 items divided into three sections:

Pain = 5 items Stiffness = 2 items Physical Function = 17 items Each question has 5 response options ranging from None to Extreme.

Scoring:

Each item = 0-4 points Pain section total = 20 Stiffness section total = 8 Physical function section total = 68 Total WOMAC score = 96

Interpretation:

0-30 = Mild 31-60 = Moderate 61-96 = Severe The higher the score, the greater the symptoms and functional limitations.

4 months
Passive Range of Motion
Tidsramme: 4 months

Passive Range of Motion Tool Used: Goniometer

A goniometer was used to assess joint range of motion.

The instrument consists of three parts:

Moving Arm - aligned with the body segment that moves. Stationary Arm - aligned with the body segment that remains stationary. Fulcrum - positioned over the joint being assessed.

The goniometer was used to measure the knee joint's range of motion before and after treatment.

4 months

Samarbeidspartnere og etterforskere

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Studierekorddatoer

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Studer hoveddatoer

Studiestart (Faktiske)

25. desember 2025

Primær fullføring (Faktiske)

12. mai 2026

Studiet fullført (Faktiske)

25. mai 2026

Datoer for studieregistrering

Først innsendt

23. juni 2026

Først innsendt som oppfylte QC-kriteriene

14. juli 2026

Først lagt ut (Faktiske)

17. juli 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

17. juli 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

14. juli 2026

Sist bekreftet

1. juli 2026

Mer informasjon

Begreper knyttet til denne studien

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