Effects of the Egoscue Exercises With and Without Mwm Among Patients With Knee Osteoarthritis
Effects of the Egoscue Exercises With and Without Mwm on Pain, Range of Motion, Balance, and Quality of Life Among Patients With Knee Osteoarthritis
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Intervenção / Tratamento
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- Nome: Samrood Akram, PhD*
- Número de telefone: 03324806143
- E-mail: samrood.akram@riphah.edu.pk
Locais de estudo
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Punjab Province
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Lahore, Punjab Province, Paquistão, 54920
- Acme Medical Center
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Contato:
- Mujjaded Ashraf, MS-OMPT
- Número de telefone: 0332 8625526
- E-mail: acmemedicalcomolex@gmail.com
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Critérios de participação
Critérios de elegibilidade
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
Aceita Voluntários Saudáveis
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
- Finalidade Principal: Tratamento
- Alocação: Randomizado
- Modelo Intervencional: Atribuição Paralela
- Mascaramento: Solteiro
Número de braços
Armas e Intervenções
Grupo de Participantes / BraçoGrupo de Participantes / Braço |
Intervenção / TratamentoIntervenção / Tratamento |
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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.
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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.
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Comparador Ativo: 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.
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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
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O que o estudo está medindo?
Medidas de resultados primários
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
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Numeric Pain Rating Scale for pain
Prazo: upto 4 weeks
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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.
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upto 4 weeks
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Goniometer for ROM
Prazo: Upto 4 weeks
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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
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Upto 4 weeks
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Timed Up and Go - TUG Test
Prazo: Upto 4 weeks
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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
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Upto 4 weeks
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Euro Qol-5D-5L
Prazo: Upto 4 weeks
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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
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Upto 4 weeks
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Colaboradores e Investigadores
Patrocinador
Patrocinador
Investigadores
Investigadores
- Investigador principal: Rahat Afzal, MS-OMPT, Governement Teaching Hospital Shahdara Lahore.
Publicações e links úteis
Publicações Gerais
- Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. doi: 10.1056/NEJMcp1903768. No abstract available.
- Dantas LO, Salvini TF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther. 2021 Mar-Apr;25(2):135-146. doi: 10.1016/j.bjpt.2020.08.004. Epub 2020 Sep 8.
- Luan L, El-Ansary D, Adams R, Wu S, Han J. Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis. Physiotherapy. 2022 Mar;114:16-29. doi: 10.1016/j.physio.2021.10.001. Epub 2021 Oct 11.
- Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.
- Lee JHT, Kan MMP, Wong AKC. The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review. EFORT Open Rev. 2025 Jan 3;10(1):37-47. doi: 10.1530/EOR-2023-0209. Print 2025 Jan 1.
- Gelber AC. Knee Osteoarthritis. Ann Intern Med. 2024 Sep;177(9):ITC129-ITC144. doi: 10.7326/ANNALS-24-01249. Epub 2024 Sep 10.
- Hattori T, Ohga S, Shimo K, Matsubara T. Pathology of knee osteoarthritis pain: contribution of joint structural changes and pain sensitization to movement-evoked pain in knee osteoarthritis. Pain Rep. 2024 Jan 24;9(1):e1124. doi: 10.1097/PR9.0000000000001124. eCollection 2024 Jan.
- Kokkotis C, Moustakidis S, Baltzopoulos V, Giakas G, Tsaopoulos D. Identifying Robust Risk Factors for Knee Osteoarthritis Progression: An Evolutionary Machine Learning Approach. Healthcare (Basel). 2021 Mar 1;9(3):260. doi: 10.3390/healthcare9030260.
- Szilagyi IA, Waarsing JH, Schiphof D, van Meurs JBJ, Bierma-Zeinstra SMA. Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females. Rheumatology (Oxford). 2022 Feb 2;61(2):648-657. doi: 10.1093/rheumatology/keab378.
- Nelson AE, Hu D, Arbeeva L, Alvarez C, Cleveland RJ, Schwartz TA, Murphy LB, Helmick CG, Callahan LF, Renner JB, Jordan JM, Golightly YM. The Prevalence of Knee Symptoms, Radiographic, and Symptomatic Osteoarthritis at Four Time Points: The Johnston County Osteoarthritis Project, 1999-2018. ACR Open Rheumatol. 2021 Aug;3(8):558-565. doi: 10.1002/acr2.11295. Epub 2021 Jul 10.
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