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

14 de julho de 2026 atualizado por: 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.

Visão geral do estudo

Descrição detalhada

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.

Tipo de estudo

Intervencional

Inscrição (Real)

26

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Locais de estudo

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

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

  • Adulto

Aceita Voluntários Saudáveis

Não

Descrição

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).

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Tratamento
  • Alocação: Randomizado
  • Modelo Intervencional: Atribuição Paralela
  • Mascaramento: Solteiro

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: 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

Experimental: 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

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
pain intensity
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
Quality of Life / Broader Function
Prazo: 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
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

25 de dezembro de 2025

Conclusão Primária (Real)

12 de maio de 2026

Conclusão do estudo (Real)

25 de maio de 2026

Datas de inscrição no estudo

Enviado pela primeira vez

23 de junho de 2026

Enviado pela primeira vez que atendeu aos critérios de CQ

14 de julho de 2026

Primeira postagem (Real)

17 de julho de 2026

Atualizações de registro de estudo

Última Atualização Postada (Real)

17 de julho de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

14 de julho de 2026

Última verificação

1 de julho de 2026

Mais Informações

Termos relacionados a este estudo

Plano para dados de participantes individuais (IPD)

Planeja compartilhar dados de participantes individuais (IPD)?

NÃO

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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