The effect of tibio-femoral traction mobilization on passive knee flexion motion impairment and pain: a case series

Abstract

The purpose of this case series was to explore the effects of tibio-femoral (TF) manual traction on pain and passive range of motion (PROM) in individuals with unilateral motion impairment and pain in knee flexion. Thirteen participants volunteered for the study. All participants received 6 minutes of TF traction mobilization applied at end-range passive knee flexion. PROM measurements were taken before the intervention and after 2, 4, and 6 minutes of TF joint traction. Pain was measured using a visual analog scale with the TF joint at rest, at end-range passive knee flexion, during the application of joint traction, and immediately post-treatment. There were significant differences in PROM after 2 and 4 minutes of traction, with no significance noted after 4 minutes. A significant change in knee flexion of 25.9°, which exceeded the MDC(95,) was found when comparing PROM measurements pre- to final intervention. While pain did not change significantly over time, pain levels did change significantly during each treatment session. Pain significantly increased when the participant's knee was passively flexed to end range; it was reduced, although not significantly, during traction mobilization; and it significantly decreased following traction. This case series supports TF joint traction as a means of stretching shortened articular and periarticular tissues without increasing reported levels of pain during or after treatment. In addition, this is the first study documenting the temporal aspects of treatment effectiveness in motion restoration.

Keywords: Knee; Pain; Range of motion; Tibio-femoral joint; Traction mobilization.

Figures

Figure 1

Rest position – knee in slight flexion.

Figure 2

End-range passive knee flexion.

Figure 3

Application of TF traction at end-range passive knee flexion.

Figure 4

Knee flexion PROM before intervention and after 2, 4, and 6 minutes of traction.

Figure 5

Knee flexion PROM comparing data collection points across seven treatment sessions.

Figure 6

Mean VAS scores at rest, during passive end-range knee flexion, after traction, and after intervention. Rest 1: before intervention (participant prone, knee slightly flexed); flexion: end-range passive knee flexion (before intervention); traction: after 6 minutes of traction intervention; rest 2: post-intervention (participant’s knee returned to rest 1 position).