CHRONIC
DISEASE AND PHYSICAL ACTIVITY
EFFICACY
OF MOBILIZATIONS WITH
MOVEMENT IN PATIENTS WITH KNEE OSTEOARTHRITIS
Evgeniya
Dimitrova
NSA,
Department of
Kinesitherapy, Sofia, Bulgaria
INTRODUCTION. Knee
osteoarthritis is a disabling disease affecting approximately 1% of the
population. This study aims to establish whether mobilizations with
movement (MWM) included in physiotherapy program, is effective in
reducing pain and improving function in individuals diagnosed with knee
osteoarthritis.
MATERIAL AND
METHODS. 42 patients diagnosed by a physician as having knee
OA were treated in NSA physiotherapy department, DKC and
private practice between January 1999 and December 2007. Mean age of
patients was 61.9 years. A lot of patients were former professional
athletes. They had received an average of 16.9 treatments
including ice/heat, relaxation techniques, and active exercises,
strengthening program, education and dietary changes. The Mulligan
method of applying a combination of manual therapy techniques while
simultaneously performing an active or
passive movement was
tried on 24 patients (Group A) as addition to conventional
physiotherapy treatment. Eighteen others (Group B) were given
conventional physiotherapy treatment.
RESULTS. The statistical
analyses were carried out using an SPSS package. The results showed
initial objective improvements in the patient¢s condition in
36 patients (85,71% of cases). Application of Mulligan¢s
mobilizations with movement techniques in Group A produced immediate
pain relief after first treatment procedures (between 1 and 5.5 cm on
the visual analogue scale). The effects were sustained four weeks
later. Pain relief was not evident in those treated conventionally.
This study demonstrated that strengthening of knee musculature was more
effective after the MWM and was associated with significant improvement
(p<0.05) in quadriceps strength and function, when compared with
controls. As a result of treatment, 21 (87,5%) of the patients in Group
A displayed a considerable increase (on the average by 10-15°)
in knee range of motion and the average quadriceps strength ratio was
85% compared to healthy leg. At the six-month follow-up 19 (87,5%) of
the patients in Group A had maintained improvement in stair climbing,
level walking and sit-to-stand activities.
CONCLUSIONS. MWM
have been found to be feasible and efficacious in individuals with knee
osteoarthritis. The comparative analysis of two groups showed the
original physiotherapy method to be more efficient than the
conventional physiotherapy treatment. A high proportion of patients
with moderate to severe knee joint disease may experience continued
functional benefits from physiotherapy programme, despite the
poor outlook often associated with the disease.
Key
Words: osteoarthritis, knee, mobilizations with
movement,
physiotherapy.
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