ORIGINAL
ARTICLE – abstractEfficacy
of mobilizations with movement in patients with knee osteoarthritis Evgeniya
Dimitrova NSA,
Department of Kinesitherapy, Sofia, Bulgaria
Abstract
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 NSAs 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 patients
condition in 36 patients (85,71% of cases). Application of Mulligans
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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