Effectiveness of Mulligan joint mobilizations and trunk stabilization exercises versus isometric knee strengthening in the management of knee osteoarthritis: study protocol for a randomized controlled trial

Abstract

Knee Osteoarthritis (KOA) patients have a huge negative impact on gait parameters and altered biomechanics in many components, including impairments of dynamic lower limb alignment and lumbopelvic movement control. The understanding of these components seems to be very crucial and there is need to add these unfocused components in treatment regimens in the research setting to see its effects; before using as a routine treatment regime in Clinical practice for patients with KOA. This study protocol focuses on whether Mulligan joint mobilization with movement provides evident effects on decreasing pain and restoring the joint biomechanics. Trunk stabilization exercises improve the stability of the trunk which distributes the weight of the body evenly on both feet biomechanically. The treatment effects of both treatments are inconclusive. Accordingly, the study aims to determine the efficacy of Mulligan joint mobilizations and trunk stabilization exercises versus isometric knee strengthening for KOA. It is a study protocol of a three-arm randomized control trial. Initial screening of the subjects will be carried out by a referring consultant. Subjects who fulfill the study criteria will be randomly allocated into three groups After an explanation of study objective and obtaining informed consent. Group 1 will receive mulligan mobilization with kinesiotaping and knee strengthening. Group 2 will receive trunk stabilization exercise, knee strengthening, and Kinesiotaping. Group 3 will receive knee strengthening along with kinesiotaping. All participants will be evaluated using visual analogue scale, Knee injury and Osteoarthritis Outcome Score, stair climb test and 6-minute walk test at 1st, 3rd and 6th week. The results of this study will answer a clearly focused question investigated in KOA patients. Finding of this study will serve as a guide to inform clinical decision making for healthcare professionals, researcher, and patients. Keywords: Osteoarthritis, knee joint, manual therapy, kinesiotape, exercise therapies, isometric contraction.