Effectiveness of Tibio-Femoral Manual Traction and Tibial Rotation in Patients with Knee Osteoarthritis For Improving Pain and Functional Abilities: A Comparison of Two Mobilization Techniques

Abstract

Knee osteoarthritis is becoming an increasingly evident cause of pain and functional disabilities throughout the world especially in women. It is a degenerative disease leading to changes in kinetic chain of lower limb. The role of manual therapy to treat this condition is under least discussion; especially the practice of Mulligan’s concept of manual therapy in improvement of this condition is almost negligible in Pakistan. Objective: To compare the effectiveness of two different mobilization techniques: - tibia-femoral manual traction and tibial rotation in patients with knee osteoarthritis for improving pain and functional abilities Methodology: This quasi experimental study with duration of 3 months was conducted after approval from the concerned institutes of study. A sample size of 42 was calculated using G power software for experimental sample size estimation. Participants with grade II-III osteoarthritis, medial side knee osteoarthritis, at least one symptomatic knee, and stiffness in knee were included, whereas participants with recent knee injury, knee strain, congenital knee deformity and ay previous knee surgery were excluded from the study. The data was collected after taking informed consent from the participant. Participants of study were divided into two groups, 21 group A osteoarthritis patients received mobilization with tibio-femoral manual traction intervention, while 21 group B patients received mobilization with tibial rotation.Two outcome measurement tools were used. Data regarding pain was gathered through McGill pain questionnaire, whereas data related to functional abilities was collected using WOMAC osteoarthritis index Results: Mean improvement in pain of Group A is 12.10 7.25 and Group B is 11.71 6.82 with P-value=0.862. Whereas improvement in functional abilities in group A is 10.62 7.97 and Group B is 35.68 10.68 with P-value= <0.001 Conclusion: Mobilization with tibio-femoral manual traction and tibial rotation were equally effective in improving pain. Whereas both techniques were effective in improving functional abilities but mobilization with tibial rotation is more effective as compared to mobilization with tibio-femoral manual traction