End-range Mobilization on Pressure Pain Threshold

University of Pecs40 enrolled

Overview

Pain in knee osteoarthritis (OA) represents increased pain intensity due to peripheral and central sensitivity. Pressure pain threshold (PPT) is a widely applied (used) method for measuring the magnitude of peripheral and central sensitivity in knee OA. Among several manual therapy techniques increasing PPT in knee OA, the effect of end-range mobilization has not been evaluated so far. The aim of this study was to investigate the immediate effect of end-range mobilization compared to placebo on increase of PPT and some function-related measures.

Knee osteoarthritis (OA) is the most common form of arthritis contributing to a major cause of disability worldwide. Although many mechanisms may contribute to knee pain severity, the patient-reported hyperalgesia can be attributed to peripheral and central sensitivity in knee OA. Pressure pain threshold (PPT) measurement is a simple and commonly applied method for measuring somatosensory function in musculoskeletal disorders, just as in knee OA. Many trials have shown a lower PPT value in knee OA underlining the presence of peripheral and central sensitivity compared to healthy controls. Manual therapy techniques, as a preferred treatment option, may not only alleviate pain, but also increase pain tolerance to locally applied mechanical pressure. Positive results of different manual therapy techniques on increase of PPT has been reported in knee OA. End-range manual therapy is an option for the decrease of sensitivity in knee OA; however, the effect of end-range mobilization has not been evaluated so far in knee OA.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Knee Osteoarthritis

Interventions

End-range mobilizationPROCEDURE

End-range mobilization performed in end-range of the tibiofemoral joints' flexion and extension

Placebo techniquePROCEDURE

Hands-on technique performed in end-range of the tibiofemoral joints' flexion and extension

Eligibility

Sex: FEMALEMin age: 60 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * the clinical classification criteria of knee OA according to the American College of Rheumatology * Categorization of patients as End Of Range Problem based on Maitland manual therapy * female patients aged between 60 and 80 years * uni/bilateral moderate-to-severe symptomatic tibiofemoral knee osteoarthritis with radiographic evidence of Kellgren-Lawrence scale 2 or 3 * pain during weight-bearing activities at least within 6 months * at least 90° knee flexion * sufficient mental status. Exclusion Criteria: * acute inflammation of the knee * total knee replacement in the opposite side * severe degenerative lumbar spine disease (e.g. spondylolisthesis) * systemic inflammatory arthritic or neurological condition * physiotherapy/balneotherapy attendance or manual therapy within 3 months * intraarticular injections in the prior 12 months * use of walking aids * contraindication for manual therapy * complex regional pain syndrome * cognitive impairment

Locations (1)

Miklós Pozsgai

Harkány, Please Select, Hungary

Outcomes

Primary Outcomes

PPT of the knee

pressure pain threshold at the knee

Time frame: 30 minutes

Secondary Outcomes

PPT of the m. Extensor Carpi Radialis Longus (ECRL)

pressure pain threshold at the ECRL

Time frame: 30 minutes

General Pain Intensity

General Pain Intensity measured with Visual Analogue Scale (VAS)

Time frame: 30 minutes

Timed Up and Go test

Timed Up and Go test measuring functional capacity

Time frame: 30 minutes

Pain intensity during Timed Up and Go test

associated pain intensity during the Timed Up and Go test

Time frame: 30 minutes

Passive tension of the knee

Passive tension of the knee at the beginning of pain

Time frame: 30 minutes

Data from ClinicalTrials.gov

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