Effect of Hip Versus Spinal Joint Mobilization on Hip Muscle Strength

NCT02700594 | Completed

• 1 other identifier: S13-00683
• Study Type: interventional
• Target: 28
• Locations: 0 countries
• Sites: N/A

Brief Summary

Patients with painful knee conditions often present with hip muscle weakness. This weakness can lead to, and perpetuate, knee problems. Diminished strength causes movement impairments that can lead to pathology, functional limitations and disablement. In some cases, this hip muscle weakness is not caused by simple disuse and muscle shrinkage (atrophy). Hip weakness may be caused by an inhibitory mechanism that limits the force output of a muscle. The inhibition is reflexive and is in response to pain or joint dysfunction. Joint mobilization/manipulation can quickly reduce pain and improve joint function, possibly decreasing inhibition and increasing strength. Joint mobilization/manipulation may facilitate strength recovery. By restoring strength sooner, the patient may avoid the deleterious effects of prolonged muscle weakness and achieve quicker or better outcomes.

Conditions

Joint; Derangement, Knee

Outcome Measures

Primary Outcomes (1)

• Change in strength from baseline to immediately after intervention (maximum voluntary contraction (MVC) and measured by an electronic hand-held dynamometer)

  The primary dependent variable is the isometric muscle strength, measured in pounds, an interval level of measurement. Muscle strength will be determined by the maximum voluntary contraction (MVC) and measured by an electronic hand-held dynamometer

  1 Hour

Secondary Outcomes (1)

• Change in pain from baseline to immediately after intervention (numeric pain rating scale (NRPS)

  1 Hour

Study Arms (2)

Hip mobilization

ACTIVE COMPARATOR

Prone posterior-to-anterior Grade IV hip joint mobilization: The subject will be placed in prone on a treatment table. The intervening physical therapist will place the heel of his hand on the greater trochanter of the femur on the involved side provide rhythmic anterior-directed force. The subject will receive 3 bouts of 30 seconds of continuous mobilizations with 10 seconds rest in between bouts. For the prone posterior-to-anterior Grade IV hip joint mobilization, the intervening therapist will perform all 3 bouts in the same position.

Other: Joint mobilization

Spine mobilization

ACTIVE COMPARATOR

Prone unilateral posterior-to-anterior Grade IV lumbar spinal joint mobilization: The subject will be placed in prone on the treatment table. The intervening physical therapist will place his thumbs on the transverse process, on the affected side, of the L3, L4 or L5 vertebrae and provide a rhythmic anterior-directed force. Prone unilateral posterior-to-anterior Grade IV lumbar spinal joint mobilization, the intervening therapist will perform 1 bout on each of L3, L4 and L5 for a total of 3 bouts

Other: Joint mobilization

Interventions

Joint mobilization OTHER

Mobilization and manipulation are manual therapy techniques" comprising a continuum of skilled passive movements to the joints and/or related soft tissues that are applied at varying speeds and amplitudes, including a small-amplitude/high- velocity therapeutic movement."16 The term joint mobilization, or nonthrust mobilization, often refers to slow, "rhythmic, repetitive passive movements to the patients' tolerance, in voluntary and/or accessory range and graded according to examination findings."

Hip mobilization; Spine mobilization

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age18-75
• Referred to out-patient physical therapy for evaluation/treatment of a knee condition
• Agreed to be in the study and signed the informed consent document

You may not qualify if:

• Presence of any medical 'red flags' suggestive of pain that is not of musculoskeletal origin
• Osteoporosis or recent fracture of the hip or spinal joints
• Spinal or hip joint surgery or prosthesis
• Spinal instability (Grade II spondylolithesis or greater), spondyloarthritides, or severe spinal misalignment
• Nervous system disease or disorder
• Pregnant

Sponsors & Collaborators

• NYU Langone Health: lead

Related Publications (2)

• Bialosky JE, Bishop MD, Price DD, Robinson ME, George SZ. The mechanisms of manual therapy in the treatment of musculoskeletal pain: a comprehensive model. Man Ther. 2009 Oct;14(5):531-8. doi: 10.1016/j.math.2008.09.001. Epub 2008 Nov 21.

  PMID: 19027342 BACKGROUND

• Makofsky H, Panicker S, Abbruzzese J, Aridas C, Camp M, Drakes J, Franco C, Sileo R. Immediate Effect of Grade IV Inferior Hip Joint Mobilization on Hip Abductor Torque: A Pilot Study. J Man Manip Ther. 2007;15(2):103-10. doi: 10.1179/106698107790819927.

  PMID: 19066650 BACKGROUND

Study Officials

• Angela Stolfi, DPT

  Rusk PT Director

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: September 23, 2014
• First Posted: March 7, 2016
• Study Start: October 1, 2013
• Primary Completion: July 1, 2014
• Study Completion: July 1, 2014
• Last Updated: March 7, 2016

Record last verified: 2016-03