Mulligan and Maitland Techniques in Post PRP Knee Osteoarthritis

NCT06460168 | Completed

• 1 other identifier: REC/RCR&AHS/23/01102
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis (OA) is a major cause of disability nowadays. Osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage. It is most common in elderly people and can be divided into two types, primary and secondary. Platelet-rich plasma (PRP) is an autologous blood product that contains a high concentration of platelets, specifically, 3 to 5 times that of normal blood. PRP contains a high concentration of autogenous growth factors, including vascular endothelial growth factor, platelet-derived growth factor, and transforming growth factor-β, which promote the proliferation of chondrocytes and the synthesis of the extracellular matrix. PRP is increasingly being used in the field of sports injury because of its simple preparation method, low cost, and high degree of safety A randomized clinical trial will be conducted at Ibne Sina Hospital,Multan. Non probability convenience sampling technique will be applied to enroll patients who will be allocated through computerized randomization into group A \& group B to collect data. Sample size will be 36. This will be allocated to three groups through lottery method. Group A will be given MWM and group B will be given Maitland techniques while Group C will receive only baseline treatment. The study will be completed within the time duration of ten months. Primary Outcome measures of the research will be Pain, Range of motion, functional status. Data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-wilk test, it will be decided either parametric or non-parametric test will be used within a group or between two groups.

Conditions

Knee Osteoarthritis

Keywords

Knee joint; exercise; Mulligan exercise; Osteoarthritis; prp

Outcome Measures

Primary Outcomes (3)

• Numeric Pain Rating scale(NPRS)

  The Numeric Pain Rating Scale (NPRS) is used to assess pain. On an 11-point Numeric scale, 0 represents the least amount of pain (no pain) and 10 Represents the most amount of pain (worst pain)

  6 weeks

• Range of motion(ROM)

  It is frequently employed as a benchmark technique for the assessment of (ROM) as the main component of all joint motions. The range of mobility of a joint is measured using a device known as a goniometer. Goniometry is the art and science of measuring the joint ranges in every plane of the joint. Short arm and long arm versions of the universal goniometer are available. Goniometric measurements are highly reliable provided measurements are conducted by the same therapist. Knee ranges will be taken by a Universal Goniometer

  6 weeks

• Functional disability

  The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a widely used, proprietary set of standardized questionnaires used by health professionals to evaluate the condition of patients with osteoarthritis of the knee and hip, including pain, stiffness, and physical functioning of the joints. It is a self-administered questionnaire consisting of 24 items divided into 3 subscales: Pain (5 items): during walking, using stairs, in bed, sitting or lying, and standing upright. The test questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). The scores for each subscale are summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function.

  6 week

Study Arms (3)

Mulligan(MWM) Technique

EXPERIMENTAL

Group of post prp knee osteoarthritis patients are given Mulligan (MWM) Mobilization technique

Other: Mulligan(MWM) MobilizationTechnique

Maitland Technique

ACTIVE COMPARATOR

Patients are given Maitland Mobilization technique.

Other: Maitland Mobilization technique

Baseline treatment

NO INTERVENTION

This group are given baseline treatment.

Interventions

Mulligan(MWM) MobilizationTechnique OTHER

Mulligan Mobilization program in MWM , a therapist-applied pain free accessory gliding force combined with active movement. No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session) No of repetitions; 3 sets for 10 repetitions with 1 minute rest between sets.

Mulligan(MWM) Technique

Maitland Mobilization technique OTHER

will receive (Maitland mobilization program manipulative physiotherapy in which chain of oscillatory joint mobilization grades l-lV based on the pathological limit of tissue are used) In this, the exercises will be performed in 3 sets and 10 repetitions with 5-10s hold and 30s to 1min rest between repetitions. No Of Sessions Per Week: 3 Per Weeks for 6 weeks (50 Min per Session)

Maitland Technique

Eligibility Criteria

• Age: 28 Years - 55 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Age group 28-55 years
• Male and female
• Grade 2,3,4 of knee osteoarthritis
• Post PRP Osteoarthritic knee joints included
• After 1st month of Post PRP, patients will be included in study

You may not qualify if:

• History of surgery of the affected knee
• Infection
• Malignancy
• Non Osteoarthritic joints excluded

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ibne Sina Hospital Multan

Multan, Punjab Province, 59070, Pakistan

Location

Related Publications (7)

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  PMID: 28615732 BACKGROUND

• Yin P, Jiang Y, Fang X, Wang D, Li Y, Chen M, Deng H, Tang P, Zhang L. Cell-Based Therapies for Degenerative Musculoskeletal Diseases. Adv Sci (Weinh). 2023 Jul;10(21):e2207050. doi: 10.1002/advs.202207050. Epub 2023 May 18.

  PMID: 37199688 BACKGROUND

• Shah S, Danda D, Kavadichanda C, Das S, Adarsh MB, Negi VS. Autoimmune and rheumatic musculoskeletal diseases as a consequence of SARS-CoV-2 infection and its treatment. Rheumatol Int. 2020 Oct;40(10):1539-1554. doi: 10.1007/s00296-020-04639-9. Epub 2020 Jul 14.

  PMID: 32666137 BACKGROUND

• Bruyere O, Honvo G, Veronese N, Arden NK, Branco J, Curtis EM, Al-Daghri NM, Herrero-Beaumont G, Martel-Pelletier J, Pelletier JP, Rannou F, Rizzoli R, Roth R, Uebelhart D, Cooper C, Reginster JY. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019 Dec;49(3):337-350. doi: 10.1016/j.semarthrit.2019.04.008. Epub 2019 Apr 30.

  PMID: 31126594 BACKGROUND

• Diez-Perez A, Brandi ML, Al-Daghri N, Branco JC, Bruyere O, Cavalli L, Cooper C, Cortet B, Dawson-Hughes B, Dimai HP, Gonnelli S, Hadji P, Halbout P, Kaufman JM, Kurth A, Locquet M, Maggi S, Matijevic R, Reginster JY, Rizzoli R, Thierry T. Radiofrequency echographic multi-spectrometry for the in-vivo assessment of bone strength: state of the art-outcomes of an expert consensus meeting organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res. 2019 Oct;31(10):1375-1389. doi: 10.1007/s40520-019-01294-4. Epub 2019 Aug 17.

  PMID: 31422565 BACKGROUND

• O'Connell NE, Smith KJ, Peterson MD, Ryan N, Liverani S, Anokye N, Victor C, Ryan JM. Incidence of osteoarthritis, osteoporosis and inflammatory musculoskeletal diseases in adults with cerebral palsy: A population-based cohort study. Bone. 2019 Aug;125:30-35. doi: 10.1016/j.bone.2019.05.007. Epub 2019 May 8.

  PMID: 31075418 BACKGROUND

• Bonanni R, Cariati I, Tancredi V, Iundusi R, Gasbarra E, Tarantino U. Chronic Pain in Musculoskeletal Diseases: Do You Know Your Enemy? J Clin Med. 2022 May 6;11(9):2609. doi: 10.3390/jcm11092609.

  PMID: 35566735 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Motor Activity; Osteoarthritis; Insomnia, Fatal Familial

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Behavior; Prion Diseases; Central Nervous System Infections; Infections; Central Nervous System Diseases; Nervous System Diseases; Neurodegenerative Diseases; Sleep Initiation and Maintenance Disorders; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders

Study Officials

• Muqaddas Shareef, DPT

  Riphah International University

  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: June 11, 2024
• First Posted: June 14, 2024
• Study Start: December 15, 2024
• Primary Completion: June 1, 2025
• Study Completion: June 11, 2025
• Last Updated: July 4, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)