Effects of MWM Vs Sustained Mobilization on Knee Osteoarthritis

NCT07315464 | Not Yet Recruiting DMC

• 1 other identifier: LCPT/DPT/ERB/35 FAKIHA
• Study Type: interventional
• Target: 68
• Locations: 1 country
• Sites: 1

Brief Summary

This article focused on people diagnosed with grade III Knee OA with sample size of 68 patients , who will randomly divided into two groups . Group A received Mulligan's MWM while group B received Kaltenborn's Sustained Mobilization along with eccentric exercises. The goal of the study was to compare the effectiveness of these two treatment conditions in reducing knee pain and improving joint function decreasing disability in daily activities. The patients followed a structured treatment plan over a set period and outcomes will measured using reliable clinical tools such as NPRS for pain KOOS for functional disability and Goniometer for ROM.

Conditions

Knee Osteoarthritis

Keywords

Knee Osteoarthritis; Mobilization with Movement (MWM); Sustained Mobilization; Eccentric Exercises; Kellgren-Lawrence (KL) system; Numeric Pain Rating Scale (NPRS); Knee Injury and Osteoarthritis Outcome Score (KOOS)

Outcome Measures

Primary Outcomes (2)

• Pain Intensity

  The tool used for accessing pain is NPRS. The Numeric Pain Rating Scale (NPRS) is a widely used subjective measure for assessing pain intensity, where participants rate pain on a scale from 0 to 10. A score of 0 indicates no pain, while 10 represents the worst pain imaginable. The NPRS is simple, quick to administer, and highly useful for tracking changes in pain levels over time, evaluating treatment effectiveness, and guiding clinical decision-making. Its reliability and ease of use make it a standard tool in both clinical practice and research settings. Both MWM and Sustained Mobilization aim to reduce pain. The time frame for assessing pain is 4 weeks . While investigator aim to measure at baseline , week 2 and week 4 .

  4 weeks

• Functional Disability

  The tool used for accessing functional disability is KOOS. The KOOS is a comprehensive, patient-reported outcome measure used to evaluate symptoms, functional limitations, and quality of life in individuals with knee injuries or knee osteoarthritis. It includes five subscales: Pain, Symptoms, Activities of Daily Living (ADL), Sport and Recreation Function, and Knee-related Quality of Life. Each item is scored on a 5-point Likert scale and then converted to a 0-100 scale, where 0 represents extreme knee problems and 100 indicates no knee problems. Each subscale is scored independently, allowing clinicians and researchers to assess specific domains of knee function and monitor changes over time. The KOOS is valued for its sensitivity to both short-term and long-term functional outcomes. While invesyigator aim to measure at baseline , week 2 and week 4 .

  4 weeks

Secondary Outcomes (1)

• ROM

  4 weeks

Study Arms (2)

Mulligan Mobilization

EXPERIMENTAL

This group will hold intervention for MWM including passive glides while the eccentric exercises includes slow controlled squats

Other: mulligan moblization

Kaltenborn Mobilization

ACTIVE COMPARATOR

This arm's intervention includes grade II traction and eccentric loading

Other: kaltenborn moblization

Interventions

mulligan moblization OTHER

This group will receive total 3 sessions / week (9-12 sessions) Intensity includes Accessory Glide with pain free active knee motion + moderate intensity eccentric loading Type includes Mulligan MWM ( Passive Glide during active knee flexion/extension + Eccentric Quadricpes Exercises (Slow Controlled Squats ) Time 30-45 mins

Also known as: slow controlled squats

Mulligan Mobilization

kaltenborn moblization OTHER

This group will receive frequency of 3 session/ week (9-12 sessions) Intensity includes Kaltenborn Grade II Traction according to pain tolerance + Moderate Intensity Eccentric Loading Type of Exercise includes Sustained Joint Mobilization in loose pack position + Quadriceps Exercises (Slow step down ) Time 35-45 mins

Also known as: Eccentric Loading

Kaltenborn Mobilization

Eligibility Criteria

• Age: 45 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age between 45 and 70 years Both male and female patients with a history of knee osteoarthritis were selectedfor this study. Clinically and radiologically diagnosed with Grade III Knee Osteoarthritis (basedon Kellgren and Lawrence scale).
• Meets ACR criteria for knee OA

You may not qualify if:

• History of knee or lower limb surgery Received corticosteroid injections (oral or intra-articular) in the past 6 months Other musculoskeletal conditions in the lower limb(e.g., fracture, bursitis, back pain with radiating symptoms) Diagnosed with inflammatory joint diseases (e.g., rheumatoid arthritis, gout) Neurological conditions affecting lower limbs (e.g., stroke, neuropathy) BMI \> 35 (severe obesity) that limits safe participation in exercises Any contraindications to manual therapy (e.g., malignancy, infection, unstablejoint)

Sponsors & Collaborators

• Lahore University of Biological and Applied Sciences: lead

Study Sites (1)

Mayo hospital, Ghurki Trust Teaching Hospital

Lahore, Punjab Province, 54600, Pakistan

Location

Related Publications (4)

• Vincent KR, Vincent HK. Concentric and Eccentric Resistance Training Comparison on Physical Function and Functional Pain Outcomes in Knee Osteoarthritis: A Randomized Controlled Trial. Am J Phys Med Rehabil. 2020 Oct;99(10):932-940. doi: 10.1097/PHM.0000000000001450.

  PMID: 32324615 BACKGROUND

• Heidari B. Knee osteoarthritis prevalence, risk factors, pathogenesis and features: Part I. Caspian J Intern Med. 2011 Spring;2(2):205-12.

  PMID: 24024017 BACKGROUND

• Kataria Sweta Shah, K., Effect of Kaltenborn Traction versus Mulligan Mobilization with Movement as an adjunct to Conventional Exercise on Pain and Functions in Knee Osteoarthritis. International Journal of Science and Research (IJSR), 2023. 12(3): p. 1178-1182.

  BACKGROUND

• Gul, H. and I. Tahir, EFFECTS OF MULLIGAN ROTATIONAL MOVEMENT VERSUS MEDIAL GAPPING TECHNIQUE ON PAIN, RANGE OF MOTION AND DISABILITY IN PATIENTS WITH KNEE OSTEOARTHRITIS. Pakistan Journal of Rehabilitation, 2024. 13(1): p. 99-110.

  BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Knee Injuries

Condition Hierarchy (Ancestors)

Osteoarthritis; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Leg Injuries; Wounds and Injuries

Central Study Contacts

Fakiha Nayab, DPT

CONTACT

03245399916; fakihamughal90@gmail.com

Wafa Mansha, MS NMPT

CONTACT

03266303005; wafamalik583@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: This study used a single-blinded design. Participants will be blinded to group allocation to minimize performance bias. Group assignment will be concealed through sealed, opaque, sequentially numbered envelopes, opened only after baseline assessment by an independent physiotherapist. The treating therapist will not be blinded due to the nature of manual therapy interventions. However, all outcome measurements-including pain, disability, and range of motion will be recorded by a separate blinded assessor to reduce detection bias.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: This study follows a Randomized Controlled Trial (RCT) model designed to compare the effectiveness of Mobilization with Movement (MWM) and Sustained Mobilization (Kaltenborn), each combined with eccentric exercises, in patients with Grade III knee osteoarthritis. Participants will be randomly allocated into two intervention groups using a computer-generated sequence with block randomization to ensure equal group sizes. A single-blinded approach will be used, where participants will unaware of group assignment, while outcome assessments were performed by an independent blinded evaluator. This model allows controlled comparison of both mobilization techniques on pain reduction, functional improvement, and range of motion.

Study Record Dates

• First Submitted: December 8, 2025
• First Posted: January 2, 2026
• Study Start: December 30, 2025
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: January 2, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)