Effects of the Egoscue Exercises With and Without Mwm Among Patients With Knee Osteoarthritis

NCT07646366 | Not Yet Recruiting

• 1 other identifier: REC/RCR&AHS/25/0123 Malyka
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

Knee osteoarthritis is a common degenerative joint disorder characterized by joint pain, stiffness, limited mobility, and reduced quality of life. It primarily affects the elderly population and poses a major burden on functional independence and healthcare resources. While various physiotherapy approaches have shown benefits in managing KOA symptoms, Mulligan's Mobilization with Movement is a manual therapy technique that has gained clinical attention for improving pain and joint mechanics. Similarly, Egoscue postural alignment exercises, which focus on restoring musculoskeletal balance through corrective movement patterns, have shown potential in addressing chronic pain and postural dysfunction, though evidence remains limited in knee osteoarthritis populations. This study aims to evaluate the effects of Egoscue exercises with and without MWM on pain, range of motion, balance, and quality of life in patients with knee osteoarthritis

Conditions

Knee Osteoarthritis

Keywords

Osteoarthritis, pain, range of motion

Outcome Measures

Primary Outcomes (4)

• Numeric Pain Rating Scale for pain

  The Numerical Pain Rating Scale (NPRS) is an 11-point scale, in which patients rate their pain in levels ranging between 0 (no pain) and 10 (worst imaginable pain). It is common because it is simple, has high test-retest reliability (ICC = 0.95) and responsiveness in musculoskeletal disorders, such as in knee osteoarthritis. A minimum of 2 points on NPRS is termed the minimal clinically important difference (MCID) on patients with musculoskeletal pain even with KOA.

  upto 4 weeks

• Goniometer for ROM

  Goniometry is a clinical instrument that can be used to evaluate the joint angles both in active and passive range of motion. It is said to be valid in knee flexion and extension (ICC values range between 0.85 and 0.99 with respect to experience of examiners), with a standard error of measurement of approximately 3-5 degrees. The MCID of range of motion may depend on the improvement in the range of motion; the range of improvement of at least 5-10 degrees in the knee flexion or extension is usually regarded as clinically significant in patients with KOA

  Upto 4 weeks

• Timed Up and Go - TUG Test

  Timed Up and Go (TUG) test refers to the time that the person requires to be seated on a chair, stand up, walk three meters, turn around, walk back, and reseat. It is a valid and reliable (ICC = 0.99) indicator of dynamic balance and functional mobility, with a sensitivity of 87% and specificity of 87% of predicting fall risk in older people. TUG is frequently employed to evaluate the improvement of balance and fall prevention in KOA patients. A difference of about 0.8 to 1.4 seconds is reported to be an MCID in older adults and KOA populations, which is a significant reduction in mobility and risk of falls

  Upto 4 weeks

• Euro Qol-5D-5L

  The EQ-5D is a standardized instrument that assesses the quality of life related to health in five dimensions which are mobility, self-care, normal activities, pain/discomfort and anxiety/depression. It is well-construct valid and test-retest reliable (ICC = 0.86 -0.90), and sensitive to clinical changes in chronic arthritis such as osteoarthritis. In the case of musculoskeletal and osteoarthritis patients, the EQ-5D index score should be changed by at least 0.074, which is the minimal rate of improvement in the health-related quality of life

  Upto 4 weeks

Study Arms (2)

Egoscue exercises with MWM

EXPERIMENTAL

Combining the Egoscue Method and Mobilization with Movement (MWM) for knee osteoarthritis (OA) is a powerful, evidence-based approach. Egoscue corrective exercises restore whole-body postural alignment, while MWM-a manual therapy technique pioneered by Brian Mulligan-corrects joint positional faults by actively moving the knee pain-free.

Other: Egoscue exercises with MWM

Egoscue Exercises without MWM

ACTIVE COMPARATOR

The Egoscue Method approach for knee osteoarthritis (OA) focuses on improving alignment, hip function, ankle mobility, and muscle balance rather than strengthening the knee in isolation.

Other: Egoscue exercises without MWM

Interventions

Egoscue exercises without MWM OTHER

The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. The exercises will be done with great caution of body alignment and posture

Egoscue Exercises without MWM

Egoscue exercises with MWM OTHER

The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. Mobilization with Movement (MWM) will be implemented after completing the Egoscue routine. This will include a medial tibial glide that is done in a non-weight bearing (NWB) position.

Egoscue exercises with MWM

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Patients aged between 40-60 years (15)
• Both male and female genders
• Clinical and radiographic diagnosis of knee OA (Kellgren-Lawrence Grade II osteoarthritis)

You may not qualify if:

• Any fracture or other injury (18)
• Any inflammatory disease (Rheumatoid arthritis, gout) (18)
• Any neuropathy or neurological issue (18)
• History of knee surgery (18)
• Participation in other physical therapy programs within the last 3 months

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Acme Medical Center

Lahore, Punjab Province, 54920, Pakistan

Location

Related Publications (10)

• Lee JHT, Kan MMP, Wong AKC. The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review. EFORT Open Rev. 2025 Jan 3;10(1):37-47. doi: 10.1530/EOR-2023-0209. Print 2025 Jan 1.

  PMID: 40071912 BACKGROUND

• Gelber AC. Knee Osteoarthritis. Ann Intern Med. 2024 Sep;177(9):ITC129-ITC144. doi: 10.7326/ANNALS-24-01249. Epub 2024 Sep 10.

  PMID: 39250809 BACKGROUND

• Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. doi: 10.1056/NEJMcp1903768. No abstract available.

  PMID: 33406330 BACKGROUND

• Luan L, El-Ansary D, Adams R, Wu S, Han J. Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis. Physiotherapy. 2022 Mar;114:16-29. doi: 10.1016/j.physio.2021.10.001. Epub 2021 Oct 11.

  PMID: 35091326 BACKGROUND

• Dantas LO, Salvini TF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther. 2021 Mar-Apr;25(2):135-146. doi: 10.1016/j.bjpt.2020.08.004. Epub 2020 Sep 8.

  PMID: 33262080 BACKGROUND

• Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.

  PMID: 33807695 BACKGROUND

• Hattori T, Ohga S, Shimo K, Matsubara T. Pathology of knee osteoarthritis pain: contribution of joint structural changes and pain sensitization to movement-evoked pain in knee osteoarthritis. Pain Rep. 2024 Jan 24;9(1):e1124. doi: 10.1097/PR9.0000000000001124. eCollection 2024 Jan.

  PMID: 38274197 BACKGROUND

• Kokkotis C, Moustakidis S, Baltzopoulos V, Giakas G, Tsaopoulos D. Identifying Robust Risk Factors for Knee Osteoarthritis Progression: An Evolutionary Machine Learning Approach. Healthcare (Basel). 2021 Mar 1;9(3):260. doi: 10.3390/healthcare9030260.

  PMID: 33804560 BACKGROUND

• Szilagyi IA, Waarsing JH, Schiphof D, van Meurs JBJ, Bierma-Zeinstra SMA. Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females. Rheumatology (Oxford). 2022 Feb 2;61(2):648-657. doi: 10.1093/rheumatology/keab378.

  PMID: 33895803 BACKGROUND

• Nelson AE, Hu D, Arbeeva L, Alvarez C, Cleveland RJ, Schwartz TA, Murphy LB, Helmick CG, Callahan LF, Renner JB, Jordan JM, Golightly YM. The Prevalence of Knee Symptoms, Radiographic, and Symptomatic Osteoarthritis at Four Time Points: The Johnston County Osteoarthritis Project, 1999-2018. ACR Open Rheumatol. 2021 Aug;3(8):558-565. doi: 10.1002/acr2.11295. Epub 2021 Jul 10.

  PMID: 34245232 BACKGROUND

MeSH Terms

Conditions

Osteoarthritis, Knee; Osteoarthritis; Pain

Condition Hierarchy (Ancestors)

Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Rahat Afzal, MS-OMPT

  Governement Teaching Hospital Shahdara Lahore.

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Samrood Akram, PhD*

CONTACT

03324806143; samrood.akram@riphah.edu.pk

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 8, 2026
• First Posted: June 12, 2026
• Study Start: May 30, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): August 30, 2026
• Last Updated: June 12, 2026

Record last verified: 2026-06

Locations

PA (1)