Knee OsteoarthritisMWMPETKOANCT06971016
"Effectiveness of Mulligan Mobilization Technique and Proprioceptive Exercises Among Patients With Knee Osteoarthritis"
A study testing Mulligan Mobilization technique, Proprioceptive Exercises and Traditional Physical therapy in people with Knee Osteoarthritis, run by National Healthcare Center at 1 site in Pakistan.
Trial summary
This research analyzes the effectiveness of Mulligan mobilization in comparison to proprioceptive exercises for treating patients with mild to moderate Knee osteoarthritis whose condition falls under Kellgren and Lawrence grading system Grades 2 and 3. Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Knee Osteoarthritis
- What is being tested?
- Mulligan Mobilization technique, Proprioceptive Exercises and Traditional Physical therapy
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 60 participants
- Where
- 1 sitePakistan
- Study dates
- 27 Mar 2025to Aug 2025
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Inclusion criteria will include diagnosed cases of knee OA with mild to moderate Grade of OA (According to Kellgren and Lawrence Scale)
- Ability to walk without assistive devices for at least 50 feet.
Who cannot join
- Patients have Kellgren and Lawrence <grade 2 or above grade 3
- History of knee surgery, knee joint replacement
- Patients have been administered corticosteroid injections in last six months - - - History of mental illness, autoimmune disorder, neurological or orthopedic conditions affecting the lower limbs
- Presence of any other conditions that may affect balance or gait.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site, 1 recruiting
- Recruiting
National Healthcare Center
Karachi, Sindh, 75600
Muhammad Atif Khan, +923322281028, mak.physio1989@gmail.com
Atif Hussain, +92213530857179, info@nhc.net.pk
About this study
Official title: "Effectiveness of Mulligan Mobilization Technique and Proprioceptive Exercises Among Patients With Knee Osteoarthritis in Karachi" The Study Will Include Individuals Diagnosed With Knee OA, Aged 40 Years and Above, Clinically Diagnosed Mild to Moderate Primary OA in Knee. Participants Will be Recruited From a Physical Therapy Clinic, and Will be Screened for Inclusion and Exclusion Criteria. Inclusion Criteria Will Include Diagnosed Cases of Knee OA With Mild to Moderate Grade of OA (According to Kellgren and Lawrence Scale) and the Ability to Walk Without Assistive Device for at Least 50 Feet
This research analyzes the effectiveness of Mulligan mobilization in comparison to proprioceptive exercises for treating patients with mild to moderate Knee osteoarthritis whose condition falls under Kellgren and Lawrence grading system Grades 2 and 3. The current study evaluates these therapeutic approaches as a combined method during a 10-week assessment period which incorporates pain intensity measures, movement analysis and functional activities and balance performance together with quality of life improvement. The study implements a preliminary test followed by standardized evaluation tests to establish robust data for Knee osteoarthritis physical therapy strategies.
The study population will include individuals diagnosed with knee OA, aged 40 years and above, clinically diagnosed mild to moderate primary OA in knee. Participants will be recruited from a physical therapy clinic, and will be screened for inclusion and exclusion criteria. Inclusion criteria will include diagnosed cases of knee OA with mild to moderate Grade of OA (According to Kellgren and Lawrence Scale) and the ability to walk without assistive devices for at least 50 feet.
A total of 60 subjects will be chosen equally for three groups (Experimental Group A=Proprioceptive Exercises group), (Experimental Group B=Mulligan Mobilization Technique Group), and (Control Group C= Traditional physical therapy). Double blinding randomized selection through simple random sampling will determine all participants. Study will continue for 10 weeks and a total number of 30 treatment sessions will be given to each patient with 3 sessions per week. Session lasting an average of 40 minutes to an hour each. Assessment of the patients will be done at the beginning of 1st Session day and at the end of treatment of 30th Session day. The research site for this investigation is Physiotherapy Out-Patient Department at National Healthcare Centre, Karachi-Pakistan.
Read the detailed description
The research examines the effectiveness comparison between Mulligan Mobilization Technique and Proprioceptive Exercises for knee OA patients by adopting the following illustrated conceptual framework.
The study's independent variable consists of both Mulligan Mobilization Technique and Proprioceptive Exercises as treatment interventions. The evaluation tools include Numeric Pain Rating Scale (NPRS), Universal Goniometer, Knee Injury and OA Outcome Score (KOOS), Berg Balance Scale (BBS) and Quality of Life Short Form (SF-36) for assessing pain, range of motion, functional status, balance and quality of life respectively.
The research's experiment expects the independent treatment to modify the analyzed outcomes. The pre-test and post-test experimental setup will assess how well the intervention treatments affect the dependent variables. Two treatments known as Mulligan Mobilization Technique with Proprioceptive Exercises will be assessed for their effectiveness in treating knee OA patients throughout the study. The study will evaluate the effect of age together with gender and body mass index (BMI) as well as disease severity on outcomes from different interventions.
CONSENT FORM (ENGLISH) Title of Study: Effectiveness of Mulligan Mobilization Technique and Proprioceptive Exercises among Patients with Knee Osteoarthritis in Karachi
Introduction: You are being invited to participate in a research study. Please read this form carefully and feel free to ask any questions you may have before agreeing to participate.
Purpose of the Study: The purpose of this study is to compare the effectiveness of Mulligan Mobilization Technique versus Proprioceptive Exercises on pain, range of motion, functional status, balance and quality of life among patients with knee OA.
Procedures: If you agree to participate in this study, you will be asked to complete a series of questionnaires to evaluate your pain, range of motion, functional status, balance and quality of life. You will also receive either Mulligan Mobilization Technique, Proprioceptive Exercises or Traditional Physical Therapy depending on the group you are randomly assigned to Mulligan Mobilization Technique is a manual therapy technique that aims to improve joint mobility and reduce pain. Proprioceptive Exercises are exercises that focus on improving balance and joint position sense. The treatment will be performed by a licensed physical therapist who has been trained to perform both techniques. You will receive 30 sessions of treatment over a period of ten weeks. Each session will last approximately 45 minutes.
Risks and Benefits: There are no anticipated risks associated with participating in this study. However, some participants may experience temporary pain or discomfort during the treatment sessions. The benefits of participating in this study include the potential to improve pain, range of motion, functional status, balance and quality of life among patients with knee OA. Participants are requested not to perform other treatment or take any painkillers during the period of intervention and evaluation.
Confidentiality: Your participation in this study will be kept confidential. Your personal information will be kept in a secure location and will only be accessible to the researchers involved in the study.
Voluntary Participation: Your participation in this study is completely voluntary. You have the right to withdraw from the study at any time without any penalty.
Contact Information: If you have any questions or concerns about the study, please feel free to contact Muhammad Atif Khan (Principal Investigator) at 0092-332-2281028 or mak_physio@yahoo.com.
Consent: By signing below, you acknowledge that you have read and understood the information provided in this form, and you voluntarily agree to participate in the study.
Participant Signature: ____________________________ Date: _________________
Researcher Signature: _____________________________ Date: _________________
- Conditions
- Knee Osteoarthritis
- Being tested
- Mulligan Mobilization technique, Proprioceptive Exercises, Traditional Physical therapy
- Keywords
- Osteoarthritis, Knee Osteoarthritis, Mulligan Mobilization, Proprioceptive training, Pain, Functional Status, Knee Managment
- Medical subject headings
- Osteoarthritis, Knee, Osteoarthritis, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Mulligan Mobilization techniqueOther
- Mulligan Mobilization for Medial Glide: During the treatment, the patient will be positioned in a prone (face-down) posture. To execute a medial glide, the therapist will position themselves on the side opposite to the target knee. They will place a belt around the patient's waist and lower leg, aligning the upper edge of the belt with the margin of the tibial joint. Using one hand to stabilize the thigh above the knee and the other hand to support the lower leg, the therapist will apply a medial force to the knee using the belt. The therapist will then instruct the patient to flex their knee while maintaining the glide. ii. Mulligan Mobilization for Lateral Glide: To administer a lateral glide to the knee, the therapist will position themselves next to the affected knee. They will employ the belt to facilitate the glide by applying force from the opposite side.
Proprioceptive ExercisesOther
- One leg balance- It requires flexing the opposite leg at the knee, hip, and ankle while standing on the affected foot. This position will be hold for one minute (60 seconds), followed by rest for 10 to 20 seconds, then continue this process twice more. Three repetitions of the same exercise will be performed with the unaffected leg after a brief break. ii. Blind advanced one leg balance- The task will resemble one-legged balance, but the participant will be required to close their eyes while executing the routine, and then repeat it two more times. iii. Toe walking- In this activity, the participant will be instructed to walk a 20-meter distance while balancing on their toes with their toes pointing straight ahead. They will then be asked to walk the same distance again, but this time with their toes pointing outward. After a brief rest, the entire procedure will be repeated once more.
Traditional Physical therapyOther
- Stretching of the Gastrocnemius and Soleus Muscles
- Frequency: 3-5 times per week.
- Intensity: Stretch to the point of mild discomfort, not pain.
- Time: Hold each stretch for 30 seconds and repeat 3 times on each leg.
- Type: Static stretching. Gastrocnemius Stretch: Stand facing a wall with one foot forward (slightly bent) and the other foot back (straight). Press the back heel into the floor and lean forward to feel the stretch in the calf.
Soleus Stretch: From the same position, slightly bend the back knee while keeping the heel on the ground to target the lower calf (soleus muscle).
- Stretching of the Hamstrings
- Frequency: 3-5 times per week.
- Intensity: Stretch to a tolerable point of tension without causing pain.
- Time: Hold each stretch for 30 seconds and repeat 3 times on each leg.
- Type: Static stretching. Seated Hamstring Stretch: Sit on the floor with one leg straight and the other bent.
| Study group | Role | What they receive |
|---|---|---|
| Proprioceptive Exercises | Experimental | Proprioceptive exercises aim to enhance an individual's ability to perceive body position and movement in space, improving balance, stability, and injury prevention. These exercises have shown significant benefits for various populations, including institutionalized older adults, where they improved functional mobility, balance, gait, and reduced fall risk. Receives: Other: Proprioceptive Exercises |
| Mulligan Mobilization Technique | Active comparator | The Mulligan Mobilization Technique, specifically Mobilization with Movement (MWM), is an effective manual therapy approach for treating musculoskeletal conditions. In knee osteoarthritis treatment, Mulligan mobilization was found to be more effective than Maitland technique in alleviating pain and improving function scores. The technique can be combined with other therapeutic measures such as conventional treatments and exercises for optimal results. Overall, Mulligan Mobilization Technique emerges as a promising intervention for various musculoskeletal conditions, offering pain relief and functional improvement. Receives: Other: Mulligan Mobilization technique |
| Placebo | Placebo comparator | Traditional Physical Therapy Receives: Other: Traditional Physical therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Knee Injury and Osteoarthritis Outcome Score
The KOOS exists to measure both brief and persistent symptoms together with actual functions of people who have knee ligament damage or osteoarthritis. General healthcare providers rely on the KOOS tool as well as research investigators to track patient health evolution through registries and clinical use. This evaluation instrument contains five distinct subcategories which assess Pain as well as Symptoms alongside Activities of Daily Living (ADL) and Sports and Recreation Function (Sport/Rec) and Knee-Related Quality of Life (QOL). Each subscale in KOOS receives scoring on a 5-point Likert scale before the scores transform into a 0 to 100 scale representing extreme symptoms to no symptoms.
Measured: 10 weeks
Universal Goniometer
Physical therapy practitioners use universal goniometers (UG) to conduct goniometry which stands as an necessary technique for measuring joint range of motion (ROM). A two-armed handheld device provides stable measured results through valid procedures if users adhere to specific placement protocols.
Measured: 10 weeks
Numeric Pain Rating Scale (NPRS)
Through NPRS participants rate their pain levels on a 0 to 10 scale by choosing numbers that show no pain at 0 and maximum pain at 10. The pain intensity score is determined by the number that the participant selects.
Measured: 10 weeks
Berg Balance Scale (BBS)
The Berg Balance Scale stands as a common instrument which evaluates testing both static and dynamic balance levels. The BBS created by Katherine Berg during 1989 contains 14 specific tasks that measure both sitting and standing and dynamic balance abilities of patients. Therapy participants receive scores ranging from 0 to 4 on each task distributed across a total rate of 56 points in the assessment process.
Measured: 10 weeks
Secondary outcomes (1)
Quality of Life Short Form (SF-36)
The SF-36 provides a full instrument for measuring health-related quality of life through 36 items with eight domain categories including Physical Function (PF) and Role Physical (RP) and Bodily Pain together with General Health (GH) as well as Vitality (VT) and Social Function (SF) and Role Emotional (RE) and Mental Health (MH). The SF-36 organizes its measures under two main domains named Physical Component Summary and Mental Component Summary which serve as scoring categories. Standard deviation scores follow norms that use 50 as mean and 10 as standard deviation to achieve population-wide evaluations.
Measured: 10 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 May 2025
- Study start27 Mar 2025
- Primary completionJun 2025 (estimated)
- Study completionAug 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Knee OsteoarthritisStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Total 60 subjects will be selected by simple random sampling and equally divided into 3 groups: Experimental Group A=Proprioceptive exercises group Experimental Group B=Mulligan Mobilization Technique Group Control Group C= Traditional Physical Therapy. The study will follow a pre-test and post-test design, with assessments to be conducted at baseline, immediately after intervention and 10-weeks follow-up. Study will be continued for 10 weeks and a total number of 30 treatment sessions will be given to each patient with 3 sessions per week. Assessment of the patients will be done at the beginning of 1st Session day and at the end of treatment of 30th Session day.
- Masking
- Double blind
- Who is masked
- Participant, Care provider
- Enrolment
- 60 participants (estimated)
Sponsor and investigators
- Lead sponsor
- National Healthcare Center
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Muhammad Atif Khan, National Healthcare Center
- Investigators
- Muhammad Atif Khan, PhD Scholar, Principal investigator, National Healthcare Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06971016
- Sponsor's protocol ID
- LUC/MKT/IND/SP/03/327
- Other IDs
- Lincoln University College
- Acronym
- MWMPETKOA
- Status last verified
- May 2025
- First submitted
- 15 Apr 2025
- Last updated
- 21 May 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No: Due to ethical considerations and the need to protect participant confidentiality, individual participant data will not be shared. The informed consent obtained from participants does not include permission for data sharing with external researchers.
Publications
Rao RV, Balthillaya G, Prabhu A, Kamath A. Immediate effects of Maitland mobilization versus Mulligan Mobilization with Movement in Osteoarthritis knee- A Randomized Crossover trial. J Bodyw Mov Ther. 2018 Jul;22(3):572-579. doi: 10.1016/j.jbmt.2017.09.017. Epub 2017 Sep 28.
PubMed 30100279
Study at a glance
From the registry record, last updated by the sponsor on 21 May 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- "Effectiveness of Mulligan Mobilization Technique and Proprioceptive Exercises Among Patients With Knee Osteoarthritis in Karachi" The Study Will Include Individuals Diagnosed With Knee OA, Aged 40 Years and Above, Clinically Diagnosed Mild to Moderate Primary OA in Knee. Participants Will be Recruited From a Physical Therapy Clinic, and Will be Screened for Inclusion and Exclusion Criteria. Inclusion Criteria Will Include Diagnosed Cases of Knee OA With Mild to Moderate Grade of OA (According to Kellgren and Lawrence Scale) and the Ability to Walk Without Assistive Device for at Least 50 Feet
- ClinicalTrials.gov ID
- NCT06971016
- Acronym / sponsor ID
- MWMPETKOA / LUC/MKT/IND/SP/03/327
- Conditions
- Knee Osteoarthritis
- Keywords
- Osteoarthritis, Knee Osteoarthritis, Mulligan Mobilization, Proprioceptive training, Pain, Functional Status, Knee Managment
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 60 participants (estimated)
- Lead sponsor
- National Healthcare CenterUniversity, hospital or other
- Study start
- 27 Mar 2025 (actual)
- Primary completion
- Jun 2025 (estimated)
- Study completion
- Aug 2025 (estimated)
- First posted
- 14 May 2025 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This research analyzes the effectiveness of Mulligan mobilization in comparison to proprioceptive exercises for treating patients with mild to moderate Knee osteoarthritis whose condition falls under Kellgren and Lawrence grading system Grades 2 and 3. The current study evaluates these therapeutic approaches as a combined method during a 10-week assessment period which incorporates pain intensity measures, movement analysis and functional activities and balance performance together with quality of life improvement. The study implements a preliminary test followed by standardized evaluation tests to establish robust data for Knee osteoarthritis physical therapy strategies.
The study population will include individuals diagnosed with knee OA, aged 40 years and above, clinically diagnosed mild to moderate primary OA in knee. Participants will be recruited from a physical therapy clinic, and will be screened for inclusion and exclusion criteria. Inclusion criteria will include diagnosed cases of knee OA with mild to moderate Grade of OA (According to Kellgren and Lawrence Scale) and the ability to walk without assistive devices for at least 50 feet.
A total of 60 subjects will be chosen equally for three groups (Experimental Group A=Proprioceptive Exercises group), (Experimental Group B=Mulligan Mobilization Technique Group), and (Control Group C= Traditional physical therapy). Double blinding randomized selection through simple random sampling will determine all participants. Study will continue for 10 weeks and a total number of 30 treatment sessions will be given to each patient with 3 sessions per week. Session lasting an average of 40 minutes to an hour each. Assessment of the patients will be done at the beginning of 1st Session day and at the end of treatment of 30th Session day. The research site for this investigation is Physiotherapy Out-Patient Department at National Healthcare Centre, Karachi-Pakistan.
Detailed description
The research examines the effectiveness comparison between Mulligan Mobilization Technique and Proprioceptive Exercises for knee OA patients by adopting the following illustrated conceptual framework.
The study's independent variable consists of both Mulligan Mobilization Technique and Proprioceptive Exercises as treatment interventions. The evaluation tools include Numeric Pain Rating Scale (NPRS), Universal Goniometer, Knee Injury and OA Outcome Score (KOOS), Berg Balance Scale (BBS) and Quality of Life Short Form (SF-36) for assessing pain, range of motion, functional status, balance and quality of life respectively.
The research's experiment expects the independent treatment to modify the analyzed outcomes. The pre-test and post-test experimental setup will assess how well the intervention treatments affect the dependent variables. Two treatments known as Mulligan Mobilization Technique with Proprioceptive Exercises will be assessed for their effectiveness in treating knee OA patients throughout the study. The study will evaluate the effect of age together with gender and body mass index (BMI) as well as disease severity on outcomes from different interventions.
CONSENT FORM (ENGLISH) Title of Study: Effectiveness of Mulligan Mobilization Technique and Proprioceptive Exercises among Patients with Knee Osteoarthritis in Karachi
Introduction: You are being invited to participate in a research study. Please read this form carefully and feel free to ask any questions you may have before agreeing to participate.
Purpose of the Study: The purpose of this study is to compare the effectiveness of Mulligan Mobilization Technique versus Proprioceptive Exercises on pain, range of motion, functional status, balance and quality of life among patients with knee OA.
Procedures: If you agree to participate in this study, you will be asked to complete a series of questionnaires to evaluate your pain, range of motion, functional status, balance and quality of life. You will also receive either Mulligan Mobilization Technique, Proprioceptive Exercises or Traditional Physical Therapy depending on the group you are randomly assigned to Mulligan Mobilization Technique is a manual therapy technique that aims to improve joint mobility and reduce pain. Proprioceptive Exercises are exercises that focus on improving balance and joint position sense. The treatment will be performed by a licensed physical therapist who has been trained to perform both techniques. You will receive 30 sessions of treatment over a period of ten weeks. Each session will last approximately 45 minutes.
Risks and Benefits: There are no anticipated risks associated with participating in this study. However, some participants may experience temporary pain or discomfort during the treatment sessions. The benefits of participating in this study include the potential to improve pain, range of motion, functional status, balance and quality of life among patients with knee OA. Participants are requested not to perform other treatment or take any painkillers during the period of intervention and evaluation.
Confidentiality: Your participation in this study will be kept confidential. Your personal information will be kept in a secure location and will only be accessible to the researchers involved in the study.
Voluntary Participation: Your participation in this study is completely voluntary. You have the right to withdraw from the study at any time without any penalty.
Contact Information: If you have any questions or concerns about the study, please feel free to contact Muhammad Atif Khan (Principal Investigator) at 0092-332-2281028 or mak_physio@yahoo.com.
Consent: By signing below, you acknowledge that you have read and understood the information provided in this form, and you voluntarily agree to participate in the study.
Participant Signature: ____________________________ Date: _________________
Researcher Signature: _____________________________ Date: _________________
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, care provider)
- Number of arms
- 3
- Model description
- Total 60 subjects will be selected by simple random sampling and equally divided into 3 groups: Experimental Group A=Proprioceptive exercises group Experimental Group B=Mulligan Mobilization Technique Group Control Group C= Traditional Physical Therapy. The study will follow a pre-test and post-test design, with assessments to be conducted at baseline, immediately after intervention and 10-weeks follow-up. Study will be continued for 10 weeks and a total number of 30 treatment sessions will be given to each patient with 3 sessions per week. Assessment of the patients will be done at the beginning of 1st Session day and at the end of treatment of 30th Session day.
| Arm | Type | Receives |
|---|---|---|
| Proprioceptive Exercises | Experimental | Other: Proprioceptive ExercisesProprioceptive exercises aim to enhance an individual's ability to perceive body position and movement in space, improving balance, stability, and injury prevention. These exercises have shown significant benefits for various populations, including institutionalized older adults, where they improved functional mobility, balance, gait, and reduced fall risk. |
| Mulligan Mobilization Technique | Active comparator | Other: Mulligan Mobilization techniqueThe Mulligan Mobilization Technique, specifically Mobilization with Movement (MWM), is an effective manual therapy approach for treating musculoskeletal conditions. In knee osteoarthritis treatment, Mulligan mobilization was found to be more effective than Maitland technique in alleviating pain and improving function scores. The technique can be combined with other therapeutic measures such as conventional treatments and exercises for optimal results. Overall, Mulligan Mobilization Technique emerges as a promising intervention for various musculoskeletal conditions, offering pain relief and functional improvement. |
| Placebo | Placebo comparator | Other: Traditional Physical therapyTraditional Physical Therapy |
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (2 listed)
- Inclusion criteria will include diagnosed cases of knee OA with mild to moderate Grade of OA (According to Kellgren and Lawrence Scale)
- Ability to walk without assistive devices for at least 50 feet.
Key exclusion criteria (4 listed)
- Patients have Kellgren and Lawrence <grade 2 or above grade 3
- History of knee surgery, knee joint replacement
- Patients have been administered corticosteroid injections in last six months - - - History of mental illness, autoimmune disorder, neurological or orthopedic conditions affecting the lower limbs
- Presence of any other conditions that may affect balance or gait.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Mulligan Mobilization techniquei. Mulligan Mobilization for Medial Glide: During the treatment, the patient will be positioned in a prone (face-down) posture. To execute a medial glide, the therapist will position themselves on the side opposite to the target knee. They will place a belt around the patient's waist and lower leg, aligning the upper edge of the belt with the margin of the tibial joint. Using one hand to stabilize the thigh above the knee and the other hand to support the lower leg, the therapist will apply a medial force to the knee using the belt. The therapist will then instruct the patient to flex their knee while maintaining the glide. ii. Mulligan Mobilization for Lateral Glide: To administer a lateral glide to the knee, the therapist will position themselves next to the affected knee. They will employ the belt to facilitate the glide by applying force from the opposite side. | Other | Mulligan Mobilization Technique |
| Proprioceptive Exercisesi. One leg balance- It requires flexing the opposite leg at the knee, hip, and ankle while standing on the affected foot. This position will be hold for one minute (60 seconds), followed by rest for 10 to 20 seconds, then continue this process twice more. Three repetitions of the same exercise will be performed with the unaffected leg after a brief break. ii. Blind advanced one leg balance- The task will resemble one-legged balance, but the participant will be required to close their eyes while executing the routine, and then repeat it two more times. iii. Toe walking- In this activity, the participant will be instructed to walk a 20-meter distance while balancing on their toes with their toes pointing straight ahead. They will then be asked to walk the same distance again, but this time with their toes pointing outward. After a brief rest, the entire procedure will be repeated once more. | Other | Proprioceptive Exercises |
| Traditional Physical therapy• Stretching of the Gastrocnemius and Soleus Muscles * Frequency: 3-5 times per week. * Intensity: Stretch to the point of mild discomfort, not pain. * Time: Hold each stretch for 30 seconds and repeat 3 times on each leg. * Type: Static stretching. Gastrocnemius Stretch: Stand facing a wall with one foot forward (slightly bent) and the other foot back (straight). Press the back heel into the floor and lean forward to feel the stretch in the calf. Soleus Stretch: From the same position, slightly bend the back knee while keeping the heel on the ground to target the lower calf (soleus muscle). • Stretching of the Hamstrings * Frequency: 3-5 times per week. * Intensity: Stretch to a tolerable point of tension without causing pain. * Time: Hold each stretch for 30 seconds and repeat 3 times on each leg. * Type: Static stretching. Seated Hamstring Stretch: Sit on the floor with one leg straight and the other bent. | Other | Placebo |
Primary outcome
Knee Injury and Osteoarthritis Outcome Score
Time frame: 10 weeks
The KOOS exists to measure both brief and persistent symptoms together with actual functions of people who have knee ligament damage or osteoarthritis. General healthcare providers rely on the KOOS tool as well as research investigators to track patient health evolution through registries and clinical use. This evaluation instrument contains five distinct subcategories which assess Pain as well as Symptoms alongside Activities of Daily Living (ADL) and Sports and Recreation Function (Sport/Rec) and Knee-Related Quality of Life (QOL). Each subscale in KOOS receives scoring on a 5-point Likert scale before the scores transform into a 0 to 100 scale representing extreme symptoms to no symptoms.
Universal Goniometer
Time frame: 10 weeks
Physical therapy practitioners use universal goniometers (UG) to conduct goniometry which stands as an necessary technique for measuring joint range of motion (ROM). A two-armed handheld device provides stable measured results through valid procedures if users adhere to specific placement protocols.
Numeric Pain Rating Scale (NPRS)
Time frame: 10 weeks
Through NPRS participants rate their pain levels on a 0 to 10 scale by choosing numbers that show no pain at 0 and maximum pain at 10. The pain intensity score is determined by the number that the participant selects.
Berg Balance Scale (BBS)
Time frame: 10 weeks
The Berg Balance Scale stands as a common instrument which evaluates testing both static and dynamic balance levels. The BBS created by Katherine Berg during 1989 contains 14 specific tasks that measure both sitting and standing and dynamic balance abilities of patients. Therapy participants receive scores ranging from 0 to 4 on each task distributed across a total rate of 56 points in the assessment process.
1 secondary outcome
Quality of Life Short Form (SF-36)
Time frame: 10 weeks
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 May 2025.
- Background: PubMed 30100279Rao RV, Balthillaya G, Prabhu A, Kamath A. Immediate effects of Maitland mobilization versus Mulligan Mobilization with Movement in Osteoarthritis knee- A Randomized Crossover trial. J Bodyw Mov Ther. 2018 Jul;22(3):572-579. doi: 10.1016/j.jbmt.2017.09.017. Epub 2017 Sep 28.
- this the evidence which help to formulate the study protocolLink provided by the sponsor.
- Individual participant dataSharing planned: No. Due to ethical considerations and the need to protect participant confidentiality, individual participant data will not be shared. The informed consent obtained from participants does not include permission for data sharing with external researchers.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Muhammad Atif Khan, PhD Scholar principal investigator
National Healthcare Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Mulligan Mobilization technique, Proprioceptive Exercises and Traditional Physical therapy in people with Knee Osteoarthritis, run by National Healthcare Center at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 21 May 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Muhammad Atif Khan, PhD Scholar (+923322281028, mak.physio1989@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Knee Injury and Osteoarthritis Outcome Score (time frame: 10 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06971016, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 May 2025.