Comparison of Effects of Mulligan Techniques and Muscle Energy Technique on Pain and Function in Knee Osteoarthritis

Osteoarthritis (OA) is a chronic degenerative disabling worldwide disorder in which the knee osteoarthritis range of motion (ROM) is particularly reduced. Mobilization with Movement (MWM) has shown rapid improvements in pain and functions. The muscle energy technique (MET) is claimed to be effective in muscle lengthening, strengthening, and increasing joint ROM.

A clinical trial was conducted to compare knee Mulligan (lateral, medial, and rotational glides) techniques (n=15), and post-isometric relaxation muscle energy techniques (quadriceps, hamstring, and tensor fascia latae) (n=15) on pain and function in OA.

Twenty-two subjects (73.3%) were grade-II of knee OA and 8 subjects (26.7%) with grade III. The visual analogue scale (VAS) showed significant changes in the reduction of pain. In the VAS, the main effect of time of treatment shows that the mean value of the VAS score was statistically significant between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.001) in each group. In knee osteoarthritis outcome score (KOOS), the main effect of time of treatment shows that the mean value of KOOS score is statistically significant in increasing KOOS between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.001) in each group. KOOS showed significant changes for increasing function. Timed up and go (TUG) score showed decremental significant changes in time. In the TUG score, the main effect of time of the treatment shows that the mean value of the TUG score was statistically significant between at least two assessment stages (before the first session, after the third session, and after a month ) (P<0.008). In ROM score, the main effect of time of the treatment shows that the mean value of ROM score was statistically significant in increasing ROM between at least two assessment stages (before the first session, after the third session, and after a month) (P<0.002, observed power= 0.927).

Applying MWM is more functionally effective than applying the post-isometric relaxation muscle energy technique, both interventions increase functional performance in the short term in patients with chronic knee osteoarthritis, but they are not functionally effective from a single session. Applying both techniques has effects on reducing pain immediately and in the short term.