Effectiveness of Mulligan joint mobilizations and trunk stabilization exercises versus isometric knee strengthening in the management of knee osteoarthritis: study protocol for a randomized controlled trial

BackgroundKnee Osteoarthritis (KOA) has a huge negative impact on gait parameters and on many components of biomechanics, including impairment of dynamic lower limb alignment and control of lumbopelvic movement. Specifically addressing these problems in treatment regimens is therefore critical but they must first be studied in detail before they can be used clinically to treat patients with KOA. This study protocol focuses on whether Mulligan joint mobilization with movement demonstrably decreases pain and restores healthy joint biomechanics and whether trunk stabilization exercises improve stability of the trunk, thereby distributing the weight of the body evenly on both feet. Because the treatment effects of neither treatment are conclusive, this study aims to determine their efficacy versus isometric knee strengthening. MethodThe study protocol is a three-arm randomized controlled trial. After initial screening by a referring consultant, subjects who fulfil the study criteria will be randomly assigned to one of three groups. They will then be given an explanation of study objective and asked for their informed consent to participate in the study. Group 1 will receive Mulligan mobilization with kinesiotaping and knee strengthening. Group 2 will receive trunk stabilization exercises, knee strengthening, and kinesiotaping. Group 3 will receive knee strengthening along with kinesiotaping. All participants will be evaluated using a visual analogue scale, Knee injury and Osteoarthritis Outcome Score, stair climb test and 6-minute walk test at the baseline, 3rd and end of 6th week. DiscussionThe results of this study will answer focused questions concerning the relative efficacy of each treatment in KOA patients. The findings of this study will inform clinical decision-making by healthcare professionals and researchers. Trial registrationNCT04099017