Effect of Manual therapy over conventional treatment among chronic degenerative joint disease of the knee – A Prospective Comparative study

A D Gopalswami, S.Senthil Kumar, S. Venkatesan

A D Gopalswami, S.Senthil Kumar, S. Venkatesan – Effect of Manual therapy over conventional treatment among chronic degenerative joint disease of the knee – A Prospective Comparative study. Fizjoterapia Polska 2019; 19(3); 82-90

Abstract
Background. Degenerative Joint Disease (DJD) of knee is a musculoskeletal disorder that affects about 22% to 39% of population in India. The physical impairments among DJD patients poses a significant challenge to clinicians in order to manage and restore their functional capabilities. The disease has been well managed with conventional physiotherapy and exercises. The potential benefits of such physiotherapy lasted for short term.
Aim. Thus, the primary aim was to find the efficacy of less explored methods of treating muscular deficits such as Muscle Energy Techniques (MET) and structured exercise program. The primary objectives of the study were to analyze the effectiveness of MET and joint mobilization in relieving pain severity, improving knee joint ROM and muscle strength.
Material and methods. One hundred patients diagnosed to have tibiofemoral joint degeneration with a grade 2 or 3 on Kellgren and Lawrence scale, were allocated in to Experimental Group (EG) and Comparative Group (CG). EG had received manual therapy in the form of joint mobilization, MET, strengthening exercises and patient education whereas CG had received the referred treatment program (Interferential therapy) along with strengthening exercises and patient education for a period of two weeks.
Results. The analyses of outcome variables for Pain (VAS), knee joint Range of Motion (ROM), Muscle Power and Isometric muscle strength of Quadriceps and Hamstrings was done. Choice of statistical tests (Wilcoxon signed rank test and Mann Whitney U test) was used based on the type of variables.
Conclusions. In a disease specific program, inclusion of manual therapy as a part of treatment regimen would be an effective management for knee osteoarthritis patients. Such an intervention may possibly delay or reduce the need for joint replacement.

Key words:
Degenerative Joint Disease, Manual therapy, Muscle energy technique, Exercise program

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