Efficacy of Mulligan MWMs along with Conventional Physical Therapy in Knee Osteoarthritis

Abstract

Background: Knee osteoarthritis is a prevalent degenerative joint disease that impairs mobility and causes significant pain, particularly in the aging population. Conservative management, including physical therapy, remains a cornerstone of treatment. The addition of Mulligan Mobilization with Movement (MWM) to conventional therapy has been proposed to improve outcomes, though its efficacy had not been robustly quantified. Objective: The objective of this study was to compare the efficacy of Mulligan MWM in conjunction with conventional physical therapy to conventional physical therapy alone in reducing pain and stiffness and improving functional outcomes in patients with grade 2 knee osteoarthritis. Methods: This randomized clinical trial included 28 participants with grade 2 knee osteoarthritis, randomly allocated into two groups: one receiving Mulligan MWM alongside conventional physical therapy and the other receiving only conventional physical therapy. The intervention lasted one month, with assessments conducted at baseline, two weeks, and four weeks using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as outcome measures. Statistical analysis was performed using SPSS version 25. Results: The MWM plus physical therapy group exhibited a greater reduction in VAS scores (baseline: 6.71, SD 1.729 to week 4: 2.21, SD 1.051) compared to the physical therapy alone group (baseline: 7.14, SD 1.562 to week 4: 3.86, SD 0.663), with a significant mean difference (P<0.001). Similarly, WOMAC scores for pain, stiffness, and physical function significantly improved in the MWM group compared to the physical therapy group at week 4 (Pain: 2.79 vs. 6.86, Stiffness: 1.14 vs. 3.36, Function: 9.79 vs. 27.57, all P<0.001). Conclusion: Mulligan MWM combined with conventional physical therapy was more effective than conventional physical therapy alone in reducing pain, stiffness, and improving functional outcomes in patients with grade 2 knee osteoarthritis. These results support the inclusion of MWM in the management of knee osteoarthritis.