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Osteoarthritis, KneeNCT06329128

Evaluation of the Effectiveness of Manual Therapy in Patients With Knee Osteoarthritis

A study testing Experimental: Study Group in people with Osteoarthritis, Knee, run by Hasan Kalyoncu University at 1 site in Turkey (Türkiye).

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The aim of this study is to investigate the effects of three different applications (Manual therapy, electrotherapy and home program) on long-term pain, joint range of motion and, secondarily, the functional level of the knee. Read more about this study

Who is it for?
Ages 40 years and olderHealthy volunteers can take part
Conditions the study is for
Osteoarthritis, Knee
What is being tested?
Experimental: Study Group
Could I receive a placebo?
No, everyone receives an active treatment
How many people
40 participants
Where
1 siteTurkey (Türkiye)
Study dates
25 Mar 2024to 30 Sep 2024
Phase
Interventional
Are there results?
None posted in the registry

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
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Diagnosis of knee osteoarthritis according to the clinical and radiological diagnostic criteria of the American College of Rheumatology
  • Patients with osteoarthritis stage II or III according to the Kellgren-Lawrence classification

Who cannot join

  • Having had knee surgery or lower extremity surgery
  • Those who have received any physical therapy program in the last week
  • Those with serious arrhythmia or a pacemaker
  • Inflammatory arthritis or neuromuscular
  • Having a history of malignancy
  • Pregnant
Show all 9Show fewer
  • Those with open wounds and infections in the knee area
  • Those with severe hypoesthesia or neurological disease
  • Those with bleeding conditions and thrombophlebitis

Trial locations and contacts

1 site in 1 country.

Tuğba GÖNEN, Asst. Prof. contact

05050905846

tugba.badat@hku.edu.tr

Turkey (Türkiye)1 site
  • Hasan Kalyoncu University

    Gaziantep, Şahinbey, 27100

Other trials in Turkey (Türkiye)

About this study

Official title: Evaluation of the Effectiveness of Manual Therapy in Patients With Knee Osteoarthritis: Randomized Controlled Single-blind Clinical Study

The aim of this study is to investigate the effects of three different applications (Manual therapy, electrotherapy and home program) on long-term pain, joint range of motion and, secondarily, the functional level of the knee.

Read the detailed description

Osteoarthritis (OA); It is a chronic degenerative joint disorder characterized by joint pain, stiffness, decreased range of motion and muscle weakness. The main goal of healthcare professionals is to control the pain that increases with the gradually decreasing quality of life and to improve functions as a result. Conservative treatments include medical approaches as well as methods with demonstrated therapeutic effects such as exercise and physical activity. Exercise plays an important role in the management of chronic disabling disease. Looking at systematic reviews, there is high evidence that exercise reduces pain and improves physical function in patients with knee osteoarthritis. Manual therapy approaches have also been used recently to inhibit movement limitation and pain in the joint, and studies showing their benefits are increasing. The American College of Rheumatology has stated that it is beneficial to add manual therapy sessions to individual exercises in rehabilitation methods for patients. In terms of physiotherapy approaches in OA, electrotherapy modalities with low evidence are used. Among these modalities, the effects of TENS and Ultrasound are the most studied applications. Although the effects of TENS compared to placebo have been shown, there are also opposite results regarding TENS and ultrasound applications. There are many studies in the literature comparing types of manual therapy and investigating their combination with exercise. Some studies have demonstrated the effects of combining exercise treatments with a manual therapy program in improving pain and function. A recent study showed that patients who participated in an MT program had improved functional level compared to those who did not receive MT, but exercise therapy alone was superior in improving performance-based functional scores. A few studies comparing manual therapy with electrotherapy have been conducted recently. In this study, TENS and cold application were shown to be ineffective in improving pain, joint stiffness and physical functions compared to manual therapy in patients with OA. While manual therapy can reduce pain in OA thanks to its neurophysiological effects, it also aims to correct the changed arthrokinematics by restoring the optimal kinematics between joint accessory mobility and joint surfaces. Taylor et al. showed that the combination of exercise and extension mobilization applied in a single session can reduce end-range rotational stiffness. However, in the applications, comparisons are made between manual therapy and exercise combination or manual therapy and electrotherapy modalities. To our knowledge, there is no study in the literature comparing three different applications. Therefore, we hypothesized that manual therapy would be more effective than electrotherapy modalities and a home program in the long term in patients with knee OA. The aim of this study is to investigate the effects of three different applications (Manual therapy, electrotherapy and home program) on long-term pain, joint range of motion and, secondarily, the functional level of the knee.

Being tested
Experimental: Study Group, Active Comparator: Control Group
Keywords
Manual therapy, Exercise, Osteoarthritis
Medical subject headings
Osteoarthritis, Knee, Motor Activity, Osteoarthritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Experimental: Study GroupOther

    A 15-session (5 days a week / 3 weeks) physiotherapy and rehabilitation (electrotherapy and home program) program will be applied to both groups.

    Electrotherapy application; It will consist of Hotpack (15 minutes), TENS (20 minutes), Ultrasound (10 minutes) applications. For the home program, a program consisting of isometric and isotonic exercises will be given to the muscles around the knee. The home program will be followed with an exercise diary.

    In the manual therapy group, in addition to the above treatment, manual therapy will be given 3 days a week. The content of the manual therapy program is as follows;

    • Patellofemoral joint superior-inferior mobilization
    • Medial-lateral mobilization with active knee flexion
    • Tibiofemoral joint ventral (anterior-posterior) mobilization
    • Tibiofemoral traction mobilization
  • Active Comparator: Control GroupOther

    A 15-session (5 days a week / 3 weeks) physiotherapy and rehabilitation (electrotherapy and home program) program will be applied to both groups.

    Electrotherapy application; It will consist of Hotpack (15 minutes), TENS (20 minutes), Ultrasound (10 minutes) applications. For the home program, a program consisting of isometric and isotonic exercises will be given to the muscles around the knee. The home program will be followed with an exercise diary.

Study groups in NCT06329128
Study groupRoleWhat they receive
Study GroupExperimentalThis group will get manuel therapy that combinated electroterapy and hm programme (exercise).
Receives: Other: Experimental: Study Group
Control GroupActive comparatorThis group will get traditional therapy (electrotherapy and exercise)
Receives: Other: Active Comparator: Control Group

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The pain

    Mc Gill Short Form will used to determine the type and severity of the pain. A short form of the McGill Pain Questionnaire (SF-MPQ) has been developed. The main component of the SF-MPQ consists of 15 descriptors (11 sensory; 4 affective) which are rated on an intensity scale as 0 = none, 1 = mild, 2 = moderate or 3 = severe.

    Measured: through of the study, average 5 weeks and 3 months later

  2. Functional status

    Western Ontario ve McMaster Universities (WOMAC) index will used to determine the knee osteoarthritis functional status. The questionnaire, developed at Western Ontario and McMaster University in 1982, includes a total of 24 items consisting of the subparameters Pain (5), Stiffness (2), and Physical function (17). Scoring of the items is done according to the Likert scale. The degree of pain and strain is indicated by giving points from 0 to 4 on the Likert scale. The total score is calculated as a percentage by multiplying the score by 100 and dividing by 96, which is the maximum total score.

    Measured: through of the study, average 5 weeks and 3 months later

  3. The quality of Life

    Nothingham Health Profile will used to determine the quality of life. Hunt et al. NHP, which was developed in 1981 and used to evaluate the quality of life, consists of 2 subsections. Part 1 includes the subparameters of Pain, Emotional Reactions, Sleep, Social Isolation, Physical Activity and Energy, and Part 2 measures the frequency of health-related problems in work and home life, hobbies, social and sexual life. Part 1 is measured between 0-600 points, and Part 2 is measured between 0-7 points. As the score increases, the quality of life decreases

    Measured: through of the study, average 5 weeks and 3 months later

  4. Lower extremity functional strength and balance test

    Sit to stand test will used to determine Lower extremity strength and balance. The sit to stand test, which evaluates lower extremity muscle strength and endurance and is frequently used in osteoarthritis patients, is performed on a chair without armrests with a height of approximately 44 cm. The patient sits in the middle of the chair with his back straight. Feet touch the ground approximately shoulder-width apart, with one foot slightly in front of the other to help maintain balance. Arms are crossed on the shoulders and the patient is asked to stand up and sit like this for 30 seconds. Sitting and standing for less than 10 repetitions after 30 seconds indicates lower extremity weakness.

    Measured: through of the study, average 5 weeks and 3 months later

  5. Functional mobility

    Time up and go test will used to determine functional mobility. Time up and go test was developed by Podsiadlo et al. in 1991. It was developed by Mathias et al. as a modification of the Get-Up and Go Test. For performance measurement that evaluates fall risk and functional mobility, a 3-meter area is determined in front of the chair. The patient is asked to get up from the chair, walk a distance of 3 meters, and then come back and sit on the chair. Time is measured in seconds with a stopwatch. It is determined that there is a risk of falling when the test is completed in more than 12 seconds.

    Measured: through of the study, average 5 weeks and 3 months later

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Mar 2024
  2. Study start25 Mar 2024 (estimated)
  3. Primary completion30 Jun 2024 (estimated)
  4. Study completion30 Sep 2024 (estimated)

Resources

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
Participants were divided in two groups. One groups will get electrotherapy, exercise(home programme) and manuel therapy intervention. One group will be the control group. Control group will get electrotherapy and exercise (home programme).
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
40 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06329128
Sponsor's protocol ID
2022/04
Status last verified
Mar 2024
First submitted
18 Mar 2024
Last updated
25 Mar 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Nelson AE, Allen KD, Golightly YM, Goode AP, Jordan JM. A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum. 2014 Jun;43(6):701-12. doi: 10.1016/j.semarthrit.2013.11.012. Epub 2013 Dec 4.

    PubMed 24387819
  • Zeng C, Li H, Yang T, Deng ZH, Yang Y, Zhang Y, Ding X, Lei GH. Effectiveness of continuous and pulsed ultrasound for the management of knee osteoarthritis: a systematic review and network meta-analysis. Osteoarthritis Cartilage. 2014 Aug;22(8):1090-9. doi: 10.1016/j.joca.2014.06.028. Epub 2014 Jul 4.

    PubMed 24999112
  • Hochberg MC, Altman RD, April KT, Benkhalti M, Guyatt G, McGowan J, Towheed T, Welch V, Wells G, Tugwell P; American College of Rheumatology. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care Res (Hoboken). 2012 Apr;64(4):465-74. doi: 10.1002/acr.21596.

    PubMed 22563589
  • McAlindon TE, Bannuru RR, Sullivan MC, Arden NK, Berenbaum F, Bierma-Zeinstra SM, Hawker GA, Henrotin Y, Hunter DJ, Kawaguchi H, Kwoh K, Lohmander S, Rannou F, Roos EM, Underwood M. OARSI guidelines for the non-surgical management of knee osteoarthritis. Osteoarthritis Cartilage. 2014 Mar;22(3):363-88. doi: 10.1016/j.joca.2014.01.003. Epub 2014 Jan 24.

    PubMed 24462672
  • Rutjes AW, Nuesch E, Sterchi R, Kalichman L, Hendriks E, Osiri M, Brosseau L, Reichenbach S, Juni P. Transcutaneous electrostimulation for osteoarthritis of the knee. Cochrane Database Syst Rev. 2009 Oct 7;2009(4):CD002823. doi: 10.1002/14651858.CD002823.pub2.

    PubMed 19821296
  • Conaghan PG, Kloppenburg M, Schett G, Bijlsma JW; EULAR osteoarthritis ad hoc committee. Osteoarthritis research priorities: a report from a EULAR ad hoc expert committee. Ann Rheum Dis. 2014 Aug;73(8):1442-5. doi: 10.1136/annrheumdis-2013-204660. Epub 2014 Mar 13.

    PubMed 24625626
  • Zasadzka E, Borowicz AM, Roszak M, Pawlaczyk M. Assessment of the risk of falling with the use of timed up and go test in the elderly with lower extremity osteoarthritis. Clin Interv Aging. 2015 Aug 7;10:1289-98. doi: 10.2147/CIA.S86001. eCollection 2015.

    PubMed 26300633
  • Dobson F, Hinman RS, Roos EM, Abbott JH, Stratford P, Davis AM, Buchbinder R, Snyder-Mackler L, Henrotin Y, Thumboo J, Hansen P, Bennell KL. OARSI recommended performance-based tests to assess physical function in people diagnosed with hip or knee osteoarthritis. Osteoarthritis Cartilage. 2013 Aug;21(8):1042-52. doi: 10.1016/j.joca.2013.05.002. Epub 2013 May 13.

    PubMed 23680877
  • Courtney CA, Witte PO, Chmell SJ, Hornby TG. Heightened flexor withdrawal response in individuals with knee osteoarthritis is modulated by joint compression and joint mobilization. J Pain. 2010 Feb;11(2):179-85. doi: 10.1016/j.jpain.2009.07.005. Epub 2009 Nov 27.

    PubMed 19945353

Questions about this trial

What is this clinical trial studying?

A study testing Experimental: Study Group in people with Osteoarthritis, Knee, run by Hasan Kalyoncu University at 1 site in Turkey (Türkiye).

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 9 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: status not confirmed, as of the sponsor's last update on 25 Mar 2024. 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 Turkey (Türkiye). 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. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Tuğba GÖNEN, Asst. Prof. (05050905846, tugba.badat@hku.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The pain (time frame: through of the study, average 5 weeks and 3 months later). The study lists 5 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 NCT06329128, which also lists 9 linked publications.

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 25 Mar 2024.

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