Knee OsteoarthritisNCT07646366
Effects of the Egoscue Exercises With and Without Mwm Among Patients With Knee Osteoarthritis
A study testing Egoscue exercises with MWM and Egoscue exercises without MWM in people with Knee Osteoarthritis, run by Riphah International University at 1 site in Pakistan.
Trial summary
Knee osteoarthritis is a common degenerative joint disorder characterized by joint pain, stiffness, limited mobility, and reduced quality of life. It primarily affects the elderly population and poses a major burden on functional independence and healthcare resources. Read more about this study
- Who is it for?
- Ages 40 to 60 years
- Conditions the study is for
- Knee Osteoarthritis
- What is being tested?
- Egoscue exercises with MWM and Egoscue exercises without MWM
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 56 participants
- Where
- 1 sitePakistan
- Study dates
- 30 May 2026to 30 Aug 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
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 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Patients aged between 40-60 years (15)
- Both male and female genders
- Clinical and radiographic diagnosis of knee OA (Kellgren-Lawrence Grade II osteoarthritis)
Who cannot join
- • Any fracture or other injury (18)
- Any inflammatory disease (Rheumatoid arthritis, gout) (18)
- Any neuropathy or neurological issue (18)
- History of knee surgery (18)
- Participation in other physical therapy programs within the last 3 months
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
Acme Medical Center
Lahore, Punjab Province, 54920
Mujjaded Ashraf, MS-OMPT, 0332 8625526, acmemedicalcomolex@gmail.com
About this study
Official title: Effects of the Egoscue Exercises With and Without Mwm on Pain, Range of Motion, Balance, and Quality of Life Among Patients With Knee Osteoarthritis
Knee osteoarthritis is a common degenerative joint disorder characterized by joint pain, stiffness, limited mobility, and reduced quality of life. It primarily affects the elderly population and poses a major burden on functional independence and healthcare resources. While various physiotherapy approaches have shown benefits in managing KOA symptoms, Mulligan's Mobilization with Movement is a manual therapy technique that has gained clinical attention for improving pain and joint mechanics. Similarly, Egoscue postural alignment exercises, which focus on restoring musculoskeletal balance through corrective movement patterns, have shown potential in addressing chronic pain and postural dysfunction, though evidence remains limited in knee osteoarthritis populations. This study aims to evaluate the effects of Egoscue exercises with and without MWM on pain, range of motion, balance, and quality of life in patients with knee osteoarthritis
Read the detailed description
This single-blinded randomized clinical trial will be conducted at Riphah Clinic and Sir Ganga Ram Hospital, Lahore, over 10 months following ethical approval. A total of 56 participants, diagnosed with KOA based on clinical criteria, will be recruited using non probability purposive sampling and randomly assigned to two groups. Group A will receive Egoscue exercises, MWM, and conventional physiotherapy exercises, while Group B will receive Egoscue exercises and conventional physiotherapy only. Each group will undergo treatment five times per week for 3 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), range of motion (Goniometry), balance (Timed Up and Go Test), and quality of life (EQ-5D-5L). Data will be analyzed using SPSS to determine the comparative effectiveness of the interventions in improving functional and clinical outcomes among KOA.
- Conditions
- Knee Osteoarthritis
- Being tested
- Egoscue exercises with MWM, Egoscue exercises without MWM
- Keywords
- Osteoarthritis, pain, range of motion
- Medical subject headings
- Osteoarthritis, Knee, Osteoarthritis, Pain
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Egoscue exercises with MWMOther
The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. Mobilization with Movement (MWM) will be implemented after completing the Egoscue routine. This will include a medial tibial glide that is done in a non-weight bearing (NWB) position.
Egoscue exercises without MWMOther
The exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. The exercises will be done with great caution of body alignment and posture
| Study group | Role | What they receive |
|---|---|---|
| Egoscue exercises with MWM | Experimental | Combining the Egoscue Method and Mobilization with Movement (MWM) for knee osteoarthritis (OA) is a powerful, evidence-based approach. Egoscue corrective exercises restore whole-body postural alignment, while MWM-a manual therapy technique pioneered by Brian Mulligan-corrects joint positional faults by actively moving the knee pain-free. Receives: Other: Egoscue exercises with MWM |
| Egoscue Exercises without MWM | Active comparator | The Egoscue Method approach for knee osteoarthritis (OA) focuses on improving alignment, hip function, ankle mobility, and muscle balance rather than strengthening the knee in isolation. Receives: Other: Egoscue exercises without MWM |
What is being measured
The primary outcome is the main question the study is designed to answer.
Numeric Pain Rating Scale for pain
The Numerical Pain Rating Scale (NPRS) is an 11-point scale, in which patients rate their pain in levels ranging between 0 (no pain) and 10 (worst imaginable pain). It is common because it is simple, has high test-retest reliability (ICC = 0.95) and responsiveness in musculoskeletal disorders, such as in knee osteoarthritis. A minimum of 2 points on NPRS is termed the minimal clinically important difference (MCID) on patients with musculoskeletal pain even with KOA.
Measured: upto 4 weeks
Goniometer for ROM
Goniometry is a clinical instrument that can be used to evaluate the joint angles both in active and passive range of motion. It is said to be valid in knee flexion and extension (ICC values range between 0.85 and 0.99 with respect to experience of examiners), with a standard error of measurement of approximately 3-5 degrees. The MCID of range of motion may depend on the improvement in the range of motion; the range of improvement of at least 5-10 degrees in the knee flexion or extension is usually regarded as clinically significant in patients with KOA
Measured: Upto 4 weeks
Timed Up and Go - TUG Test
Timed Up and Go (TUG) test refers to the time that the person requires to be seated on a chair, stand up, walk three meters, turn around, walk back, and reseat. It is a valid and reliable (ICC = 0.99) indicator of dynamic balance and functional mobility, with a sensitivity of 87% and specificity of 87% of predicting fall risk in older people. TUG is frequently employed to evaluate the improvement of balance and fall prevention in KOA patients. A difference of about 0.8 to 1.4 seconds is reported to be an MCID in older adults and KOA populations, which is a significant reduction in mobility and risk of falls
Measured: Upto 4 weeks
Euro Qol-5D-5L
The EQ-5D is a standardized instrument that assesses the quality of life related to health in five dimensions which are mobility, self-care, normal activities, pain/discomfort and anxiety/depression. It is well-construct valid and test-retest reliable (ICC = 0.86 -0.90), and sensitive to clinical changes in chronic arthritis such as osteoarthritis. In the case of musculoskeletal and osteoarthritis patients, the EQ-5D index score should be changed by at least 0.074, which is the minimal rate of improvement in the health-related quality of life
Measured: Upto 4 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Jun 2026
- Study start30 May 2026 (estimated)
- Primary completion30 Jun 2026 (estimated)
- Study completion30 Aug 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Knee OsteoarthritisStudies of the same condition, open and under way.
- More trials run by Riphah International UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 56 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Riphah International University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Rahat Afzal, MS-OMPT, Principal investigator, Governement Teaching Hospital Shahdara Lahore.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07646366
- Sponsor's protocol ID
- REC/RCR&AHS/25/0123 Malyka
- Status last verified
- Jun 2026
- First submitted
- 8 Jun 2026
- Last updated
- 12 Jun 2026
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Lee JHT, Kan MMP, Wong AKC. The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review. EFORT Open Rev. 2025 Jan 3;10(1):37-47. doi: 10.1530/EOR-2023-0209. Print 2025 Jan 1.
PubMed 40071912Gelber AC. Knee Osteoarthritis. Ann Intern Med. 2024 Sep;177(9):ITC129-ITC144. doi: 10.7326/ANNALS-24-01249. Epub 2024 Sep 10.
PubMed 39250809Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. doi: 10.1056/NEJMcp1903768. No abstract available.
PubMed 33406330Luan L, El-Ansary D, Adams R, Wu S, Han J. Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis. Physiotherapy. 2022 Mar;114:16-29. doi: 10.1016/j.physio.2021.10.001. Epub 2021 Oct 11.
PubMed 35091326Dantas LO, Salvini TF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther. 2021 Mar-Apr;25(2):135-146. doi: 10.1016/j.bjpt.2020.08.004. Epub 2020 Sep 8.
PubMed 33262080Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.
PubMed 33807695Hattori T, Ohga S, Shimo K, Matsubara T. Pathology of knee osteoarthritis pain: contribution of joint structural changes and pain sensitization to movement-evoked pain in knee osteoarthritis. Pain Rep. 2024 Jan 24;9(1):e1124. doi: 10.1097/PR9.0000000000001124. eCollection 2024 Jan.
PubMed 38274197Kokkotis C, Moustakidis S, Baltzopoulos V, Giakas G, Tsaopoulos D. Identifying Robust Risk Factors for Knee Osteoarthritis Progression: An Evolutionary Machine Learning Approach. Healthcare (Basel). 2021 Mar 1;9(3):260. doi: 10.3390/healthcare9030260.
PubMed 33804560Szilagyi IA, Waarsing JH, Schiphof D, van Meurs JBJ, Bierma-Zeinstra SMA. Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females. Rheumatology (Oxford). 2022 Feb 2;61(2):648-657. doi: 10.1093/rheumatology/keab378.
PubMed 33895803Nelson AE, Hu D, Arbeeva L, Alvarez C, Cleveland RJ, Schwartz TA, Murphy LB, Helmick CG, Callahan LF, Renner JB, Jordan JM, Golightly YM. The Prevalence of Knee Symptoms, Radiographic, and Symptomatic Osteoarthritis at Four Time Points: The Johnston County Osteoarthritis Project, 1999-2018. ACR Open Rheumatol. 2021 Aug;3(8):558-565. doi: 10.1002/acr2.11295. Epub 2021 Jul 10.
PubMed 34245232
Study at a glance
From the registry record, last updated by the sponsor on 12 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of the Egoscue Exercises With and Without Mwm on Pain, Range of Motion, Balance, and Quality of Life Among Patients With Knee Osteoarthritis
- ClinicalTrials.gov ID
- NCT07646366
- Acronym / sponsor ID
- REC/RCR&AHS/25/0123 Malyka
- Conditions
- Knee Osteoarthritis
- Keywords
- Osteoarthritis, pain, range of motion
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 56 participants (estimated)
- Lead sponsor
- Riphah International UniversityUniversity, hospital or other
- Study start
- 30 May 2026 (estimated)
- Primary completion
- 30 Jun 2026 (estimated)
- Study completion
- 30 Aug 2026 (estimated)
- First posted
- 12 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Knee osteoarthritis is a common degenerative joint disorder characterized by joint pain, stiffness, limited mobility, and reduced quality of life. It primarily affects the elderly population and poses a major burden on functional independence and healthcare resources. While various physiotherapy approaches have shown benefits in managing KOA symptoms, Mulligan's Mobilization with Movement is a manual therapy technique that has gained clinical attention for improving pain and joint mechanics. Similarly, Egoscue postural alignment exercises, which focus on restoring musculoskeletal balance through corrective movement patterns, have shown potential in addressing chronic pain and postural dysfunction, though evidence remains limited in knee osteoarthritis populations. This study aims to evaluate the effects of Egoscue exercises with and without MWM on pain, range of motion, balance, and quality of life in patients with knee osteoarthritis
Detailed description
This single-blinded randomized clinical trial will be conducted at Riphah Clinic and Sir Ganga Ram Hospital, Lahore, over 10 months following ethical approval. A total of 56 participants, diagnosed with KOA based on clinical criteria, will be recruited using non probability purposive sampling and randomly assigned to two groups. Group A will receive Egoscue exercises, MWM, and conventional physiotherapy exercises, while Group B will receive Egoscue exercises and conventional physiotherapy only. Each group will undergo treatment five times per week for 3 weeks, with each session lasting 45 minutes. Pre- and post-intervention assessments will include pain (NPRS), range of motion (Goniometry), balance (Timed Up and Go Test), and quality of life (EQ-5D-5L). Data will be analyzed using SPSS to determine the comparative effectiveness of the interventions in improving functional and clinical outcomes among KOA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Egoscue exercises with MWM | Experimental | Other: Egoscue exercises with MWMCombining the Egoscue Method and Mobilization with Movement (MWM) for knee osteoarthritis (OA) is a powerful, evidence-based approach. Egoscue corrective exercises restore whole-body postural alignment, while MWM-a manual therapy technique pioneered by Brian Mulligan-corrects joint positional faults by actively moving the knee pain-free. |
| Egoscue Exercises without MWM | Active comparator | Other: Egoscue exercises without MWMThe Egoscue Method approach for knee osteoarthritis (OA) focuses on improving alignment, hip function, ankle mobility, and muscle balance rather than strengthening the knee in isolation. |
Who may qualify
- Ages
- 40 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- • Patients aged between 40-60 years (15)
Key exclusion criteria (5 listed)
- • Any fracture or other injury (18)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Egoscue exercises with MWMThe exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. Mobilization with Movement (MWM) will be implemented after completing the Egoscue routine. This will include a medial tibial glide that is done in a non-weight bearing (NWB) position. | Other | Egoscue exercises with MWM |
| Egoscue exercises without MWMThe exercises will consist of: knee drops, standing knee pillow squeezer, hook-lying knee pillow squeezer, floor/knee block, kneeling groin stretch, assisted runners stretch, sitting double, sitting single switch, counter stretch (wall) and supine foot circles. The exercises will be done with great caution of body alignment and posture | Other | Egoscue Exercises without MWM |
Primary outcome
Numeric Pain Rating Scale for pain
Time frame: upto 4 weeks
The Numerical Pain Rating Scale (NPRS) is an 11-point scale, in which patients rate their pain in levels ranging between 0 (no pain) and 10 (worst imaginable pain). It is common because it is simple, has high test-retest reliability (ICC = 0.95) and responsiveness in musculoskeletal disorders, such as in knee osteoarthritis. A minimum of 2 points on NPRS is termed the minimal clinically important difference (MCID) on patients with musculoskeletal pain even with KOA.
Goniometer for ROM
Time frame: Upto 4 weeks
Goniometry is a clinical instrument that can be used to evaluate the joint angles both in active and passive range of motion. It is said to be valid in knee flexion and extension (ICC values range between 0.85 and 0.99 with respect to experience of examiners), with a standard error of measurement of approximately 3-5 degrees. The MCID of range of motion may depend on the improvement in the range of motion; the range of improvement of at least 5-10 degrees in the knee flexion or extension is usually regarded as clinically significant in patients with KOA
Timed Up and Go - TUG Test
Time frame: Upto 4 weeks
Timed Up and Go (TUG) test refers to the time that the person requires to be seated on a chair, stand up, walk three meters, turn around, walk back, and reseat. It is a valid and reliable (ICC = 0.99) indicator of dynamic balance and functional mobility, with a sensitivity of 87% and specificity of 87% of predicting fall risk in older people. TUG is frequently employed to evaluate the improvement of balance and fall prevention in KOA patients. A difference of about 0.8 to 1.4 seconds is reported to be an MCID in older adults and KOA populations, which is a significant reduction in mobility and risk of falls
Euro Qol-5D-5L
Time frame: Upto 4 weeks
The EQ-5D is a standardized instrument that assesses the quality of life related to health in five dimensions which are mobility, self-care, normal activities, pain/discomfort and anxiety/depression. It is well-construct valid and test-retest reliable (ICC = 0.86 -0.90), and sensitive to clinical changes in chronic arthritis such as osteoarthritis. In the case of musculoskeletal and osteoarthritis patients, the EQ-5D index score should be changed by at least 0.074, which is the minimal rate of improvement in the health-related quality of life
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 12 Jun 2026.
- Background: PubMed 40071912Lee JHT, Kan MMP, Wong AKC. The structure, process and outcomes of interprofessional care among knee osteoarthritis patients: a scoping review. EFORT Open Rev. 2025 Jan 3;10(1):37-47. doi: 10.1530/EOR-2023-0209. Print 2025 Jan 1.
- Background: PubMed 39250809Gelber AC. Knee Osteoarthritis. Ann Intern Med. 2024 Sep;177(9):ITC129-ITC144. doi: 10.7326/ANNALS-24-01249. Epub 2024 Sep 10.
- Background: PubMed 33406330Sharma L. Osteoarthritis of the Knee. N Engl J Med. 2021 Jan 7;384(1):51-59. doi: 10.1056/NEJMcp1903768. No abstract available.
- Background: PubMed 35091326Luan L, El-Ansary D, Adams R, Wu S, Han J. Knee osteoarthritis pain and stretching exercises: a systematic review and meta-analysis. Physiotherapy. 2022 Mar;114:16-29. doi: 10.1016/j.physio.2021.10.001. Epub 2021 Oct 11.
- Background: PubMed 33262080Dantas LO, Salvini TF, McAlindon TE. Knee osteoarthritis: key treatments and implications for physical therapy. Braz J Phys Ther. 2021 Mar-Apr;25(2):135-146. doi: 10.1016/j.bjpt.2020.08.004. Epub 2020 Sep 8.
- Background: PubMed 33807695Jang S, Lee K, Ju JH. Recent Updates of Diagnosis, Pathophysiology, and Treatment on Osteoarthritis of the Knee. Int J Mol Sci. 2021 Mar 5;22(5):2619. doi: 10.3390/ijms22052619.
- Background: PubMed 38274197Hattori T, Ohga S, Shimo K, Matsubara T. Pathology of knee osteoarthritis pain: contribution of joint structural changes and pain sensitization to movement-evoked pain in knee osteoarthritis. Pain Rep. 2024 Jan 24;9(1):e1124. doi: 10.1097/PR9.0000000000001124. eCollection 2024 Jan.
- Background: PubMed 33804560Kokkotis C, Moustakidis S, Baltzopoulos V, Giakas G, Tsaopoulos D. Identifying Robust Risk Factors for Knee Osteoarthritis Progression: An Evolutionary Machine Learning Approach. Healthcare (Basel). 2021 Mar 1;9(3):260. doi: 10.3390/healthcare9030260.
- Background: PubMed 33895803Szilagyi IA, Waarsing JH, Schiphof D, van Meurs JBJ, Bierma-Zeinstra SMA. Towards sex-specific osteoarthritis risk models: evaluation of risk factors for knee osteoarthritis in males and females. Rheumatology (Oxford). 2022 Feb 2;61(2):648-657. doi: 10.1093/rheumatology/keab378.
- Background: PubMed 34245232Nelson AE, Hu D, Arbeeva L, Alvarez C, Cleveland RJ, Schwartz TA, Murphy LB, Helmick CG, Callahan LF, Renner JB, Jordan JM, Golightly YM. The Prevalence of Knee Symptoms, Radiographic, and Symptomatic Osteoarthritis at Four Time Points: The Johnston County Osteoarthritis Project, 1999-2018. ACR Open Rheumatol. 2021 Aug;3(8):558-565. doi: 10.1002/acr2.11295. Epub 2021 Jul 10.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Rahat Afzal, MS-OMPT principal investigator
Governement Teaching Hospital Shahdara Lahore.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Egoscue exercises with MWM and Egoscue exercises without MWM in people with Knee Osteoarthritis, run by Riphah International University at 1 site in Pakistan.
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 3 inclusion and 5 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: opening soon, as of the sponsor's last update on 12 Jun 2026. 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 Pakistan. 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?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Samrood Akram, PhD* (03324806143, samrood.akram@riphah.edu.pk), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Numeric Pain Rating Scale for pain (time frame: upto 4 weeks). The study lists 4 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 NCT07646366, which also lists 10 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 12 Jun 2026.