Comparing Manipulation, Rehabilitation and Combination of the Two in the Treatment of Knee Osteoarthritis

Summary

Common medical therapies for knee osteoarthritis are patient education, drug and physical therapy, exercise and surgery. These modalities may offer improvement but drugs and surgery carry significant risk. Manipulative therapy for KOA gives pain relief and increased function. However, research suggests addition of manipulative and soft tissue therapy (to the entire kinetic chain: lumbosacral, sacroiliac, hip, knee, ankle and foot joints), may give a better outcome. Exercise therapy is considered an effective and standard care for KOA.

Conditions

• Osteoarthritis, Knee

Interventions

OTHER

Full Kinetic Chain Manipulative Therapy

Treatment will focus on restoring knee flexion and extension by lesser grades of mobilization and patellar mobilization along with careful high velocity low amplitude axial elongation of the knee joint. Additionally, manipulative therapy will be applied where needed to the full kinetic chain using diversified techniques, such as HVLA manipulation or mobilization. This group will receive a total of 6 treatments over a 3 week period. Outcome measures will be taken at baseline, prior to the 4th treatment and at the one week follow-up. A 3 month follow-up will be done by mail, phone or email.

OTHER

Full Kinetic Chain Rehabilitation

Rehabilitative therapy includes exercises, focused soft tissue treatment and stretch to the knee and the full kinetic chain where needed based upon functional assessment. Also included; patient advice, education and home exercise recommendations for managing their KOA. This group will receive a total of 6 treatments over a 3 week period. Outcome measures will be taken at baseline, prior to the 4th treatment and at the one week follow-up. A 3 month follow-up will be done by mail, phone or email. The rehabilitative therapy group will be required to attend the initial treatment/training, the 4th visit and 1 week follow-up. Treatments 2, 3, 5 and 6 are considered optional; they may be done at home

OTHER

Full Kinetic Chain Manipulative Therapy with Rehabilitation

This arm is a combination of the manipulative therapy arm and the rehabilitative therapy arm. This group receives 6 treatments over a 3 week period with a one week follow-up on site and a 3 month follow-up by mail, phone or email.

Sponsors & Collaborators

• Durban University of Technology

  collaborator OTHER

• Murdoch University

  collaborator OTHER

• Cleveland Chiropractic College

  lead OTHER

Principal Investigators

• James W Brantingham, DC, PhD · Cleveland Chiropractic College

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

38 Years

Max Age

80 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2010-09-30

Primary Completion

2011-10-31

Completion

2011-10-31

Countries

• United States
• South Africa

Study Locations