Comparing the Effects of Macquarie Injury Management Group Protocol and Targeted Knee Exercise Program on Pain, Range of Motion and Functional Disability in Patients With Grade II Knee Osteoarthritis

Osteoarthritis (OA), the most prevalent type of arthritis, is the foremost cause of disability. Knee OA mainly affects the synovial membrane, bones, and cartilage of the joint. The synovial membrane is a smooth lining that protects the joint. Conservative management through manual therapy is widely used, but comparative effectiveness of different techniques remains unclear. This randomized clinical trial was designed to compare the effects of macquire injury management group protocol and targeted knee exercise program on pain and range of motion and functional disability in patients with knee osteoarthritis grade 2.A total of 84 participants diagnosed with knee osteoarthritis grade 2 were recruited . All the screened and willing participants were randomly allocated to two groups by lottery method with 42 patients in each group. (Group A: Experimental group /MIMG group, Group B: Comparative Group / CK group) .Group A received macquire injury management group protocol . The MIMG Knee Protocol is known for its emphasis on soft tissue mobilization. The patients were made to lie down in a supine position and their knee joints were in an extended position during the treatment. In order to perform the soft tissue mobilization, the physiotherapist gently worked on the soft tissues of the knee joint for about two to three minutes using both his hands. In addition to the manual treatment method, the patients also underwent 45 minutes of physical therapy exercises . Group B received targeted knee exercise program , was aimed at improving the strength, proprioception, and stability of the knee joint. It comprised of progressively increasing knee exercises for the quadriceps (for example, straight leg raises and terminal knee extensions), hip abductors, and hamstrings. In addition to these exercises, there were also exercises to increase the stability of the joint by means of proprioceptive exercises involving single leg standing and dynamic stability exercises. Functional exercises including sit-to-stand and step up were also included. The intervention period lasted for 12 weeks with 3 sessions per week. Outcome measures were assessed at baseline and post-intervention.

Pain was assessed using the numeric pain rating scale and functional disability was measured using WOMAC index. Range of motion was also evaluated before and after treatment by universal goniometer. The primary objective of this study is To determine the effects of Macquire Injury Management Group protocol and Targeted Knee Exercise Program on Pain, Range of Motion and Functional Disability in Patients with Grade II Knee Osteoarthritis. The findings will help clinicians select the most effective manual therapy approach for managing Grade II Knee Osteoarthritis.

Inclusion criteria

• Both female and male subjects aged between 40 to 60 year
• Diagnosed knee osteoarthritis, Grade II by Kellegren Lawrence.

Exclusion criteria

• Any surgical procedure done for lower extremity
• Any infection
• Post traumatic knee stiffness
• Secondary knee osteoarthritis
• Peripheral vascular disease.