Skip to main content
OpenTrials
Completed

NCT Number: NCT07710404

Effectiveness of Joint Distraction Versus Passive End Range Overpressure in Osteoarthritis:

Knee osteoarthritis was a common degenerative joint condition that caused pain, stiffness, reduced range of motion, and functional limitations. This study compared two manual therapy techniques: Joint Distraction and Passive Joint End-Range Overpressure. The goal was to determine which technique was more effective at reducing pain, improving knee range of motion, enhancing function, and improving quality of life in patients with knee osteoarthritis. Participants were randomly assigned to receive either Joint Distraction or Passive Joint End-Range Overpressure for 4 weeks.

Completed

Looking for future studies?

Notify Me

Key information

Conditions

Osteoarthritis Arthritis Joint Diseases Joint Distraction Musculoskeletal Diseases Neurologic Manifestations Osteogenesis Pain Pathological Conditions, Signs and Symptoms Rheumatic Diseases Signs and Symptoms

Age range

40 year–59 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

The university of Faisalabad

Faisalābad, Punjab Province, 3800, Pakistan

About this study

This study was a randomized clinical trial. A sample of 26 participants aged 40-60 with Grade 2 or Grade 3 Knee Osteoarthritis was recruited from DHQ Hospital and Madinah Teaching Hospital Faisalabad. Participants were randomly assigned to two groups (n=13 each). Group A received the Joint Distraction Technique involving sustained traction of the knee joint for 20 minutes at the patient's perceived threshold. Group B received Passive Joint End-Range Overpressure involving Maitland Grade IV mobilization for 3 minutes, twice, with a 30-second rest interval. Both groups received a 10-minute hot pack before their respective techniques. Interventions occurred 3 times per week for 4 weeks (12 sessions total). Outcome measures included the Visual Analogue Scale (VAS), Goniometer, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and Knee Injury and Osteoarthritis Outcome Scale (KOOS), measured at baseline and after 4 weeks.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients diagnosed with Grade 2 or Grade 3 Knee Osteoarthritis.
  • A Kellgren-Lawrence Grade (KLG) of at least 2.
  • Age between 40-60 years.
  • Knee pain for at least 6 months.
  • A minimum pain score of 3 on the Visual Analogue Scale (VAS).

Exclusion criteria

  • Acute inflammation.
  • Total Knee Replacement (TKR) surgery.
  • Any lumbar spine disease (disc herniation or lumbar stenosis).
  • Intra-articular injection.
  • Recent tibia or femur fracture.
  • Any systemic inflammatory arthritic condition or neurological condition (e.g., rheumatoid arthritis or stroke).

Treatment and study plan

Joint distraction GROUP A

Other

The joint distraction is the manual approach in knee osteoarthritis. This is very efficient in managing pain, to increase range of motion and reduce stiffness of joint due to osteoarthritis. A specialized greave would be created to distract the knee joint.

Using a platform beneath the lower leg to create counterpressure, the knee would be put in flexion while sustained traction will be performed for 20 minutes while the patient would be in a supine posture. In each session, the traction would be adjusted to the patients' perceived threshold. The least amount of work that caused patients to get distracted would be employed as a diversion

Passive Joint End-Range Overpressure TO GROUP B

Other

The passive joint end-range overpressure is the technique of Maitland grade IV which is performed passively. End-range Individual Maitland mobilizations were carried out at the tibiofemoral joint. Depending on the patient's level of pain and tolerance, an oscillatory accessory approach using Grade III or IV was carried out. Patients positioned their knees in their true end range while lying supine on the plinth. The most limited or reproducible knee pain was caused by the accessory approach that was employed. By moving the therapist's body without making any additional movements, the physical contact accurately replicated the hand position of the mobilization. For three minutes, Maitland mobilization was carried out twice at a rate of one oscillation every one or two seconds, with a 30-second break in between

Primary outcomes

  1. pain intensity

    Time frame: 4 months

    Primary Outcome Measure Pain Tool Used: Visual Analogue Scale (VAS)

    The Visual Analogue Scale (VAS) was used to assess the patient's pain level. Participants were asked to rate their pain on a scale from 0 to 10.

    0 = No pain 1-3 = Mild pain 4-6 = Moderate pain 7-10 = Severe pain This scale was used to categorize the intensity of pain experienced by patients with knee osteoarthritis.

Secondary outcomes

  1. Quality of Life / Broader Function

    Time frame: 4 months

    Quality of Life / Broader Function Tool Used: KOOS Questionnaire (Knee Injury and Osteoarthritis Outcome Scale.

    The KOOS questionnaire was used to assess:

    Pain Symptoms Activities of Daily Living (ADLs) Sport and Recreation Function Knee-related Quality of Life

    It contains 42 items divided into five sections:

    Pain = 9 items Symptoms = 7 items Activities of Daily Living = 17 items Sport and Recreation Function = 5 items Quality of Life = 4 items

    Each item is scored from 0 to 4.

    Maximum score:

    42 items × 4 = 168

    Interpretation (Percentage Based):

    < 40% = Extreme disability 40-59% = Severe problems 60-79% = Moderate problems 80-99% = Mild disability This questionnaire evaluates the overall impact of knee osteoarthritis on function and quality of life.4 months

  2. Disability

    Time frame: 4 months

    Secondary Outcome Measures

    • Osteoarthritis Symptoms and Functions Tool Used: WOMAC Questionnaire (Western Ontario McMaster Universities Osteoarthritis Index)

    The WOMAC questionnaire was used to assess:

    Pain Stiffness Physical function

    It contains 24 items divided into three sections:

    Pain = 5 items Stiffness = 2 items Physical Function = 17 items Each question has 5 response options ranging from None to Extreme.

    Scoring:

    Each item = 0-4 points Pain section total = 20 Stiffness section total = 8 Physical function section total = 68 Total WOMAC score = 96

    Interpretation:

    0-30 = Mild 31-60 = Moderate 61-96 = Severe The higher the score, the greater the symptoms and functional limitations.

  3. Passive Range of Motion

    Time frame: 4 months

    Passive Range of Motion Tool Used: Goniometer

    A goniometer was used to assess joint range of motion.

    The instrument consists of three parts:

    Moving Arm - aligned with the body segment that moves. Stationary Arm - aligned with the body segment that remains stationary. Fulcrum - positioned over the joint being assessed.

    The goniometer was used to measure the knee joint's range of motion before and after treatment.

Sponsors and collaborators

Lead sponsor

University of Faisalabad

Other

Registry information

Official study title

Comparative Effectiveness of Joint Distraction Versus Passive End Range Overpressure in Managing Knee Osteoarthritis: A Randomized Clinical Trial

Important dates

Study start
2025
Primary completion
2026
Study completion
2026
First posted
Jul 17, 2026
Registry last updated
Jul 17, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Related clinical trials

Published trials that share one or more normalized conditions with this study.