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

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

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.

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.

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).