Efficacy of Maitland Mobilization and Myofascial Release Technique in Patients with knee osteoarthritis: A Randomized Controlled Trial

Abstract

Background
Knee osteoarthritis (OA) is a common musculoskeletal condition characterized by pain, joint stiffness, restricted range of motion (ROM), and functional limitations. Manual therapy techniques, including Maitland mobilization and myofascial release (MFR), are commonly used in physiotherapy to address these impairments. This study evaluated the effects of combined Maitland mobilization and MFR on pain, knee ROM, functional disability, and kinesiophobia in patients with knee OA.
Materials & Methods
A comparative interventional study was conducted among 36 patients with knee OA, with 18 participants allocated to each group. Group A received combined Maitland mobilization and MFR, whereas Group B received the comparator intervention according to the study protocol. Pain intensity was assessed using the Visual Analogue Scale (VAS), knee mobility was evaluated by measuring flexion and extension ROM, functional disability was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and kinesiophobia was evaluated using the Tampa Scale for Kinesiophobia (TSK). Assessments were performed before and after the intervention, with the final assessment conducted on Day 14. Within-group changes were analyzed using paired t-tests.
Results
The mean VAS score decreased from 7.11 at baseline to 2.83 after treatment in Group A and from 7.11 to 5.11 in Group B. In Group A, the reduction in VAS score was statistically significant (t = −16.821, df = 17, p < 0.001). At Day 14, the mean knee flexion was 117.7 ± 2.94° in Group A and 107.9 ± 2.49° in Group B, while the mean knee extension values were 3.27 ± 1.22° and 6.33 ± 1.18°, respectively. The reported paired t-test analyses for knee flexion and extension in Group A demonstrated statistically significant changes (p < 0.001). Mean WOMAC scores decreased from 64.30 to 37.50 in Group A and from 65.30 to 52.90 in Group B. Mean TSK scores decreased from 45.50 to 31.50 in Group A and from 46.90 to 41.90 in Group B. The reported paired analysis demonstrated a statistically significant reduction in TSK scores (t = −21.678, p < 0.001).
Conclusion
Combined Maitland mobilization and MFR was associated with improvements in pain, knee ROM, functional disability, and kinesiophobia over the 14-day intervention period. Greater numerical reductions in VAS, WOMAC, and TSK scores were observed in Group A than in Group B. However, as the reported statistical analyses primarily assessed within-group changes, these findings do not establish whether the magnitude of improvement differed significantly between the two groups. Appropriate between-group analyses are required to determine the statistical significance of differences in treatment effects. Further studies involving larger samples and longer follow-up periods are recommended.