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CTRI Number  CTRI/2025/03/081662 [Registered on: 05/03/2025] Trial Registered Prospectively
Last Modified On: 03/03/2025
Post Graduate Thesis  Yes 
Type of Trial  Interventional 
Type of Study   Physiotherapy (Not Including YOGA) 
Study Design  Non-randomized, Multiple Arm Trial 
Public Title of Study   A Study to Compare the Effectiveness of Mulligan Mobilization Technique and Traditional Therapy on Knee Function and Movement in People with Chronic Osteoarthritis – A Comparison Study 
Scientific Title of Study   A Study to Assess the Effectiveness of Mulligan Mobilization Technique Versus Conventional Therapy on Functional Performance and Mobility in Subjects with Chronic Osteoarthritis Knee – A Comparative Study.  
Trial Acronym  NIL 
Secondary IDs if Any  
Secondary ID  Identifier 
NIL  NIL 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr. Mansoureh Mobaraki 
Designation  Post Gradute 
Affiliation  RV College of Physiotherapy 
Address  RV College of Physiotherapy Department of Musculoskeletal Sciences Room No 03

Bangalore
KARNATAKA
560011
India 
Phone  8792038383  
Fax    
Email  sourimobaraki@gmail.com  
 
Details of Contact Person
Scientific Query  
Name  Dr Archana P 
Designation  Associated Professor  
Affiliation  RV College of Physiotherapy 
Address  RV College of Physiotherapy Department of Musculoskeletal Sciences Room No 03

Bangalore
KARNATAKA
560011
India 
Phone  8095347575  
Fax    
Email  archanap.rvcp@rvei.edu.in  
 
Details of Contact Person
Public Query  
Name  Dr Archana P 
Designation  Associated Professor  
Affiliation  RV College of Physiotherapy 
Address  RV College of Physiotherapy Department of Musculoskeletal Sciences Room No 03

Bangalore
KARNATAKA
560011
India 
Phone  8095347575  
Fax    
Email  archanap.rvcp@rvei.edu.in  
 
Source of Monetary or Material Support  
RV College of Physiotherapy No CA 2 83 3 9th Main Rd 4th T Block East 4th Block Jayanagar Bengaluru Karnataka India 560011 
 
Primary Sponsor  
Name  NIL 
Address  NIL 
Type of Sponsor  Other [NIL] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 1  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Archana P  RV College of Physiotherapy  RV College of Physiotherapy Department of Musculoskeletal Sciences Room No 03
Bangalore
KARNATAKA 		 8095347575

archanap.rvcp@rvei.edu.in 
 
Details of Ethics Committee  
No of Ethics Committees= 1  
Name of Committee  Approval Status 
RV Institution Ethic Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  (1) ICD-10 Condition: M179||Osteoarthritis of knee, unspecified,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Conventional Therapy   exercises (strengthening 15-20 reptations) + IFT (10 minutes) 3days/ 4 weeks 
Intervention  Mulligan Mobilization  Mulligan mobilization with movements 3 sets of 6-10 repetitions for 3 days/ 4 weeks  
 
Inclusion Criteria  
Age From  50.00 Year(s)
Age To  70.00 Year(s)
Gender  Both 
Details  Subjects diagnosed with chronic OA knee & Subjects with grade 2 and Grade 3 based on kellgren and Lawrence Radiographic scale
Age group 50-70 years
All genders
Subjects willing to participate as volunteers and who fill the consent form
Score of WOMAC outcome measure to identify moderate to chronic OA knee
 
 
ExclusionCriteria 
Details  Subjects with any neurological condition
Subjects with undergoing any form of surgeries
Subjects with other knee pathologies and injuries
Subjects with recent fracture/other trauma of lower limb
Subjects with contraindication to manual therapy
Subjects with any lower limb deformities & any recent surgeries
Subjects taken on priority
Subjects with received Knee rehabilitation
 
 
Method of Generating Random Sequence   Not Applicable 
Method of Concealment   Not Applicable 
Blinding/Masking   Not Applicable 
Primary Outcome  
Outcome  TimePoints 
The Western Ontario McMaster University Arthritis Index Score (WOMAC)  At baseline and after 4 weeks 
 
Secondary Outcome  
Outcome  TimePoints 
Locomotive Syndrome Risk Questionnaire  At baseline & after 4 weeks 
• Time up & Go Test(TUG)
• Sit to Stand
• Gait Speed Test
 		 At baseline & after 4 weeks 
 
Target Sample Size   Total Sample Size="80"
Sample Size from India="80" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   N/A 
Date of First Enrollment (India)   15/03/2025 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="6"
Days="0" 
Recruitment Status of Trial (Global)   Not Applicable 
Recruitment Status of Trial (India)  Not Yet Recruiting 
Publication Details   N/A 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Response - NO
Brief Summary   INTRODUCTION

Osteoarthritis is a chronic degenerative condition with multiple causes, it is characterized by the degradation of articular cartilage, bone enlargement around the edges, thickening of bone underneath the cartilage, and various biochemical and structural changes in the synovial membrane and joint capsule.1

Osteoarthritis, the second most prevalent rheumatologic condition, it is the predominant joint disorder in India, affecting between 22% to 39% of the population. Although it is more prevalent in women, its occurrence escalates notably with advancing age.1

 From a clinical perspective, osteoarthritis of the knee manifests through pain experienced during weight-bearing, tenderness, limited range of motion, crepitus, occasional swelling, and fluctuating levels of local inflammation.2Pain, being the predominant symptom, imposes substantial social, psychological, and financial burdens on patients, necessitating medical attention and rehabilitation, which can further strain their finances. 2

OA is classified into two groups according to its etiology: primary (idiopathic or non-traumatic) and secondary (usually due to trauma or mechanical misalignment). The severity of the disease can also be graded according to the radiographical findings by the Kellgren–Lawrence (KL) system described in 1957.3

An evidence-based management approach should involve
educating patients about osteoarthritis (OA) and its management. This education should include information on pain management, methods to improve function, reduce disability, and strategies to slow down the progression of the disease.4Physiotherapy focuses on achieving proper posture and enhancing muscle strength through various techniques, including manual therapy such as mobilization, along with exercises to strengthen muscles and stretch soft tissues. In the case of knee osteoarthritis (OA), the objective of physical therapy is to alleviate pain, preserve joint function, and restore or maintain normal joint activity.5

Mobilization with Movement (MWM) is a manual therapy technique frequently employed in the treatment of musculoskeletal conditions. Developed by Brian Mulligan, it offers a novel approach to addressing a range of soft tissue issues in both upper and lower limb joints. This technique involves executing pain-free physiological movements while applying accessory glides in the direction opposite to the previously painful movement, with the aim of achieving maximum improvement.6Hence, Mobilization with Movement (MWM) involves the therapist administering a corrective technique by applying a passive accessory glide perpendicular to the joint plane to address positional issues. Simultaneously, the patient actively executes the problematic movement repeatedly. Throughout this process, the goal is for pain to consistently diminish or vanish, and for pain-free function to be reinstated.7

Osteoarthritis can significantly impact functional performance and mobility, presenting a considerable challenge to individuals affected by the condition. As the disease progresses, the degeneration of cartilage and changes in joint structure can lead to stiffness, pain, and reduced range of motion, all of which can profoundly affect day-to-day activities. Tasks that once seemed effortless, such as walking, climbing stairs, or even getting out of a chair, may become arduous and painful.Furthermore, osteoarthritis often causes muscle weakness and imbalance around the affected joint, further compromising mobility and stability. This can lead to a vicious cycle where reduced activity due to pain and limitations exacerbates muscle weakness, ultimately worsening functional performance. As mobility declines, individuals may experience decreased independence and quality of life, impacting not only physical health but also mental well-being.

However, proactive management strategies, including physical therapy, exercise, weight management, and joint protection techniques, can play a crucial role in mitigating the impact of osteoarthritis on functional performance and mobility. By improving muscle strength, flexibility, and joint stability, these interventions can help individuals maintain or regain independence in daily activities, enhancing their overall quality of life despite the challenges posed by osteoarthritis.



 
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