Effectiveness of manipulation with movement and muscle energy technique in elderly with knee osteoarthritis: A double-blind randomized control trial

BackgroundManaging knee Osteoarthritis (KOA) effectively often requires a multifaceted approach that includes various manual therapy techniques to reduce pain and improve joint function in the elderly. The effectiveness of manipulation with movement (MWM) and muscle energy technique (MET) is still unclear.ObjectiveTo compare the efficacy of MWM and MET in the elderly with KOA over time.MethodsA double-blind randomized control trial was conducted in the rehabilitation division of Surakarta Hospital, Indonesia, with 54 participants randomized into two groups. The effects of MWM and MET on pain (Numeric Rating Scale), knee range of motion, static and dynamic balance, lower limb muscle strength, and fear of falling (FoF) were observed after 4 weeks of treatment and 2 weeks of follow-up. Repeated-measures ANOVA compared mean outcomes over time between the groups, and a t-test compared mean differences between groups.ResultsThere was no mean difference in baseline between groups. MET and MWM showed a significant effect of time on all outcome measures (p < 0.05). MWM revealed higher knee flexion (<i>p </i>< 0.001), TUG (<i>p </i>= 0.010) and FoF (<i>p </i>= 0.008) after 4 weeks (p < 0.05). The follow-up resulted in significant differences between groups, knee flexion, TUG and one leg stance (OLS) on the left side and open eyes were higher in the MWM group.ConclusionsBoth MWM and MET were effective treatment strategies in managing KOA. MWM had a greater effect on improving knee flexion movement, dynamic balance and FoF than MET. OLS with open eyes was observed stable in follow-up observation in the MWM group.