Comparative Study of Short Term Response between Maitland Mobilization and Mulligan's Mobilization with Movement of Hip Joint in Osteoarthritis of Knee Patients Identified as Per Clinical Prediction Rule

Background and Purpose: Research suggests that many patients with knee osteoarthritis (OA) have hip impairments. A study demonstrated that subjects with knee OA had favourable outcome following a single intervention of hip mobilizations. With a Clinical Prediction Rule (CPR) various components are combined to determine the diagnosis, prognosis, or likely response to treatment of that individual. Thus the purpose of this study is to compare the short term response between Maitland mobilization and Mulligan's Mobilization with Movement (MWM) of hip in osteoarthritis of knee patients identified as per Clinical Prediction Rule.

Methodology: An experimental study was done with 60 subjects with OA knee who completed selfreport questionnaires -Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Patient Specific Functional Scale (PSFS), Numerical Pain Rating Scale (NPRS), underwent clinical examination of the hip and knee, and functional tests. These 60 subjects were divided into 2 groups -Group I received Maitland Mobilization and Group II received Mulligan mobilization. Follow-up testing was completed 2 days later. The reference criterion for determining a favourable response was either (1) a decrease of at least 30% on composite NPRS score obtained during functional tests or (2) a Global Rating of Change Scale (GRCS) score of at least 3.

Results: At 48 hour follow-up, 48 subjects (80%) out of 60 - 21(35%) from Maitland group and 27(45%) from Mulligan group were considered to have a favourable short-term response to the treatment. The mean difference in WOMAC, PSFS and NPRS were not statistically significant, whereas GRCS was statistically significant in Mulligan group.

Conclusion: Mulligan mobilization of hip was found to be extremely significant than Maitland mobilization in patients with OA knee identified as per CPR.