60 Participants Needed

Ankle Mobilization for Knee Pain

EL
Overseen ByEverett Lohman, DSc
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: Loma Linda University
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how limited ankle movement might affect knee pain, particularly during exercises like squats. Researchers are testing whether "Mobilization with Movement," involving specific ankle exercises, can improve knee pain. Participants will be divided into two groups: one will perform the ankle exercises, while the other will engage in minimal exercise and read an infographic. This trial suits women who have experienced knee pain for over six months, have not received recent treatment for it, and have limited ankle flexibility.

As an unphased trial, this study allows participants to contribute to innovative research that could lead to new insights and treatments for knee pain.

Do I need to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What prior data suggests that this ankle mobilization technique is safe for knee pain?

Research has shown that mobilization with movement (MWM) is generally well-tolerated by people with knee osteoarthritis. In various studies, participants experienced less pain and improved knee movement. However, information on safety remains limited. Only a few studies specifically examined safety, and they did not identify any clear safety issues with MWM. This suggests that the treatment is likely safe for most people, but further research may be needed for confirmation.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores a novel approach to managing knee pain by targeting ankle mobility. Unlike traditional treatments such as pain relievers or physical therapy focused solely on the knee, this method aims to improve dorsiflexion range of motion in the ankle, which may indirectly alleviate knee discomfort. This could offer a new, non-invasive pathway to pain relief that could complement existing therapies. By examining the effects of ankle mobilization, researchers hope to uncover a deeper understanding of the interconnectedness of joint movements and pain relief.

What evidence suggests that ankle mobilization could be effective for knee pain?

Studies have shown that a technique called mobilization with movement (MWM) effectively alleviates knee pain and enhances knee function. Research indicates that MWM benefits individuals with knee osteoarthritis by increasing their knee's range of motion and reducing pain. In this trial, participants in the Primary Intervention Group will receive MWM to increase dorsiflexion range of motion. One study found that combining MWM with regular physiotherapy was more effective than physiotherapy alone. This method not only eases pain but also improves knee flexibility and aids in daily activities. Overall, MWM appears to be a promising approach to managing knee pain and improving movement.14678

Who Is on the Research Team?

EL

Everett Lohman, Dsc

Principal Investigator

Loma Linda University

Are You a Good Fit for This Trial?

This trial is for women aged 18-59 with Patellofemoral Pain lasting at least 6 months, who haven't had clinic treatments in that time. They must have limited ankle movement (<45 degrees on a lunge test) and no knee swelling, abnormal limb structures, severe resting pain, or past surgery/fractures affecting leg/spine biomechanics.

Inclusion Criteria

History of active Patellofemoral Pain for at least 6 months
No clinic based therapeutic interventions for a 6-month period prior to testing
You have difficulty moving your foot upwards when standing, as detected by a test called weight bearing lunge test, where you are required to bend your knee and tilt your body forward.

Exclusion Criteria

Current knee effusion
You have had bone or muscle problems in the limb being tested before.
You have severe pain at rest, rated greater than 5 out of 10.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1 week
1 visit (in-person)

Baseline Assessment

Participants complete self-reported questionnaires and undergo initial measurements of dorsiflexion and hip abductor strength

1 day
1 visit (in-person)

Intervention

Experimental group receives interventions to increase dorsiflexion; minimal intervention group reads an infographic and walks on a treadmill

1 day
1 visit (in-person)

Post-Intervention Assessment

Participants undergo post-intervention measurements and complete additional trials of the Lateral Step Down test

1 day
1 visit (in-person)

Follow-up

Participants are monitored for any changes in dorsiflexion and functional outcomes

1 week

What Are the Treatments Tested in This Trial?

Interventions

  • Mobilization with Movement
  • No mobilization with movement and education
Trial Overview The study examines how limited ankle flexibility affects single-leg squats in those with knee pain. Participants will either receive 'Mobilization with Movement' therapy or just education without mobilization to see which method better improves squat performance.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Primary Intervention GroupExperimental Treatment1 Intervention
Group II: Minimal Intervention GroupActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Loma Linda University

Lead Sponsor

Trials
322
Recruited
267,000+

Published Research Related to This Trial

In a study of 41 subjects with acute ankle inversion sprains, adding anteroposterior joint mobilization to the standard RICE protocol resulted in fewer treatment sessions needed to achieve pain-free dorsiflexion.
The experimental group also showed greater improvements in stride speed compared to the control group, indicating that this specific joint mobilization can enhance recovery outcomes in ankle sprain rehabilitation.
A randomized controlled trial of a passive accessory joint mobilization on acute ankle inversion sprains.Green, T., Refshauge, K., Crosbie, J., et al.[2022]
Accessory knee joint mobilization significantly increased pressure pain threshold (PPT) by 27.3% in individuals with knee osteoarthritis, indicating a strong local pain relief effect compared to manual contact and no-contact interventions.
The mobilization technique also improved functional performance, as evidenced by a significant reduction in 'up and go' time, suggesting that it can enhance mobility in patients with knee pain.
The initial effects of knee joint mobilization on osteoarthritic hyperalgesia.Moss, P., Sluka, K., Wright, A.[2022]
Mobilization with movement (MWM) significantly improved pain and function in patients with knee osteoarthritis compared to sham MWM, with benefits observed immediately after treatment and lasting for at least 2 days.
MWM enhanced various measures including pain reduction, pressure pain threshold, walking speed, knee flexor and extensor strength, and knee flexion range of motion, indicating its efficacy as a therapeutic intervention for knee OA.
The effect of mobilization with movement on pain and function in patients with knee osteoarthritis: a randomized double-blind controlled trial.Alkhawajah, HA., Alshami, AM.[2020]

Citations

A Systematic Review of Randomized Controlled TrialsThis systematic review demonstrated that MWM was effective to improve pain, range of motion, and functional activities in subjects with knee osteoarthritis.
Effectiveness of mobilisation with movement (MWM) along ...This randomised clinical trial provides robust evidence that MWM combined with usual physiotherapy care significantly outperforms conventional ...
Effectiveness of Mobilisation with Movement (MWM) along ...This randomized clinical trial demonstrated significant improvements in pain, knee flexion range of motion, and functional ability in patients ...
The effect of mobilization with movement on pain and function ...The current study suggests that MWM but not sham MWM for patients with knee OA provides a local and widespread hypoalgesic effect, increases ...
The Efficacy of Manual Therapy in Patients with Knee ...The available studies indicated that MT can induce a short-term reduction in pain and an increase in knee ROM and functionality in patients with knee OA.
systematic review and network meta-analysisThe safety outcome was reported in a small proportion of studies (40 studies, 18%), and no clear differences were observed between exercise ...
a study protocol for a randomised clinical trialA study to determine the effectiveness of mobilization with movement techniques in knee osteoarthritis pain. Int J Health Sci Res. 2017;7 ...
EMMATKA trial: the effects of mobilization with movement ...The study demonstrated short/medium-term statistically significant improvements in the primary outcome of knee joint flexion ROM. The current ...
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