Abstract
Background: Knee osteoarthritis (OA) is associated with changes in walking biomechanics such as altered excursion or change in joint load. Manual therapy (MT) may modulate pain via the enhancement of descending pain mechanisms that could influence neuromuscular activity and subsequently lead to changes in the mechanical behaviour of the joint such as modification of joint load. There is limited research, and an opportunity exists to further explore whether MT can influence biomechanics during walking.
Objective: The primary aim of this study is to explore whether MT intervention influences the biomechanical outcomes of gait in people with knee OA. The secondary aim is to explore the relationship between biomechanical outcomes of gait and clinical outcomes (pain and function), following MT intervention.
Methods: Prospective registration no. ACTRN12624000157572p. Study design: single-arm pre-test-post-test design. The participants will be included as per defined inclusion and exclusion criteria. Primary outcome: Peak knee adduction moment (KAM) measured by biomechanical gait analysis. Secondary outcomes: knee range of motion, pain while walking, fear and avoidance, recommended core set of patient-reported outcomes, and 2° biomechanical outcome measures of gait. Time-points: Baseline I, baseline II at 4-week, post-intervention at 8-week, and follow-up at 6-month. Knee-focused tailored MT will be provided with the frequency of 2 sessions/week x 45–60 mins x 3 consecutive weeks.
Results: We will report descriptive statistics of each outcome measure. To evaluate our 1° aim, we will use repeated measures ANOVA and a Tukey HSD post hoc test. We will perform repeated measure correlation tests to assess our 2° aim.
Conclusion: It is an exploratory study that will provide preliminary evidence on whether MT could influence biomechanical outcomes of gait.
Implications: This study will advance the knowledge of MT mechanisms. It may provide further support for the role of MT in the management of people with knee OA.