Original Article: JRCRS. 2025; 13(1):21-27.
5-Comparative Effects of Hold Relax Technique and Mulligan Mobilization on Pain, Range of Motion and Function in Post-Operative Knee Joint – RCT
Inbeast Fatima1, Nosheen Manzoor2, Aisha Waseem3, Hina Manzoor4
1Physical Therapist, Akhtar Memorial Hospital and Maternity Home Sheikhupura, Punjab, Pakistan
2Assistant Professor, University of Management & Technology, Lahore, Pakistan
3Clinical Physiotherapist, Riaz Institute of Medical Sciences, Jhang, Pakistan
4Physical Therapist, Aziz Fatima Hospital, Faisalabad, Pakistan
ABSTRACT:
BACKGROUND: Knee stiffness is a common consequence of knee fracture, that can result in the loss of range of motion, strength, pain and difficult to perform daily life activities. This stiffness can be seen in 11% of the patient. It is due to prolong period of immobilization. Many treatment techniques have been used to treat the pain, knee stiffness and functional mobility. Mulligan’s mobilization and hold relax technique was also used to treat pain, increase range of motion and functional mobility of knee joint.
OBJECTIVE: To compare the effects of hold relax technique and mulligan’s mobilization on pain, range of motion and function in post-operative knee joint.
METHODOLOGY: It was randomized clinical trial, the research had been carried out from January to March 2022 at the DHQ Hospital Jhang, Pakistan. 34 subjects of both genders 26 were males and 8 were females were randomly assigned into two groups based on their inclusion and exclusion criteria. The study was done at DHQ hospital Jhang. Subjects in one group were given Mulligan’s mobilization along with Moist heat pack (baseline treatment) and the other group were given hold relax technique along with moist heat pack (baseline treatment) for 4 weeks. Recorded values were analyzed by using spss. Group A was assigned the mulligan mobilization technique, while Group B was assigned the holdrelax technique. Both interventions were conducted over six weeks, with three sessions per week. Both groups also received baseline treatment, which included the application of a hot pack and ultrasound therapy. The outcome measure used was numeric pain rating scale used for pain, goniometer used to measure range of motion and time up and go test to measure the functional mobility.
RESULTS: After treatment protocols both groups showed effective outcomes in decreasing pain and stiffness of knee joint and improving functional mobility. Mean value of NPRS was reduced from 4.47 ± 1.13 to 1.65 ± 0.93 in MWM group while in hold relax group from 4.35± 1.22 to 2.35 ± 0.99. Mean value of knee flexion ROM was increased from 56.76±6.11 to 109.1 ± 4.04 in MWM group while in hold relax group from 57.35 ± 5.62 to 85.88±4.76. Mean value of TUG test was reduced from 25.41 ± 2.39 to 9.29 ± 0.69 in MWM group while in hold relax group from 24.29 ± 2.34 to 15.29 ± 0.99. The group treated with the Mulligan technique showed significantly greater improvements compared to the group treated with the hold-relax technique in patients with knee stiffness.
CONCLUSION: In the management of post-operative knee stiffness, Mulligan mobilization is more efficient than the hold relax approach.
KEYWORDS: Hold-Relax, Knee Stiffness, Mulligans mobilization, NPRS, Range of Motion.