Effects of Joint Mobilization on Pain, Range of Motion, and Function in Patients with Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Abstract

Background: Knee osteoarthritis (KOA) is a common degenerative joint disease that severely affects patients' quality of life. Joint-mobilization technique reportedly improves joint pain, limited mobility, and dysfunction significantly. This meta-analysis aimed to systematically assess the clinical efficacy of joint-mobilization technique treatment on the level of knee pain, function, and mobility in patients with KOA. We also aimed to provide evidence-based medical data for the clinical management of KOA. Methods: We searched four English databases (PubMed, Web of Science, Embase, and Cochrane) and three Chinese databases (China Biomedical Literature Database, CNKI, VIP, and Wanfang). The search date was from the date of inception to February 1, 2024 for each database. Randomized controlled trials investigating the efficacy of joint release in KOA were identified. Meta-analysis was performed using RevMan 5.4 and Stata 17.0. Results: A total of 8 studies involving 432 patients with KOA were included. Our meta-analysis showed that compared with the control group, the experimental group showed a significant improvement in knee pain level (SMD=-1.69, 95% CI [-1.74, -0.82] Z=3.96 P<0.0001), WOMAC scale (SMD=-0.74 95% CI [-1.39, -0.10] Z= 2.25 P=0.02) were significantly improved. However, they were not superior to controls in knee flexion (SMD=2.3 95% CI [0.98, 3.62] Z=3.41 P=0.00006) and extension mobility (SMD=1.79, 95% CI [1.38, 2.20], Z=8.54,P<0.00001). Conclusion: Joint-mobilization technique has some advantages in improving the degree of knee pain and dysfunction in patients with KOA, but it is not better than the control group in improving knee mobility. This study provides theoretical support for the promotion of joint-mobilization technique in KOA treatment. Abbreviations: KOA=Knee Osteoarthritis, WOMAC= Western Ontario and McMaster Universities Arthritis Index, CI = confidence interval, SMD = standard mean difference. This research is important as knee osteoarthritis is one of the most prevalent joint disorders that significantly impacts the quality of life of affected individuals. By exploring the effects of joint mobilization on pain, range of motion, and functional outcomes, we aim to provide a more evidence-based approach to the management of this condition. This topic aligns closely with the focus of PLOS ONE on advancing public health and clinical practice, making a meaningful contribution to the field. Our study addresses a critical academic question: Does joint mobilization significantly improve pain, range of motion, and function in patients with knee osteoarthritis? Through a thorough systematic review and meta-analysis of randomized controlled trials, we discovered that joint mobilization has a statistically significant impact on reducing pain and improving function. Additionally, our results indicate that this intervention effectively enhances the range of motion in patients. These findings lend strong support to the integration of joint mobilization into the management strategies for knee osteoarthritis. We would like to affirm that this manuscript has not been published elsewhere and is not under consideration for publication by any other journal. All authors have reviewed and approved the submission of this manuscript to PLOS ONE.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

Yes

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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This study is a meta-analysis and does not require an ethical application

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Data Availability

All relevant data are within the manuscript and its Supporting Information files.

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