Manual mobilization with the OMT Nordic System method as an additional treatment to physical exercise and patient education for patients with knee osteoarthritis : Single subject experimental design

Abstract: Background: Osteoarthritis (OA) in the knee is one of the most common joint diseases in the world. The symptoms include local joint pain, joint stiffness, crepitation etc. Treatment follows national clinical guidelines which includes patient education, exercise and weight loss. Manual therapy can be used as an additional treatment and has shown a positive effect on pain, range of motion (ROM) and function but the method is not studied enough. Purpose: To investigate the effect of manual mobilization with the OMT Nordic System method as a complement to exercise and patient education for patients with knee OA on pain, Quality of Life (QoL) and ROM. Method: A Single subject experimental design study with 4 participants was conducted. Participants underwent a standardized patient education followed by a 6-week baseline of physical exercise, then a 3-week intervention phase which added manual therapy of the knee joint two times a week for the entire phase. The data was analysed regarding changes in both trend and level. Result: All participants had a significant positive change in level of pain and one participant had a positive change in trend. QoL varied among the participants, two had no change in level, one had a significantly positive change and one had a significantly negative change. Only one participant had a positive change of trend in QoL. ROM increased significantly in level in three out of four participants and the trend changed positively among two of the participants Conclusion: This study indicates that OMT Nordic system as a complement to physical exercise and patient education have a positive effect on pain and ROM in patients with knee OA in the short term. However, since not both level and trend were all over significant the result lacks in significance. Due to the study’s design the results should not be generalized on a group level. To be able to draw general conclusions further studies needs to investigate the effect of the OMT Nordic System with more participants and in different settings.