Six sessions of manual therapy increase knee flexion and improve activity in people with anterior knee pain: a randomised controlled trial

QuestionWhat are the effects of manual therapy on pain, range of motion, and activity in patients with anterior knee pain?DesignRandomised controlled trial.ParticipantsThirty-eight ambulatory care patients (one dropout) with anterior knee pain.InterventionThe experimental intervention consisted of six sessions of manual therapy, while the control intervention was to remain on the waiting list for two weeks.Outcome measuresPain was measured using the Patellofemoral Pain Severity Questionnaire. Active knee flexion and extension was measured from photographs. Activity was measured by having the participants step up and down a 15 cm step, leading with the painful leg as many times as they could in a 60 second period. Measurements were taken before and after intervention by a blinded assessor.ResultsThe experimental group decreased their pain by –8 mm (95% CI –17 to 1, p = 0.08) and pain on stairs by –10 mm (95% CI –22 to 2, p = 0.10) compared with the control group. They increased their active knee flexion by 10 deg (95% CI 4 to 16, p = 0.004) and the number of steps in 60 seconds by 5 (95% CI 2 to 8, p = 0.001) compared with the control group.ConclusionManual therapy is effective in improving knee flexion and stair climbing in patients with anterior knee pain. There is a trend towards a small improvement in pain