Effectiveness of Mobilisation with Movement (MWM) along with Usual Care for Knee Osteoarthritis: A Randomised Clinical Trial
Bibliographic record
Abstract
Abstract Introduction Knee osteoarthritis (OA) is a degenerative joint disorder involving progressive cartilage loss, subchondral bone changes, and periarticular tissue involvement. It is a major cause of pain, stiffness, and reduced mobility, particularly in weight-bearing joints. Mobilisation with Movement (MWM), a Mulligan Concept manual therapy, aims to correct minor joint positional faults during active movement, potentially reducing pain and restoring function. This study examined the effectiveness of MWM with usual physiotherapy care compared with usual care alone in individuals with knee OA. Methods and analysis A single-blind randomised controlled trial was conducted from June to August 2025 at the Musculoskeletal Physiotherapy Unit, Centre for the Rehabilitation of the Paralysed (CRP), Bangladesh. Fifty adults aged 40–65 years with radiographically confirmed knee OA (Kellgren–Lawrence grade ≥2) were allocated to MWM plus usual care (n=25) or usual care alone (n=25). Both groups received 30-minute sessions, three times weekly for six weeks. Outcomes included pain (Numeric Pain Rating Scale, NPRS), active and passive knee range of motion (ROM), and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, WOMAC). The primary outcome was pain intensity (NPRS). Secondary outcomes included knee ROM and WOMAC scores. Results Both groups improved significantly (p<0.001), but the MWM group achieved greater pain reduction (median NPRS change –4.0 vs –2.0; p<0.001), larger ROM gains, and greater WOMAC score improvements (mean change –19.2 vs –10.8; p<0.001). Conclusions MWM combined with usual care produced superior improvements in pain, ROM, and function versus usual care alone, supporting its integration into physiotherapy protocols for knee OA. Clinical Trial Registry India CTRI/2025/05/086343 [Registered on: 05/05/2025]
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.012 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".