The immediate effects of knee flexion range of motion following manual therapy or self-stretching/active range of motion following a total knee arthroplasty: a case report.
Thomas A Koc, Michael Durante, Inah A Bunales and 2 others
PMID 32038072WHAT IT FOUND
In one man three days after right total knee replacement, knee flexion increased after each technique.
Typical joint mobilization showed 10-degree gains. This cannot show which treatment works.
Key findings
01Active and passive knee flexion range increased after each listed technique, with gains reported in degrees.
02Typical arthrokinematic joint mobilization had the greatest immediate gain, 10 degrees for both active and passive knee flexion.
03The authors state that these findings do not demonstrate treatment efficacy because of the case study design.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only one participant was studied, so the paper cannot show what would happen in other people after total knee replacement. No statistical tests were performed because the sample size was one. The same physical therapist delivered the interventions and measured range of motion, and knew the study purpose, so rater bias was not controlled. The participant received pain medication about 30 minutes before each session, so the paper cannot separate any range of motion gain from the medication. The study measured only knee flexion range of motion before and after each intervention, not other outcomes. The therapist’s skill in applying the techniques may affect the results.
Declared interests
There was no funding provided, and the authors declared no conflict of interest.
The easy way to misread this
Do not read the 10-degree gain after typical joint mobilization as proof that this technique is better than self-stretching or other manual therapy. Only one participant was studied, pain medication was given before each session, and the therapist who treated him also measured him.