Comparative Effects of PNF Hold–Relax & Mobilization With Movement on Functional Restoration & Pain Modulation among Knee Osteoarthritis Patients

Abstract

Background: Knee osteoarthritis is a prevalent degenerative joint disorder causing persistent pain, stiffness, and progressive functional limitation, and manual therapy approaches such as Mobilization with Movement (MWM) and Proprioceptive Neuromuscular Facilitation Hold–Relax (PNF-HR) are commonly used despite limited comparative evidence. Objective: To compare the short-term effects of MWM and PNF-HR on pain, stiffness, functional difficulty, and overall WOMAC outcomes among individuals with knee osteoarthritis. Methods: A quasi-experimental two-group pretest–posttest study was conducted at the CASHT Clinic, Rawalpindi, Pakistan (January–August 2025). Thirty eligible participants (aged 40–60 years) with clinically diagnosed knee osteoarthritis and ≥3 months of knee pain were recruited by non probability purposive sampling and allocated (sequential assignment) to MWM (n=15) &  PNF-HR (n=15). Both groups received intervention on alternate days for two weeks (three sets of ten repetitions per session) alongside standardized conventional therapy. Outcomes were assessed pre- and post-intervention using the WOMAC index; analyses used paired and independent t-tests with p<0.05. Results: Both groups showed significant within-group improvements across WOMAC domains (all p<0.001). Total WOMAC decreased from 75.93±16.97 to 34.20±8.59 in the MWM group and from 79.27±10.40 to 38.53±8.12 in the PNF-HR group (both p<0.001), with no significant between-group difference in total WOMAC at 2 weeks (p=0.167). Post-intervention pain scores favored MWM (5.40±1.92 vs 7.13±1.41; p=0.009). Conclusion: Both MWM and PNF-HR yield substantial short-term improvements in pain and function in knee osteoarthritis, with MWM demonstrating a modest but statistically significant advantage for pain reduction