Comparing the Effect of Proprioception Exercises with and Without Maitland Mobilization in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial

Abstract

Background: Knee osteoarthritis (OA) is a leading cause of disability worldwide, characterized by progressive pain, stiffness, and loss of function. Physiotherapy interventions such as proprioceptive training and Maitland mobilization have been independently shown to reduce symptoms and improve mobility, yet evidence on their combined effectiveness remains limited. Objective: To evaluate whether adding Maitland mobilization to proprioceptive exercises results in superior clinical and functional outcomes compared to proprioceptive training alone in individuals with knee OA. Methods: This single-blinded randomized controlled trial recruited 40 participants aged 40–60 years with Kellgren–Lawrence grade I–III knee OA. Participants were randomly assigned to either Group A (Maitland mobilization + proprioception, n=20) or Group B (proprioception only, n=20). Interventions were delivered three times weekly for four weeks. Outcomes included pain (VAS), range of motion (goniometer), functional mobility (Timed Up and Go test), and knee-specific quality of life (KOOS). Statistical analysis employed paired and independent t-tests with effect sizes and 95% confidence intervals. Results: Both groups improved significantly; however, Group A demonstrated greater reductions in pain (–0.75 vs –0.40, p=0.028) and superior gains in knee flexion, extension, and functional mobility (all p<0.05). KOOS subscales, particularly quality of life (+3.40 vs +1.35, p=0.023) and sports/recreation (+2.90 vs +1.00, p=0.006), showed significantly larger improvements in Group A. Conclusion: The integration of Maitland mobilization with proprioceptive training produced greater clinical and functional benefits than proprioceptive exercises alone, supporting a multimodal rehabilitation strategy for knee OA.