Belinda J Sanchez1, Russell T Baker2. 1. WWAMI Medical Education Program, University of Idaho, Moscow, Idaho. 2. Department of Movement Sciences, University of Idaho, Moscow, Idaho.
Abstract
OBJECTIVE: The purpose of this case study was to report on the immediate effects of the combined use of mobilizations with movement and the "squeeze" technique on a patient with knee stiffness, popping, and swelling. CLINICAL FEATURES: The patient presented with right knee stiffness, swelling, and a popping sensation of insidious onset. Clinical examination revealed pain with terminal knee extension and flexion, joint line tenderness, a positive Apley's compression test, and a positive Thessaly's test at 20° of knee flexion. A working diagnosis was established of a meniscal pathology with the differential diagnoses of meniscal derangement and synovial plica. INTERVENTION AND OUTCOME: The patient received 3 total treatments using the Mulligan concept over the course of 11 days. The treatments included the application of a tibia internal rotation mobilization with movement and the "squeeze" technique to the affected knee. Patient outcomes, including the Disablement in the Physically Active Scale, the Patient-Specific Functional Scale, and the Numeric Rating Scale for pain, were collected throughout the course of treatment. The patient reported a minimal clinically important difference on the Numeric Rating Scale for pain after each treatment and on all outcomes after the third treatment. The patient reported improvement on her follow-up visit 4 days after the third treatment; the results of a clinical exam and patient outcomes supported a complete discharge after 3 treatments. CONCLUSION: This patient responded favorably to use of the Mulligan concept as a manual therapy technique for the treatment of symptoms related to possible meniscal derangement.
OBJECTIVE: The purpose of this case study was to report on the immediate effects of the combined use of mobilizations with movement and the "squeeze" technique on a patient with knee stiffness, popping, and swelling. CLINICAL FEATURES: The patient presented with right knee stiffness, swelling, and a popping sensation of insidious onset. Clinical examination revealed pain with terminal knee extension and flexion, joint line tenderness, a positive Apley's compression test, and a positive Thessaly's test at 20° of knee flexion. A working diagnosis was established of a meniscal pathology with the differential diagnoses of meniscal derangement and synovial plica. INTERVENTION AND OUTCOME: The patient received 3 total treatments using the Mulligan concept over the course of 11 days. The treatments included the application of a tibia internal rotation mobilization with movement and the "squeeze" technique to the affected knee. Patient outcomes, including the Disablement in the Physically Active Scale, the Patient-Specific Functional Scale, and the Numeric Rating Scale for pain, were collected throughout the course of treatment. The patient reported a minimal clinically important difference on the Numeric Rating Scale for pain after each treatment and on all outcomes after the third treatment. The patient reported improvement on her follow-up visit 4 days after the third treatment; the results of a clinical exam and patient outcomes supported a complete discharge after 3 treatments. CONCLUSION: This patient responded favorably to use of the Mulligan concept as a manual therapy technique for the treatment of symptoms related to possible meniscal derangement.
Authors: Robinetta Hudson; Amy Richmond; Belinda Sanchez; Valerie Stevenson; Russell T Baker; James May; Alan Nasypany; Don Reordan Journal: Int J Sports Phys Ther Date: 2016-08
Authors: Paavo-Ilari Kuikka; Petri Sillanpää; Ville M Mattila; Maria H Niva; Harri K Pihlajamäki Journal: Am J Sports Med Date: 2009-02-13 Impact factor: 6.202