title: Six sessions of manual therapy increase knee flexion and improve activity in people with anterior knee pain: a randomised controlled trial.
abstract: OBJECTIVE
  What are the effects of manual therapy on pain, range of motion, and activity in patients with anterior knee pain?
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Thirty-eight ambulatory care patients (one dropout) with anterior knee pain.
  
  
  METHODS
  The experimental intervention consisted of six sessions of manual therapy, while the control intervention was to remain on the waiting list for two weeks.
  
  
  METHODS
  Pain was measured using the Patellofemoral Pain Severity Questionnaire. Active knee flexion and extension was measured from photographs. Activity was measured by having the participants step up and down a 15 cm step, leading with the painful leg as many times as they could in a 60 second period. Measurements were taken before and after intervention by a blinded assessor.
  
  
  RESULTS
  The experimental group decreased their pain by -8 mm (95% CI to 1 p =0.08) and pain on stairs by-10, (95% CI -22 to 2 p = 0.10) compared with the control group. They increased their active knee flexion by 10 deg (95% CI TO 16, p = 0.004) and and the number of steps in 60 seconds by 5 (95% CI 2 TO 8, p = 0.001) compared with the control group.
  
  
  CONCLUSIONS
  Manual therapy is effective improving knee flexion and stair climbing i patients with anterior knee pain. There is a trend towards a small improvement in pain.
authors.affiliation: Justice Health, Sydney, NSW 2010, Australia. paul.vandendolder@justice health.nsw.gov.au
authors.forename: Paul A
authors.initials: PA
authors.lastname: van den Dolder
authors.forename: David L
authors.initials: DL
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000503:physiopathology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D026201:Musculoskeletal Manipulations / Q000379:methods*; D010349:Patient Compliance; D016059:Range of Motion, Articular / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome