A Comparison of the Movement System Impairment Approach vs Standard Physiotherapy Protocols for Managing Knee Pain
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Abstract
Background: Knee pain is a common musculoskeletal complaint that limits walking, stair negotiation, squatting, functional mobility, and participation in occupational or recreational activities. Standard physiotherapy commonly includes hip-knee strengthening, stretching, functional advice, and activity modification, whereas the Movement System Impairment approach uses movement classification and individualized correction of faulty alignment and motor-control patterns. Objective: To compare the effectiveness of Movement System Impairment-based treatment with standard physiotherapy protocols for improving pain, strength, and functional outcomes in adults with unilateral non-traumatic knee pain. Methods: A randomized clinical comparison was conducted over six weeks. Participants received either Movement System Impairment-based assessment and treatment, including alignment correction, task-specific retraining, strengthening, stretching, and activity modification, or standard physiotherapy consisting of general hip-knee strengthening, stretching, progressive resistance exercise, and functional advice. Outcomes included pain intensity, Knee Injury and Osteoarthritis Outcome Score, Tegner Activity Scale, muscle power, flexibility, and pain during functional activities. Results: Both groups demonstrated improvement in pain, symptoms, activities of daily living, sport/recreation function, and selected muscle performance outcomes. Between-group findings favored the Movement System Impairment group for walking-related knee pain, hip lateral rotator strength, and knee extensor strength. Conclusion: Both interventions were effective for short-term knee pain rehabilitation, but Movement System Impairment-based treatment provided additional benefit for outcomes related to lower-limb alignment, hip-knee control, and functional loading.
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