Background: Knee osteoarthritis (OA) is one of the most common degenerative musculoskeletal disorders, leading to chronic pain, reduced joint mobility, muscle weakness, and functional limitations that adversely affect quality of life. Physiotherapy plays a vital role in the conservative management of knee OA. Among manual therapy techniques, Mulligan's Mobilization With Movement (MWM) has gained recognition for its ability to reduce pain while restoring normal joint biomechanics through pain-free active movement. Although previous studies have demonstrated promising outcomes, further clinical evidence is required to establish its effectiveness in improving pain, muscle strength, and range of motion in individuals with knee osteoarthritis.

Aim: To evaluate the effects of Mulligan's Mobilization With Movement (MWM) on pain, muscle strength, and knee joint range of motion in subjects with knee osteoarthritis.

Objectives:

1. To determine the effect of Mulligan's MWM on pain intensity.


2. To evaluate changes in knee joint range of motion following intervention.


3. To assess improvements in quadriceps muscle strength after treatment.

Methodology: A single-group experimental pre-test and post-test study design was employed. Twenty participants diagnosed with Grade I–III knee osteoarthritis completed the study. Baseline assessment included pain intensity using the Visual Analogue Scale (VAS), muscle strength using Manual Muscle Testing (MMT), and knee joint range of motion using a universal goniometer. Participants received Mulligan's Mobilization With Movement applied to the tibiofemoral joint along with conventional physiotherapy comprising hot pack application, quadriceps strengthening exercises, and joint protection education. Treatment sessions were conducted three times per week for six weeks, with each session lasting approximately 20 minutes. Pre- and post-intervention data were analyzed using the paired t-test, with the level of statistical significance set at p < 0.05.

Results: The intervention produced statistically highly significant improvements in all measured outcomes. Muscle strength improved from 2.55 ± 0.51 to 4.75 ± 0.44 (t = 18.93, p < 0.0001). Pain intensity significantly decreased from 8.40 ± 1.27 to 3.30 ± 0.80 (t = 18.77, p < 0.0001). Knee flexion range of motion increased from 19.20 ± 7.09° to 123.40 ± 39.72° (t = 11.48, p < 0.0001), while extension improved from 15.15 ± 9.27° to 94.45 ± 28.50° (t = 13.62, p < 0.0001). These findings indicate substantial reductions in pain accompanied by marked improvements in muscle strength and joint mobility following the intervention.

Conclusion: Mulligan's Mobilization With Movement, when combined with conventional physiotherapy, is an effective conservative intervention for individuals with knee osteoarthritis. The treatment significantly reduced pain, enhanced quadriceps muscle strength, and improved knee joint range of motion over a six-week period. The findings support the incorporation of Mulligan's MWM into routine physiotherapy rehabilitation programs to improve functional outcomes and overall quality of life in patients with knee osteoarthritis. Further randomized controlled trials with larger sample sizes and long-term follow-up are recommended to confirm these findings and strengthen the evidence base.