الفهرس 
Title : Mechanical traction from different knee joint positions in patients with knee osteoarthritis
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Abstract
Knee osteoarthritis(OA) is a chronic articular disease affecting a significant proportion of adult population and a major cause of pain and disability. Conventional physiotherapy (CPT) treatment accompanied by mechanical knee traction was used to treat kneeOA in previous studies. However, experience in traction treatment for knee OA is lim¬ited, and the most effective position of traction applica¬tion for knee OA is unclear.Purpose:To compare the effect of mechanical traction from different knee angles to find the appropriate effecton pain, physical function, and range of motion in patients with knee OA. Methods: One hundred and twenty patients with grade 2 or3knee OA according to Kellgren–Lawrence scale were randomly selected from physical therapy outpatient clinic of Assiut General Hospital, and randomly assigned into 4 equal groups. group (A) received CPT treatment in a form of ultrasound therapy,TENS, and exercises; group (B) received CPT treatment with traction of knee joint from full extension; group (C) received CPT treatment with traction of knee joint from90°, while group (D) received CPT treatment with traction of knee joint from 20° flexion. Interventions were applied 3 sessions a week for 4 weeks. Visual analog scale (VAS), the Arabic version of the Western Ontario and Mcmaster Universities Osteoarthritis Index (WOMAC), and knee passive range of motion (PROM)were measured at baseline,after 4 weeks of intervention, and after 4 weeks of no intervention as a follow-up. Results: Statistically significant differences were found in all outcomes after 4 weeks of intervention, as well as after 4 weeks of follow-up in each group (P<.05). In comparison between the four groups,there was no statistically significant differences among the four groups in the VAS pain (p > 0.05)after 4 weeks of intervention, however, there was a significant decrease in VAS of the three traction groupsin favor of traction groups C and D, than the conventional group at follow-up(P<.05). Also, the three traction groups showed more significant change inWOMAC pain, physical function, and total WOMAC (P<0.05), in favor of traction groups C and D, than the conventional groupafter 4 weeks of intervention, as well as after 4 weeks of follow-up. Passive range of motion values significantly increased in the three traction groups (P<0.05), but not in the controlafter 4 weeks of intervention, as well as after 4 weeks of follow-up;However, there were no significant differences were found among the three traction groups regarding the PROM (P>0.05). Conclusions: Traction from 90° and 20° of knee flexion was found superior to full extension knee in improving pain and physical function, but not for knee PROM, in patients with knee OA. The improvement in pain and physical functionfrom 90°and 20° of knee flexion traction continue to follow-up, after 4 weeks of no intervention.