Eficacia de la movilización de Mulligan frente a los ejercicios propioceptivos en la osteoartritis de rodilla: un ensayo clínico aleatorizado
DOI:
https://doi.org/10.47197/retos.v75.118251Palabras clave:
Osteoartritis de rodilla, movilización de Mulligan, ejercicios propioceptivos, fisioterapia, NPRS, KOOS, ensayo clínico aleatorizadoResumen
Antecedentes. La osteoartritis de rodilla (OAR) es un trastorno ortopédico común que provoca dolor crónico, limita la movilidad y reduce la calidad de vida en general. Aunque la eficacia de la terapia con ejercicio está respaldada por evidencia empírica, la efectividad relativa de la Movilización con Movimiento de Mulligan (MMT), en comparación con el entrenamiento propioceptivo, aún no ha sido claramente establecida.
Objetivo. El objetivo del presente estudio fue comparar los efectos de la MMT, los ejercicios propioceptivos (PEG) y la fisioterapia estándar en personas con OAR, en relación con el dolor y el estado funcional.
Métodos. Se llevó a cabo un ensayo clínico aleatorizado con 60 participantes (edad ≥ 40 años) durante un período de 10 semanas. Los participantes fueron asignados a los grupos de MMT, PEG o fisioterapia convencional (grupo control). La intensidad del dolor (NPRS) y la función de la rodilla (puntuación total KOOS) se evaluaron al inicio del estudio y en la 4.ª, 8.ª y 10.ª semana. Se utilizó un ANOVA de medidas repetidas con comparaciones por pares ajustadas mediante Bonferroni.
Resultados. Se observaron mejoras estadísticamente significativas en todos los grupos de intervención (p < 0.001). La mayor reducción del dolor y la máxima mejora funcional se encontraron en el grupo MMT. El grupo PEG mostró un grado intermedio de mejoría, mientras que la fisioterapia convencional presentó el menor tamaño del efecto. Los tamaños del efecto fueron más altos en el grupo MMT (NPRS η² = 0.624; KOOS η² = 0.387).
Conclusión. En pacientes con osteoartritis de rodilla, la Movilización con Movimiento de Mulligan demostró ser superior a los ejercicios propioceptivos y a la fisioterapia tradicional para reducir el dolor y mejorar la función de la rodilla. Estos resultados respaldan el uso de la MMT como una modalidad conservadora de primera elección, ofreciendo a los clínicos una alternativa potente y eficaz para lograr mejores resultados en los pacientes.
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