Manual Therapy Versus Exercise on Knee Osteoarthritis

• Pain Visual Analog Scale [ Time Frame: Outcome measure will be measured 3 minutes prior to intervention and 3 minutes after intervention. ] [ Designated as safety issue: No ]
• Goniometric knee arc range of motion [ Time Frame: Outcome measure will be measured 5 minutes prior to intervention and 5 minutes after intervention. ] [ Designated as safety issue: No ]
• Western Ontario and McMaster Universities Index of osteoarthritis of the knee [ Time Frame: Outcome measure will be measured 12 minutes prior to intervention and 7 minutes after intervention. ] [ Designated as safety issue: No ]

• Procedure: Manual Therapy
  Grade 1 and 2 oscillatory manual mobilization of the tibiofemoral joint at various ranges of motion.
• Behavioral: Therapeutic Exercise
  Subjects will perform 5 minutes of lower extremity cycle ergometer with minimal resistance followed by 10 minutes of resistance exercise to the quadriceps at 3 tibiofemoral positions (0 degrees, 30 degrees and 60 degrees of knee flexion).
• Behavioral: Video Observation
  Subjects will watch a 15 minute video on a health topic unrelated to knee osteoarthritis.

• Experimental: Manual Therapy
  Subjects will receive oscillatory (grade 1 & 2) manual knee mobilization for 15 minutes at various knee range of motion positions.
  Intervention: Procedure: Manual Therapy
• Experimental: Therapeutic Exercise
  Subjects will perform 15 minutes of combined resistance exercise and aerobic exercise.
  Intervention: Behavioral: Therapeutic Exercise
• Placebo Comparator: Control
  Subjects will watch a 15 minute instructional video on a health topic.
  Intervention: Behavioral: Video Observation

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Inclusion Criteria:

• Diagnosis of knee osteoarthritis.

Exclusion Criteria:

• Inability to ambulate at least 100 feet, ride a stationary bicycle for at least 10 minutes, or lie in the prone position for at least 10 minutes,
• Intra-articular knee injection within one month of study inception,
• A history of exercise induced or uncontrolled angina within three months of the study entry,
• Severe dyspnea at rest,
• Previous bilateral total knee arthroplasty,
• Pregnancy, OR
• The absence of knee pain at the time of recruitment for the study.