OBJECTIVE: To compare the effect of mechanical traction from different knee angles on pain, physical function, and range of motion in patients with knee osteoarthritis. DESIGN: A single-blinded, randomized controlled trial. SETTING: Outpatient public and governmental Hospital clinics. PARTICIPANTS: One hundred and twenty patients with knee osteoarthritis were randomly assigned into 4 equal groups with 30 patients in each group. INTERVENTIONS: Group (A) received conventional physiotherapy (CPT) treatment; group (B) received CPT with knee traction from full extension, group (C) received CPT with knee traction from 90 degree flexion, while group (D) received CPT with knee traction from 20 degree flexion. Interventions were applied 3 sessions a week for 4 weeks. OUTCOME MEASUREMENTS: Visual analog scale (VAS), knee passive range of motion and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were measured at baseline, immediately after 4 weeks of intervention, and after 4 weeks of no intervention as a follow-up. RESULTS: After eight weeks, the mean (SD) for VAS scores were 30.97 +/- 8.68, 24.0 +/- 8.8, 15.43 +/- 6.31, and 16.17 +/- 6.11 mm; for total WOMAC scores were 26.77 +/- 9.19, 20.3 +/- 8.52, 13.27 +/- 6.25, and 13.43 +/- 7.14 for groups A, B, C and D, respectively. The three traction groups showed statistically significant changes in pain scores, physical function, and total WOMAC, but not for knee passive range of motion, in favor of traction groups C and D than the conventional group (p < 0.05). CONCLUSIONS: Traction from 90 degree and 20 degree of knee flexion was found superior to full extension knee in improving pain and physical function, but not for knee passive range of motion, in patients with knee osteoarthritis.

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