Investigating the effects of mechanical traction and high intensity laser therapy on pain, muscle activity, and functional balance in knee osteoarthritis.

Background: Mechanical traction (MT) is a noninvasive approach to unload the joint in knee osteoarthritis (KOA), however,its effects on co-contraction index (CCI) and balance remain unclear.

Purpose: To investigate whether combining MT with high intensity laser therapy (HILT) yields greater improvements in subjective and objective outcomes among patients with KOA compared to HILT alone.

Methods: Thirty-eight patients with KOA were randomly assigned to MT+HILT (n = 19) or HILT (n = 19) groups and received 10 treatment sessions over 2 weeks. Outcomes included pain (VAS), function (WOMAC), active knee flexion range of motion (AROM), CCI, and balance during curve tracking (CT) and sit-to-stand (STS) tasks. A two-way mixed-model ANOVA was used to assess the effects of treatment and time (pre - post).

Results: The MT+HILT showed significantly greater improvements than HILT in VAS (p < .001, η_p² = 0.27), WOMAC (p < .001, η_p² = 0.37), and AROM (p < .001, η_p² = 0.12). During CT, MT+HILT significantly reduced anteroposterior and mediolateral mean absolute errors (p = .00 and 0.03, η_p² = 0.10 and 0.15), and standard deviations of absolute errors (p = .02 and 0.04, η_p² = 0.82 and 0.15). Center of pressure area also decreased significantly in anteroposterior and mediolateral directions (p = .03 and 0.01; η_p² = 0.66 and 0.23).

Conclusion: These findings suggest that the combined application of MT+HILT may serve as an effective conservative strategy to improve pain management, functional capacity, AROM, and balance, potentially contributing to a reduced risk of falls in individuals with KOA.