The assessor lifts the right

lower leg so that the right hip and knee are flexed to 90 degrees. From this position, the amount of hip flexion is maintained at 90 degrees while the right knee is passively and carefully extended selleck kinase inhibitor with one hand on the distal posterior surface of the leg. The amount of resistance is monitored manually and the knee is extended until firm resistance to further motion is felt. During this procedure, a standard 360 degree plastic goniometer with two arms 45 cm long and 4.5 cm wide was used to determine the popliteal angle, using the greater trochanter, lateral femoral epicondyle, and lateral malleolus as anatomical reference points. Each knee’s extension lack angle was then calculated as 180 degrees minus the popliteal angle. The passive knee extension test has excellent interrater reliability and good test-retest reliability (Gnat et al 2010). Baseline characteristics were analysed using descriptive statistics and are presented as means with standard deviations. Change in the extension lack GSK-3 activity angle on the passive knee extension test was compared between groups with an independent t-test and is presented as a mean between-group difference in change with a 95% CI. This analysis assumes that the data from both knees of the same participant

are not substantially correlated, which is consistent with existing literature (Baltaci et al 2003). However, to confirm this, we also present the same analysis of the data from the right knees independently of the data from the left knees to illustrate that these data provide very similar estimates of the magnitude of the effect. Significance level was set a priori at p < 0.05. In the absence of an established minimum clinically worthwhile difference in the extension lack angle on the passive knee extension test, we nominated 10 degrees. We used the largest estimate of the standard deviation of the change in this variable from

O’Sullivan and colleagues (2009) to account for the duration of our intervention period. A total of 24 participants would provide 80% probability of detecting a difference of 10 degrees in extension lack angle at a two-sided significance level. To allow for some loss to follow-up, we others increased the total sample size to 30. Thirty individuals (sixty knees) participated and underwent familiarisation and baseline testing. Randomisation assigned 15 subjects to the experimental group and 15 subjects to the control group (30 knees in each group). Baseline characteristics of the two groups are presented in Table 1 and the first two columns of Table 2. All participants completed the interventions as randomly allocated and all completed post intervention measurement at 8 weeks (Figure 1). Vibration sessions were performed by an expert physiotherapist who had more than 10 years of experience in the field of musculoskeletal physiotherapy.