Any pain in upper limb, lower limb or spine

have altered the results of the study and were well matched.

The average age in the present study was 34.82, ranging from 18-50 years. When compared between the three groups showed equal distribution and has no statistically significant difference in age between the group. A study conducted by Peter J. Millett(2004) has taken the age group of 18-57 years with average of total participants was 35.6, which coincides with the present data.11 .

Macrae and wright in 1969 showed a substantial difference in stiffness between male and female knee joint. Males are much stiffer than females even when age, size of thigh, and size of knee is taken into account. It is interesting to note that while this work shows that females are less stiff than males. The finding of this study correlates with the above reference since maximum number of patients was males, showing more stiffness than females.12 Hutchinson M studied on gender difference in active knee joint stiffness concluded that females have reduced active stiffness compared to age matched males. The present study correlates with the above study in gender differences and has no effects on altering the results between the groups.13

When the intra group mean values of active knee range of motion of flexion was analysed, it showed statistically significant improvement in knee flexion range of motion in both the groups pre to post intervention, with the p values of 0.000 in both the groups, but when comparison was done inter-group, group C showed more improvement in knee range of motion as compared to group A and B. In the present study increase in range of motion, with the application of continuous passive motion in one group and joint mobilization in another group is consistent with the findings of previous studies. This is the first study till date has compared the combined effect of continuous passive motion and joint mobilization. Present results showed that continuous passive motion with joint mobilization is better than giving individually.

In the present study the application of moist heat for 15 mins in all three groups prior to CPM and joint mobilization showed increase in range of motion. Knight et al. Investigated the effect of 15 min hot pack application paired with static stretching on plantar flexor extensibility over four weeks and noted increases in range of motion. These findings suggest that hot pack application may be a beneficial modality when increased range of motion is desired.14

The results of the present study group receiving CPM, has shown that alone CPM is not a beneficial method to mobilize post-operative knee stiffness. As suggested by Bearpre et. al., (2001), a prospective, investigator-blinded RCT compared three rehabilitation regimens in patients who had undergone primary TKA for osteoarthritis. The results suggest that adjunct CPM and adjunct SB may not provide additional therapeutic benefit in an active mobilization regimen following TKA for osteoarthritis. Hence the present study consistent with the above study as the result concluded the same. The study done by Beaupre et. al., hypothesized that continuous passive motion may not provide therapeutic effect in active mobilization of post-operative knee stiffness.15

In the present study, group receiving CPM only, showed an average increase in ROM for post operative knee stiffness of 49.733, which was less compared to the other 2 groups ie., group B-59.80 and group C-68.93. The present study correlates with the study done by Engstrom et al. (1995) reported on a prospective randomized study of 34 patients with unilateral anterior cruciate ligament ruptures. Engstrom et al concluded that after six weeks follow–up, there was no difference in ROM between the two groups, and joint swelling was more pronounced in the early active motion group. The data suggests that CPM did not improve ROM.16

Randall et al, showed that in patients with supracondylar fracture, mobilization and exercise led to a greater increase in joint movement than exercise alone. The present study is in consistent with the above study as the results concluded the same. Hence the effect of joint mobilization has an effect in increasing range of motion17 .

Michael A. Hunt, Stephen R. found the effect of anterior tibiofemoral glides on knee extension during gait in patients with decreased range of motion after anterior cruciate ligament reconstruction. The authors concluded that a single session of anterior tibiofemoral glides increases maximal knee extension during the stance phase of gait in patients with knee extension deficits. In the present study 21 sessions of mobilization increased maximal knee extension range of motion and could not comment on the immediate effect of joint mobilization18 .

In the present study closed kinetic chain exercises were performed by the participants for 10 repetitions per session with each contraction held for 10 seconds, which is consistent with the findings of Cristina Maria and Nunes Cabral.19

Study done by Mei Hwa Jan MS et al to investigate the effect of weight bearing exercises on function, pain and knee strength in patients with knee stiffness. The results showed that weight bearing exercises were effective in decreasing pain and disability and increasing knee strength.20