Comparision between the Effectiveness of Mobilization with Movement and End Range Mobilization along with Conventional Therapy for Management of Frozen Shoulder

Srivastava, Namrata; Joshi, Sneha

doi:10.5958/0973-5674.2017.00141.1

Cited by 1 publication

(1 citation statement)

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“…Two of the RCT's were a crossover design (26,40) and two were pilot studies (10,28). Only six studies were registered with a clinical trial registry (10,12,24,26,36,38). In the evaluated studies there were a total 1014 participants.…”

Section: Qualitative Synthesismentioning

confidence: 99%

Efficacy of mobilization with movement (MWM) for shoulder conditions: a systematic review and meta-analysis

Satpute

Reid

Mitchell³

et al. 2021

Journal of Manual & Manipulative Therapy

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Objective: To assess the effects of mobilisation with movement (MWM) on pain, range of motion (ROM) and disability in the management of shoulder musculoskeletal disorders.Methods: Six databases PubMed (MEDLINE), CINAHL, SPORTDiscus, PEDro, Cochrane library, and Scopus were searched for randomized control trials (RCTs). The ROB 2 tool was used to determine risk-of-bias and the quality of the evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Meta-analyses were performed for the sub-category of frozen shoulder and shoulder pain with movement dysfunction to evaluate the effect of MWM in isolation or in addition to exercise therapy and /or electrotherapy when compared with either no treatment, exercise therapy, electrotherapy alone or other types of manual therapy Results: Out of twenty-five studies, twenty-one were included in 8 separate meta-analyses for pain, ROM, and disability in the 2 sub-categories of shoulder disorders. For frozen shoulder, the addition of MWM significantly improved pain (SMD -1.23, 95% CI -1.96, -0.51), I 2 =89%), flexion ROM (MD -11.73, 95% CI -17.83, -5.64, I 2 =82%), abduction ROM (mean difference -13.14, 95% CI -19.42, -6.87, I 2 =85%) and disability (SMD -1.50, 95% CI (-2.30, -0.7, I 2 =89%). For shoulder pain with movement dysfunction the addition of MWM significantly improved pain (SMD -1.07, 95% CI -1.87, -0.26, I 2 =86%), flexion ROM (mean difference -18.48, 95% CI-32.43, -4.54, I 2 =90%), abduction 4.84, I 2 =97%) and disability (SMD -0.88, 95% CI -2.18, 0.43, I 2 =92%). The majority of studies were found to have a high risk of bias. Where appropriate, the clinical significance of the pooled differences was compared against Minimal Clinically Important Difference values.Discussion: MWM in addition to other forms of physiotherapy is associated with improved pain, mobility and function in patients with a range of shoulder musculoskeletal disorders including frozen shoulder. The effects were clinically meaningful for flexion and abduction ROM. However these findings need to be interpreted with caution due to the high levels of heterogeneity among included studies and inclusion of studies with a high risk of bias. The reasons for high levels of heterogeneity and risk of bias are explored.

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