The initial effects of a Mulligan's mobilization with movement technique on range of movement and pressure pain threshold in pain-limited shoulders

Abstract

There is little known about the specific manual therapy techniques used to treat painfully limited shoulders and their effects on range of movement (ROM) and pressure pain threshold (PPT). The objective of this study was to investigate the initial effects of a Mulligan's mobilization with movement (MWM) technique on shoulder ROM in the plane of the scapula and PPT in participants with anterior shoulder pain. A repeated measures, double-blind randomized-controlled trial with a crossover design was conducted with 24 subjects (11 males and 13 females). ROM and PPT were measured before and after the application of MWM, sham and control conditions. Significant and clinically meaningful improvements in both ROM (15.3%, F (2,46)=16.31 P=0.00) and PPT (20.2%, F(2,46)=3.44, P=0.04) occurred immediately after post treatment. The results indicate that this specific manual therapy treatment has an immediate positive effect on both ROM and pain in subjects with painful limitation of shoulder movement. Further study is needed to evaluate the duration of such effects and the mechanism by which this occurs.

Effects of Gong's Mobilization Applied to Shoulder Joint on Shoulder Abduction

“…Teys et al (2008) measured the shoulder ROM after applying Mulligan's mobilization with movement (MWM) technique once to patients with painful shoulder conditions and found that it increased by 15.3% 7) . Souza et al (2008) reported that they applied Maitland joint mobilization grades III and IV on 25 persons and their ankle dorsiflexion ROM increased immediately after joint mobilization 8) , which showed the immediate positive effect of manual therapy.…”

The initial effects of a sustained glenohumeral postero-lateral glide during elevation on shoulder muscle activity: A repeated measures study on asymptomatic shoulders

“…Currently, the effect of physiotherapy on clinical outcomes in patients with shoulder disorders are unclear, with systematic reviews reporting divergent findings (Dorrestijn et al , 2009, Ho et al , 2009, Michener et al , 2004, van den Dolder et al , 2012. It is challenging to determine effects of physical modalities (e.g., exercise, manual therapy, electrotherapy) on clinical outcomes in multimodal randomized controlled trials (RCTs).…”

“…Mobilization With Movement (MWM) has been shown to reduce pain levels, increase range of motion (Abbott, 2001, Mulligan, 2006, Vicenzino, Hing, 2011, and function in patients with shoulder pain (Mulligan, 2006, Teys et al , 2008, Vicenzino, Hing, 2011. Correction of bony positional fault, neurophysiological effects or a combination of both have been proposed as the underlying mechanisms of MWM (Vicenzino et al , 2007).…”

Mobilization With Movement for Shoulder Dysfunction in Older Adults: A Pilot Trial

“…Although an improvement in shoulder functionality was found, the results are not similar to other studies about Mulligan technique which state that shoulder functionality is correlated to glenohumeral AROM. 31 Teys et al 16 showed the effectiveness of the Mulligan technique on pain in adults younger than 60 years. Although the study had a small sample size (n = 24), statistically significant results were found concerning immediate effects after 1 MWM treatment session.…”

“…The patient must repeat the movement several times to get an improvement that lasts over time. 14,15 The initial effects of MWM in adults were assessed by Teys et al 16 who proved its effectiveness in increasing shoulder AROM and decreasing positional faults. Therefore, it may be an effective technique in the physical therapy treatment for shoulder dysfunction, as this addresses passive and active shoulder structures.…”